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Obsessive-compulsive disorder (OCD), once thought to be rare, is now recognized as a common psychiatric disorder affecting about 2.5 % of the general population. Effective treatments for OCD exist, yet widespread misinformation about OCD also exists The potential for clinical judgment errors in assessing OCD makes this a good clinical example for illustrating methods of debiasing and hypothesis testing (P M. Spengler, D. G Strohmer, D. N. Dixon, & V. A. Shivy, 1995). We provide information about this frequently misdiagnosed disorder, delineate methods for assessment and treatment of OCD, and discuss implications of these issues for mental health counselor training and practice.
This article summarizes and integrates contemporary issues related to assessment and treatment of obsessive-compulsive disorder (OCD). Obsessive-compulsive disorder creates particular challenges for mental health counselors, due to the secretive nature of OCD sufferers and the unfounded, yet widely held, belief by mental health professionals in the low prevalence of OCD. The onset of OCD occurs most commonly during adolescent and college years (Noshirvani, Kasvikis, Marks, & Tsakirvis, 1991). This disorder frequently coexists with a number of disorders commonly treated by mental health counselors (e.g., depression, substance abuse). Consequently, mental health counselors are likely to treat clients who have OCD. However, because of diagnostic errors, the most likely of which is failure to diagnose OCD, many of these clients will not receive empirically validated treatments for OCD (Task Force on Promotion and Dissemination of Psychological Procedures, 1995).
Effective clinical assessment and treatment for most client problems requires attention to at least three content areas (Spengler et al., 1995). Counselors must first identify and dispel myths and misconceptions related to OCD, thereby building an accurate knowledge base. Second, methods must be learned for assessment of OCD. Third, because of rapid advances in OCD research, counselors must remain abreast of what is currently known about treatment of OCD. We address each of these issues with the intent of informing mental health counselors about clinical judgment, assessment, and treatment issues related to OCD in a college age and adult population.
MYTHS AND MISCONCEPTIONS
A primary threat to accurate diagnosis, inherent in any assessment activity, is biased or inaccurate information (Spengler et al., 1995). Misconceptions about typical and atypical forms of OCD, lack of client reporting, errors...