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Charles Mansueto PhD, Elspeth Bell PhD, Sony Khemlani-Patel PhD

Seeking help for an Obsessive-Compulsive Related Disorder (OCRD) is a sign of strength, and fortunately there are effective, evidence-based treatments. But, what happens when a patient struggles to engage in treatment or life with the disorder has become so normal that there’s apathy toward treatment? Incorporating Motivational Interviewing (MI) in the treatment of OCRDs – including Hoarding Disorder, Body Dysmorphic Disorder (BDD), and Body-Focused Repetitive Behaviors (BFRBs) – can increase engagement and encourage progress in the therapeutic process. With Hoarding and BDD, perhaps the most challenging symptom for clinicians is high-overvalued ideation that interferes with therapeutic engagement and compliance. Patients frequently exhibit strong convictions that their beliefs and behaviors are logical, reasoning that non-therapeutic solutions would suffice.

Clinicians often struggle with developing a shared conceptual treatment framework because the patient has difficulty recognizing the benefits of psychological therapy. With BFRBs, the frequency of behaviors can result in a lack of awareness, and pleasure from picking or pulling makes it challenging for patients not just to interrupt the behavior but even to want to stop. This presentation will outline specific MI skills and strategies for engaging with patients. Attendees will find that the content readily applies to patient interactions without treading into therapy.