ADULT

Tufts Magazine Homepage (Fall 2009) Force of Habit (pdf)

The Obsessive Compulsive Disorders Institute

A clinical collaboration between McLean Hospital
and Massachusetts General Hospital.

Michael Jenike, MD Medical Director
Diane Davey, RN, MBA Program Director

The OCD Institute at McLean Hospital is a national and regional center dedicated to the advancement of clinical care, teaching and research of obsessive compulsive disorders. The program provides partial hospital and intensive residential care for individuals age 16 and older who suffer from severe or treatment resistant OCD. It offers an innovative combination of somatic, behavioral and milieu treatments not found in other programs.

OCD occurs in two to five percent of the population, and is the fourth most common psychiatric diagnosis. The majority of OCD patients who have not experienced symptom relief may have not received adequate trials of appropriate medication and/or behavioral therapy. The remainder typically do not respond because of poor treatment compliance, unrecognized cognitive impairment, co-occuring psychiatric illness or poor understanding of treatment. Adequate treatment for OCD often requires that medication trials be longer than those for other psychiatric illnesses. Additionally, while behavioral interventions are time- and laborintensive, frequently requiring close supervision and support.

Milieu and Group Therapy

North Belknap

The milieu is constructed to stress close patient involvement in the treatment process in that the patient is viewed as a colleague in his own treatment, rather than simply a passive recipient. Each patient, based on feedback from staff and other patients, completes a weekly therapeutic contract detailing his or her treatment plan for the upcoming week. At the end of the week, the patient receives feedback once again from staff and other patients on the progress and effort he or she has made. Patients complete regular objective measures of improvement, and attend five to six therapy sessions per day. Group therapy targets increasing motivation and compliance, decreasing behavioral symptoms, increasing normalized family, work and social functioning, and education and support.

Psychopharmacology

Michael Jenike, MD, the program's clinical director, oversees the treatment of all patients, meeting with patients at least weekly and more frequently if required.

Behavior Therapy

Each patient is assigned a behavioral therapist who meets with the patient individually several times weekly. The behavior therapist is responsible for devising a program for each patient that serves as a guideline for staff to ensure consistency. The behavioral program identifies target obsessions, compulsions and avoidance behaviors, provides a menu of exposures for staff to implement and recommends special instructions for each patient. In addition to individual meetings with the behavioral therapist, the patient also engages in twice daily, two-hour exposure and response-prevention exercises.

Social Work

Each patient is assigned to one of the program's independently licensed social workers, who meets with the patient at least weekly to provide case management, develop a treatment plan and lead team meetings. In addition, the social worker also provides family therapy and works with the patient around discharge planning.

Nursing and Counseling Staff

Members of the program's nursing and counseling staff provide day-to-day patient treatment. These individuals are responsible for the overall milieu management. They work with patients both individually and in groups to meet the expectations of the patients treatment contracts and behavioral program. All counselors receive specific training on working with OCD patients
as well as general crisis prevention/intervention, CPR and group leadership skills.

Continuum of Care

The program's clinical staff evaluates all patients for admission to the program. While many will require the most intensive residential level of care due to the severity of their symptoms, others may be able to benefit from the program during the day while at home or in the evening. The goal is to move patients to less-acute levels of care as soon as they are able.

Helpful Links

Insurance Information

McLean accepts Medicare, Massachusetts Medicaid and many private insurance and managed care plans.

Contact

Diane Davey, RN, MBA, Program Director	617-855-3279	davey@ocd.mclean.org
Tricia Jamiol, Admissions Coordinator	617-855-3371	tjamiol@ocd.mclean.org

About McLean Hospital

U.S. News & World Report ranked McLean Hospital first among all freestanding psychiatric hospitals. McLean Hospital is the largest psychiatric facility of Harvard Medical School, an affiliate of the Massachusetts General Hospital and a member of Partners HealthCare.