The battle of living with obsessive compulsive disorder : a qualitative study of young people's experiences

This is the peer reviewed version of the following article: Carly Keyes, Lizette Nolte, and Timothy I. Williams, 'The battle of living with obsessive compulsive disorder: a qualitative study of young people's experiences', Child and Adolescent Mental Health, April 2017, which has been published in final form at DOI: https://doi.org/10.1111/camh.12216. The Accepted Manuscript is under embargo until 4 April 2018. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. © 2017 Association for Child and Adolescent Mental Health.Background: There has been an abundance of studies that have employed quantitative methods to research obsessive compulsive disorder (OCD) and its neurobiology and neurochemistry. However, there appears to be a paucity of research investigating how OCD is experienced by those living with the diagnosis, particularly young people. Method: A qualitative cross-sectional semistructured interview design was used to address this lack of research. Ten young people, aged 14–17 years old, with a diagnosis of OCD were recruited from Child and Adolescent Mental Health Services in the United Kingdom. Thematic analysis was used to analyse the data. Results: Four themes were identified: ‘Traumatic and stressful life events’, ‘Responses to signs of OCD’, ‘The battle of living with OCD’ and ‘Ambivalent relationship to help’. Young people reported experiencing stressful or traumatic life events prior to obsessive and compulsive behaviour. OCD behaviours were misunderstood by the young people and others, leading to delays in finding help. A sense of shame among the young people led them to keep their OCD secret due to feeling ‘crazy’. The all-encompassing nature of OCD led the young people to withdraw socially. Most of the young people experienced an inner conflict between fighting and giving in to the compulsions. Conclusions: Traumatic experiences may be an important factor in the development of OCD for young people, which might indicate a direction for prevention. The sense of shame and stigma needs addressing if young people are to access help earlier. Education of the public, medical professionals and educators should be a priority.Peer reviewedFinal Accepted Versio

The hardest part is knowing I will survive: The use of music and creative mediums to enhance empathy and facilitate life-long distance learning in professionally qualified clinicians

© Redfame Publishing Inc.Music is an experience that can cross personal and professional domains alongside cultural, gender, age and generational boundaries; it can also enhance the learning process through emotional processing and connection. This paper focuses on the learning experience of qualified clinical psychologists (CPs) working in the United Kingdom. This group of CPs had experience of undertaking experiential learning and reflective writing during their professional training. It considers the potential to continue a learning process, 3 years post qualification, through long distance methods using vignette-based material. Empathising with, and understanding, the position of others from differing backgrounds is an important competency within the therapeutic work of CPs and this comes alongside acknowledging and understanding ones‟ own experiences, both past and present. CPs work with difficult life experiences and complex issues; connecting constantly can be exhausting and, perhaps, unrealistic. Yet, to truly empathise one must connect with, and understand, the lived experiences of others. We will consider what helps and hinders this process, and how music and other creative mediums can be effectively used in learning even via long distance methods. We will further consider how CPs may be well placed to enhance the learning about, and processing of, difficult emotional experiences for themselves, other clinicians and the people they might work with.Peer reviewe

How Young People Make Sense of Developing and Getting Help for Obsessive Compulsive Disorder

There has been an abundance of studies that have adopted positivist approaches, employing quantitative methods, to research OCD ‘symptoms’ and their underlying neurobiology and neurochemistry. There appears to be a lack of research investigating how OCD is experienced by those living with the diagnosis, and in particular the experiences of young people diagnosed with OCD. Ten young people, aged 14-17 years old, with a diagnosis of OCD were recruited from Child and Adolescent Mental Health Services (CAMHS). The young people were interviewed and a Thematic Analysis (TA) was used to analyse data. Four themes were developed through the analysis. The first theme ‘Traumatic and stressful life events’ found that 9 out of the 10 participants experienced at least one of the following three life events just prior to the development of their OCD: ‘Hostility in the family’, ‘Illness and death’, ‘Bullying and friendlessness’. Four subthemes, ‘Lack of understanding of the behaviour’, ‘Being secretive’, ‘I thought I was going crazy’, and ‘Feeling different’, provided a richer understanding to the theme ‘Responses to signs of OCD’. The four subthemes ‘Feeling ‘right’’, ‘I was taking on all the responsibility’, ‘It’s ruined everything’, ‘Everyday life is now in my bedroom’ explored the third theme ‘The battle of living with OCD’. The last theme ‘Ambivalent relationship to help’ described the conflict that most participants had over exposure therapy and accommodation of their OCD. Lastly, most participants felt the long waiting time for help was frustrating. The theme is fully explored by the following three subthemes: ‘Conflicts of exposure therapy’, ‘Conflicts about accommodation of the OCD’, ‘and ‘Frustrations of long waiting lists’. The themes that emerged may provide important information for clinicians and the implications of the research findings are discussed. The strengths and limitations of the study are noted and there are suggestions for future research

So many lifetimes locked inside: reflecting on the use of music and songs to enhance learning through emotional and social connection in Trainee Clinical Psychologists

Music is universal; it can provide a common language that speaks from the heart enabling others to connect with the private felt experiences of others regardless of differences within or between people. This ability to empathise with, and understand, the position of others from differing backgrounds is an important competency within the therapeutic work of Clinical Psychologists. There are many facets to diversity just as there are many facets to music. Diversity in music genres can reflect diversity in people. Indeed, there is music to cater for all tastes, cultural/ethnic backgrounds, gender, age and generations with listening often being guided by individual preferences. In the United Kingdom training to become a Clinical Psychologist consists of a university-based 3-year full time professional research doctorate funded through the National Health Service. Trainees work on placements 3 days a week and attend university for academic and research teaching 2 days a week. As part of the academic programme, Trainees undertake experiential learning through workshops and methods such as Problem-Based Learning (PBL). One of the PBL exercises is based on a typical referral within an Adult Mental Health (AMH) service. For the AMH PBL exercise music is used to enhance trainees’ ability to connect emotionally with the personhood of referrals, consider associated complexities, and to reflect on personal and professional boundaries and reflective practice during training and beyond. This paper reflects on the utility of music and songs to enhance the learning experience

Increased Colorectal Cancer Screening Sustained with Mailed Fecal Immunochemical Test Outreach.

Background & aimsReports of mailed fecal immunochemical test (FIT) outreach effectiveness over time are minimal. We aimed to better evaluate a mailed FIT program with longitudinal metrics.MethodsA total of 10,771 patients aged 50 to 75 years not up-to-date with colorectal cancer screening were randomized to intervention or usual care. The intervention arm received an advanced notification call and informational postcard prior to a mailed FIT. Usual care was at the discretion of the primary care provider. Patients were followed for up to 2.5 years. The primary outcome was the difference in cumulative proportion of completed FIT screening between arms. Screening was further examined with the proportion of time up-to-date, consistency of adherence, and frequency of abnormal FIT.ResultsThe cumulative proportion of FIT completion was higher in the outreach intervention (73.2% vs 55.1%; P < .001). The proportion of time covered by screening was higher in the intervention group (46.8% vs 27.3%; Δ19.6%; 95% confidence interval, 18.2%-20.9%). Patients assigned to FIT outreach were more likely to consistently complete FITs (2 completed of 2 offered) (50.1% vs 21.8%; P < .001). However, for patients who did not complete the FIT during the first cycle, only 17.1% completed a FIT during the second outreach cycle. The number and overall proportion of abnormal FIT was significantly higher in the outreach intervention (6.9% Outreach vs 4.1% Usual Care; P < .01).ConclusionsOrganized mailed FIT outreach significantly increased colorectal cancer screening over multiple years in this safety-net health system. Although mailing was overall effective, the effect was modest in patients who did not complete FIT in first cycle of intervention. (ClincialTrials.gov, NCT02613260)