Why should I receive services from an OCD/anxiety specialist?

The reasons that make you seek out a neurologist for chronic migraines are the same ones that would motivate you to see a specialized mental health clinician – expert knowledge and experience. A general provider will have a good idea about how to address your problems, but they might not be up to date on the latest research or strategies. Furthermore, they might not have ever been supervised by another professional to ensure they know exactly how to effectively use the appropriate treatment approaches. In turn, Dr. Dufrene and Dr. Fitch have received extensive training and have years of experience in our areas of specialty. We also provide training and supervision to all Rise professionals. This way, you know that when you receive services at Rise you are working with someone who knows exactly what to do for you to begin feeling better as quickly as possible. 

What’s the difference between talking to you or my best friend or family?

Although it can feel really good to talk to a family member or friend about the things that are on your mind, they may not know how to best help you. Mental health professionals have the training and experience to listen in a way that makes you feel understood and to help you find real relief. They can help you approach your situation in a new way– teach you new skills, gain different perspectives, and help empower you to make behavioral changes that enable you to be your best self. If you have OCD or anxiety, you may not want to talk with loved ones about your fears because you worry that they will not understand or may judge you for the thoughts and emotions you are experiencing. Although it can sometimes be difficult to open up to a new person, our providers will listen to you without judgment or expectations. Furthermore, when you go to your loved ones when you are anxious or upset, they probably want to do whatever they can to make you feel better. They may provide you reassurance or do things for you so you can avoid feeling worse. Although they likely have the best of intentions, their behaviors actually contribute to OCD and anxiety disorders sticking around. Your loved ones may also struggle with their own worry about you or respond harshly when you are having a tough time. A trained professional will not only be able to respond in a validating way that will not maintain your symptoms, but can also teach these skills to your family. Lastly, unlike talking to a friend or family member, psychotherapy is completely confidential. You won’t have to worry about anyone else knowing about your struggles.

Why shouldn’t I just take medication?

When it comes to OCD and anxiety disorders medication is often best thought of as an important treatment tool rather than a magic cure. Research suggests that people get the best results when they are treated with either cognitive behavioral therapy (CBT) alone or a combination of CBT and medication. Individuals with mild to moderate symptoms can often experience substantial improvement from behavior therapy alone, whereas those with severe symptoms may need medication to help reduce distress to a manageable level to fully engage in behavior therapy. Many people treated with medications only (without CBT) find that their symptoms do not adequately improve, and if they do see progress, symptoms may eventually return, and possibly be more severe. Furthermore, most people do not want to have to take medication for the rest of their lives; however, when medications are discontinued, symptoms frequently return. When treating individuals who would like to stop taking psychotropic medications in the near future,  we typically work in coordination with prescribing physicians who adjust medication appropriately as someone begins to show improvement in their symptoms. This way, we can ensure that the individual is able to utilize their CBT skills to respond to any increase in anxiety that may accompany a reduction in medication dosage. The great thing about behavior therapy is that you will be able to use these skills for the rest of your life.   

How does it work? What can I expect if I contact Rise for services?

Rise offers a free 15-minute phone consultation prior to starting services. If the phone screen indicates you are likely to benefit from Rise services you will be scheduled for a detailed intake assessment. The assessment consists of a discussion between you and the provider, which allows the provider to fully assess your symptoms. After the intake assessment the provider will make recommendations, which might include individual intervention and/or group treatment. If the professional believes your needs will be best suited by another facility that recommendation will also be made. 

While the exact nature of sessions will differ somewhat between the individual and group formats, the core is the same. The treatment programs at Rise include three components, primarily based in behavior change:

1. Cognitive behavioral therapy: You’ve probably heard of cognitive behavioral therapy (CBT) and perhaps you have worked with a clinician who uses “CBT.” Cognitive behavioral interventions are considered “second wave” behavioral therapies with strong research support as being effective treatments. Since its early development, CBT has become an umbrella term that describes a number of psychotherapies. Traditional CBT focuses on the relationship between your thoughts, emotions, and behaviors.  In traditional CBT, you learn how to identify, evaluate, and change inaccurate appraisals in response to emotions like anxiety. You also are taught how avoidance and safety-seeking behaviors in turn impact your thoughts and emotions, and how changing those behaviors, often through exposure exercises, is the key to experiencing long-lasting relief from distress. At Rise, we focus primarily on a type of CBT called exposure and response prevention (ERP), which is most often discussed as a treatment for OCD. ERP is the process of confronting difficult situations you ordinarily avoid and allowing yourself to feel the full extent of your emotions by refraining from engaging in rituals or other safety behaviors. ERP focuses primarily on changing behaviors, rather than directly trying to change thoughts. Exposure exercises with response prevention are a key strategy to break the cycle of OCD/ and anxiety. During your appointments you will learn about and rehearse these strategies with the guidance of a Rise professional. You will also be expected to complete related exercises in your daily life. 

2. Acceptance and commitment therapy: Although acceptance and commitment therapy (ACT) is considered a “third wave” behavioral therapy, it is important to note that its roots lie in behaviorism rather than CBT. It is a holistic approach emphasizing the context of behaviors with the goal of increasing psychological flexibility. When using ACT as a therapeutic intervention for OCD and anxiety, we look at how your attempts to control or get rid of unpleasant emotions, thoughts, and bodily sensations has actually prolonged your struggle and pulled you further from living the life you want to live. In contrast with traditional cognitive approaches, ACT teaches you to treat intrusive thoughts as noise that does not need your attention. Utilizing acceptance and mindfulness techniques, as well as engagement in values-driven behavior, we will help you become more willing to experience whatever thoughts and emotions come your way so that you can be in your life rather than in your head. ACT and ERP are very complementary approaches, thus we often integrate the two treatments at Rise. 

3. Holistic approaches to wellness: At Rise, we know that OCD and anxiety interferes with many parts of life and often results in putting our needs on the back burner. We also know that when we don’t take good care of ourselves, it can snowball and make us more vulnerable to negative moods. In contrast, when we treat our bodies well, this can substantially decrease our distress. Rise professionals facilitate discussions and provide guidance for making incremental improvements to sleep, nutrition, physical activity, stress management, and overall self-care.

Why don’t you accept insurance?

The co-owners of Rise are dedicated to increasing access to effective treatment for OCD, anxiety, and related disorders in Louisiana. Unfortunately, it has been our experience that insurance companies place unnecessary restrictions on providers that make it more difficult to provide the best services possible. Examples of restrictions include: the frequency of treatment sessions per month or year, the duration of or number of sessions per day, the types of services that must be provided in-person vs. via telehealth, and restriction on the location of services. Insurance companies also require you to authorize clinicians to share your confidential health information. 

As you might expect, when there are problems with payment, it is a time-consuming process to sort out with insurance companies, taking away from time that your provider can focus on patient care. If the provider does not do this work themself, they must see more patients to pay for an insurance biller. Either way, it means you are not getting the full attention you deserve. Most clinicians who have sought out specialization in evidence-based treatments, like exposure and response prevention for OCD, often find reimbursement rates by insurance companies to be inadequate for the services provided. Although another clinician might be in-network with your insurance, it is likely that they might provide services, like “talk-therapy” that are not effective for your condition. As a result, you might be seeing them for years without much improvement. The treatments we use at Rise are time-limited and very efficacious. Although you will need to make a larger upfront investment, you will reclaim the time stolen by OCD and anxiety within a few months. 

Rise is happy to support our clients as they seek reimbursement for services. We provide all of the information that an insurance company would need to submit for out-of-network reimbursement. This is called a superbill, and includes information like diagnosis and service codes. Rise also provides guidance on the steps needed to gather out-of-network benefit information and submit a claim to an insurance carrier. Additionally, Rise regularly offers scholarships to reduce the cost of services, as well as economical options such as group programming.