Obsessive-Compulsive Disorder, Anxiety, and Related Disorders (OCRDs) Psychotherapy Clinic
Our Mission
The OCD, Anxiety, and Related Disorders Psychotherapy Clinic provides comprehensive and high-quality psychological services for children, adolescents, adults, and families with OCD and related disorders at the UF Health Division of Psychology Clinic located at Springhill 2. Our mission is to enhance patient care via culturally competent, evidenced-based assessment and treatment that assists people in optimizing their functioning and reaching their full potential for their health and wellbeing. We take action oriented, cognitive-behavioral approaches to therapy with a focus on teaching individuals and families skills so they can take charge of their own therapy.
Types of Therapy
Individual Therapy
Cognitive Behavioral Therapy (CBT)
Individual
Exposure and Response Prevention (E/RP)
Individual
Acceptance and Commitment Therapy (ACT)
Individual
Habit Reversal Training (HRT)
Individual Therapy
Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST)
Group therapy
Controlling Clutter
Levels of Care Provided
Frequently Asked Questions
How do I get into clinic for services?
Can I continue to be seen in your clinic after I complete my episode of care?
Will I see the same person for each session?
Is UF’s intensive outpatient treatment the same as a hospital IOP?
How do I know which level of care I need?
What times are appointments offered?
What local lodgings are available?
How does collaboration work between psychology and psychiatry?
Are family members or support persons included in treatment?
What will help me be successful in treatment?
Who is not a good fit for treatment?
Where can I find alternative providers and higher levels of care?
Types of Therapy
Cognitive Behavioral Therapy (CBT)
CBT is a short-term, problem-focused intervention based on decades of research on the interactions between our thoughts, feelings, behaviors, and environments. There are many skills that are a part of CBT including: how to set attainable goals, how to identify and change unhelpful thought patterns, how to modify our homes and social environments for success, how to improve our tolerance to distressing feelings, how to help our bodies relax, and how to retrain our bodies to adapt to distressing situations.
Exposure and Response Prevention (E/RP)
E/RP is a behavioral strategy that is part of CBT. This is the primary intervention that we use to treat OCD, Social Anxiety, Specific Phobias, and Panic Disorder. Exposures occur when we approach a feared object or situation. Response Prevention is when we resist engaging in neutralizing, safety behaviors, or quick-fixes. Overtime, our bodies stop reacting as strongly to the fear (habituation) and we gain confidence in our ability to manage the situation (distress tolerance). Additional learning happens after each exposure exercise when we start to realize things are not as dangerous as we thought (inhibitory learning).
Acceptance and Commitment Therapy (ACT)
ACT is an action-oriented approach that stems from behavioral therapy and cognitive behavioral therapy. Like with CBT, ACT is short-term and focused on building flexibility in our actions and thinking to help us live out what is truly important to us (our values). ACT is particularly helpful for our neurodiverse patients, patients with generalized anxiety, or those who have had only partial benefit from prior CBT.
Parent Management Training for OCD and Anxiety Disorders (PMT)
Parenting a child with OCD or anxiety is difficult and oftentimes counterintuitive no matter the age of the child. PMT can be combined with CBT, ACT, and ERP part of individual therapy for a minor or as a separate service for parents of adult children. In PMT we teach skills related to using effective rewards and consequences, reducing family accommodation, setting and maintaining boundaries, increasing daily living skills in the child, and managing caregiver emotions. Families who are primarily seeking PMT are best served by the Supportive Parenting for Anxious Childhood Emotions (SPACE) Program (not currently offered in our clinic), or a separate PMT program before engaging in ERP.
Habit Reversal Training (HRT)
HRT is the primary intervention for tic disorders. It trains individuals to break habits through awareness, competing behaviors, and maintenance/social support. Individuals are encouraged to be aware of psychological, physiological, and habitual components of their undesired behaviors. Competing behaviors involving learning and practicing movements that are matched to and oppose the performance of unwanted behaviors to eventually lead to extinction of the unwanted habit.
Comprehensive Behavioral Intervention for BFRBs (ComB)
ComB is a natural extension from HRT for BFRBs. The first phase of ComB involves a functional analysis assessment of antecedents and consequences of engaging in unwanted habits including Sensory (sensations), Cognitive (thoughts), Affective (emotions), Motor (behaviors), and Place (environment; SCAMP). The second phase involves identification and selection of target domains using the SCAMP assessment, and the third phase includes implementation of specific interventions, or applying the plan made in the second phase. This phase can include other CBT techniques such as cognitive restructuring, relaxation, competing response/response prevention training, stimulus control, and sensory substitution techniques. Phase four incudes evaluation of treatment progress, termination, and relapse prevention strategies.
Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST)
CREST is primarily based on E/RP with a focus on discarding items. However, it also adds in some cognitive rehabilitation training as most individuals with hoarding or clutter problems report having poor memories or frequently feeling disorganized. After learning these cognitive skills, individuals either work on telehealth or bring a box of items into clinic and work with their therapist to decide which to keep and which to discard. As therapy continues, the therapist helps the patient make faster decisions and discard a higher percentage of items. CREST is particularly helpful for older adults.
Controlling Clutter
This is a closed enrollment psychotherapy group for adults, ages 18 and older, whose clutter and/or hoarding symptoms are negatively affecting them and those around them. This group meets for 12 sessions and utilizes CBT as well as skills training to decrease functional impairment related to clutter and/or hoarding disorder. Psychologists and other mental health professionals will work collaboratively with members of the group to improve daily functioning and living environments. This group is facilitated by Dr. Matthew Daley and runs about two times per year. New participants will have a screening session with Dr. Daley and then everyone will start the group at session one together.
Levels of Care Provided
Weekly Individual Therapy
Meeting with a therapist for 45-60 minutes one time per week is the most common delivery method. After an initial assessment, you will be matched with a therapist who is the best fit for your needs. Family members (e.g., parents or spouses) will be included into treatment as appropriate, though, the individual patient will remain the center of attention for each session. Practice exercises or “homework” will be assigned at the end of each session. We consider 15 sessions to be a “dose” of treatment. Most individuals experience a 30-50% reduction in their symptoms in this timeframe. Completion of assignments is directly correlated with the success of treatment. We aim to have most participants move out of weekly therapy after 15 sessions or a significant reduction in their symptoms. Many of our patients no longer experience clinically significant symptoms after their treatment, though some will experience chronic, although less distress or impairing, symptoms even after treatment. We provide one- and two-month follow-up appointments to insure our patients are still doing well and adjusting to life without therapy. We can also provide booster sessions if our patients encounter a novel stressor for which they would like help. We do not provide ongoing supportive therapy or maintenance therapy after two months of reduced symptoms without a novel stressor. We have a network of therapists who trained at UF who we can refer to for ongoing maintenance care if desired.
Outpatient Setting Intensive Therapy (IOP)
The highest level of care we can provide is once-daily 45-60 minute individual therapy sessions. This treatment option is appropriate for individuals who have severe symptoms that require more frequent appointments to make progress, individuals who have limited time for treatment (e.g., summer break, parental leave), or individuals who live far away from treatment. For those living far away, most choose to stay in a hotel or short-term rental and attend their session in person each day.
Like in weekly therapy, you will be matched with a therapist who is the best fit for your needs after an initial assessment. For those coming from far away, you may participate in phone screeners before your arrival. Family members (e.g., parents or spouses) will be included into treatment as appropriate, though, the individual patient will remain the center of attention for each session. Practice exercises or “homework” will be assigned at the end of each session. We consider 15 sessions to be a “dose” of treatment. This is usually scheduled across 3 weeks of 5-day a week sessions. Most individuals experience a 30-50% reduction in their symptoms in this timeframe. Completion of assignments is directly correlated with the success of treatment. We aim to have most participants move out of weekly therapy after 15 sessions or a significant reduction in their symptoms. Many of our patients no longer experience clinically significant symptoms after their treatment, though some will experience chronic, although less distress or impairing, symptoms even after treatment. We provide one- and two-month follow-up appointments to insure our patients are still doing well and adjusting to life without therapy. For individuals residing in Florida, these appointments may occur over video conference/tele-health. We can also provide booster sessions if our patients encounter a novel stressor for which they would like help. For instance, an individual may return for a one-week IOP “booster” after the birth of a new child. We do not provide ongoing supportive therapy or maintenance therapy after two months of reduced symptoms without a novel stressor. We have a network of therapists who trained at UF who we can refer to for ongoing maintenance care if desired.
Telehealth/Video Conferencing
Telehealth/Video Conferencing can be part of any level of care we offer. We require that the first appointment be in person and you must be physically present within the State of Florida for the visit. Telehealth is most commonly used for follow-up appointments but has other uses as well; however, it is not appropriate for everyone. Options will be discussed with you at your first appointment.
Group Therapy
Our offering of group therapy is not always the same. Individuals are able to participate in weekly group therapy and weekly individual therapy at the same. Participation in IOP and group therapy is sometimes limited by insurance. Some people also choose to participate in a group after completing individual therapy as a form of maintenance.
Frequently Asked Questions
How do I get into clinic for services?
Contact the clinic at 352-265-4357 and state that you are interested in the OCD program and that you would like to receive therapy, medication management, or both. You will be given an intake packet to complete and return to clinic on or before your intake assessment. The psychology and psychiatry clinics are scheduled separately, so be sure to indicate which service you are wanting. Your referring provider can fax their referral to 352-627-4161. Please also have your referring provider indicate which clinic you are interested in working with. For psychology, you will be scheduled for intake assessment in person. At your intake assessment, it will be determined if you are a good fit for weekly or daily treatment, though your preferences are taken into account. There is sometimes a wait between intake and start of your episode of care, and we may need to schedule a second session for more in depth assessment if you have complicating comorbidities, but this session can sometimes be completed over telehealth if you live in the state of Florida and telehealth is clinically indicated.
How long does treatment last?
Our standard episode of care is an average of 15 sessions. On average, patients in the true intensive program come 5 days per week and stay 3 weeks. Patients in weekly treatment are seen for an average of 15 weeks. However, the length of treatment varies depending on the progress of the patient based on engagement in session, monitoring measures, and homework completion.
Can I continue to be seen in your clinic after I complete my episode of care?
For follow-up we attempt to refer to other experienced professionals who treat OCRDs and are more locally accessible to our patients. In some cases, we maintain appointments with patients and/or families for a one or three month follow up. We may continue to see patients in our clinic at a reduced frequency on a case by case basis, though the goal is for patients to complete an episode of care and utilize skills on their own outside of therapy.
Can I continue to be seen in your clinic after I complete my episode of care?
For follow-up we attempt to refer to other experienced professionals who treat OCRDs and are more locally accessible to our patients. In some cases, we maintain appointments with patients and/or families for a one or three month follow up. We may continue to see patients in our clinic at a reduced frequency on a case by case basis, though the goal is for patients to complete an episode of care and utilize skills on their own outside of therapy.
Will I see the same person for each session?
We typically take a team approach to treatment, so it is common for a team of 2 or 3 therapists to be assigned to each individual during weekly treatment and 4 to 5 therapists during intensive treatment. A maximum of three therapists will be present each session, unless clinically indicated to include more providers for specific exposures (e.g., social exposures, sports exposures, etc.). We have rotating medical students and psychiatry residents and fellows that may also join your therapy team on a limited basis, and are not guaranteed. You are more likely to have a consistent primary provider in weekly appointments.
Is UF’s intensive outpatient treatment the same as a hospital IOP?
No, our intensive treatment is an increase in frequency of treatment, not length. In a hospital IOP, patients are seen for multiple hours per day and often include integrated individual, group, and possibly family interventions. At our non-hospital outpatient IOP, patients are generally seen from 45-60 minutes per day with homework assigned for every visit. The billing for our IOP is the same codes used for weekly treatment (usually 90791 for the initial assessment, 90834 or 90837 for return appointments, and 90785 for interactive complexity), not a multi-hour hospital billing code.
How do I know which level of care I need?
You will first participate in a diagnostic assessment. During this time, we will assess your current symptoms, daily functioning, and social environment. The highest level of care we offer is IOP in the outpatient setting (1hr/day on weekdays for 3 weeks). We will work together to identify the level of care that is most appropriate for you. If we determine your symptoms require a higher level of care than we can offer, we will help you identify who to contact next. We are also happy to serve as step-down care for you when you are ready.
What times are appointments offered?
Intensive and weekly sessions are generally scheduled at 9:00am, 10:00am, and 11:00am Monday through Friday. 8:00am and afternoon appointments may be available for weekly appointments, but are limited and are not guaranteed to be available. Psychiatry has a separate schedule for their OCD clinics.
What local lodgings are available?
Due to our IOP being an outpatient program, we do not have included lodging with our treatment. Patients are encouraged to make their own lodging arrangements during their episode of care. Some patients find it useful to stay somewhere that includes a kitchen or kitchenette to be able to complete therapy homework, if applicable. As a reminder, our clinic is on the north side of Gainesville and is not in the same location as the main UF Health Shands Hospital. See below for helpful links:
- UF Health – Where to Stay
- UF Health Hotel Eleo – For Patients
- Visit Gainesville – Medical Related Stays in Gainesville
How does collaboration work between psychology and psychiatry?
Psychology and Psychiatry clinics engage in a weekly case conference to discuss shared or upcoming OCRD patients. Since all three clinics are run separately, we cannot guarantee that you can start both psychotherapy and psychiatry services at the same time. Most of the time patients will continue to be seen by their external providers (PCP, general psychiatrist) for medication management while they are waiting to get into UF’s specialty OCD psychiatry clinic, or may continue to see their outside psychotherapy provider while on the waitlist for the psychology clinic. Your team may have you complete a Release of Information (ROI) to collaborate with providers external to UF. If it is determined that medication is an integral part of your success in treatment, we may delay starting your psychotherapy episode of care until you are able to start medication treatment. CBT-E/RP is an inherently distressing therapy, and we want your activation levels to be manageable enough for you to be motivated to engage in purposeful exposures to triggers and tolerate the resulting distress.
Are family members or support persons included in treatment?
Yes! Research shows that including support persons or family members in treatment can help reduce accommodation and increase treatment outcomes. We welcome anyone that you or your treatment team think will be helpful to include in your care for partial or full sessions, or also to help you complete therapy homework between sessions. We may send assessment measures home with you for support persons to complete to aid in treatment planning.
What will help me be successful in treatment?
We believe that motivation to engage in exposures in session and for homework, as well as belief in the process and your therapy team will help you be successful in learning new skills in treatment. See these 25 tips on the IOCDF website for other ways to help you succeed in OCD treatment.
Who is not a good fit for treatment?
Despite some patients meeting criteria for one of the above diagnoses, they may not be appropriate for the OCD, Anxiety, and Related Disorders Psychotherapy Clinic at this time.
Reasons for exclusion from the clinic include:
- Low to no motivation: CBT-E/RP is a difficult therapy, and patients who are not motivated to engage in session or complete homework between sessions might not be the best fit for this type of therapy. In some instances (on a case-by-case basis), family therapy can be conducted to teach parents or caregivers CBT-E/RP skills for child and adolescent patients who are unwilling to engage in therapy.
- Severe comorbidities or when OCRDs are not primary diagnosis: If patients have comorbid diagnoses of personality disorder, substance use disorder, primary severe depression, primary severe generalized anxiety, primary eating disorder, primary disruptive behavior disorder or other primary diagnoses that need to be managed before engaging in CBT-E/RP, they would be more appropriate to be referred to the community or our general clinic to manage these symptoms before engaging in the CBT-E/RP program, or they may need higher level of care than our program can provide them. This also applies to patients with moderate to severe autism spectrum disorder or cognitive functioning deficits whose symptoms inhibits their ability to engage in outpatient treatment appropriately. Patients in our program should be appropriate to engage in CBT-E/RP, HRT or ComB from the start of treatment with our clinic.
Where can I find alternative providers and higher levels of care?
You can find providers that are covered by your insurance by contacting your insurance company. Please see below for OCRD specific resources for providers: