Obsessive Compulsive Disorder (OCD) is part of a "obsessive compulsive (OC) spectrum" of disorders that include Hypochondriasis, Body Dysmorphic Disorder, Trichotillomania, Tourette's Syndrome and possibly others neurobiological illnesses. All appear to have in common elements of obsessive thinking and partially involuntary compulsive rituals or motor tic behaviors. Genetically influenced disturbances or damage in different layers of the striatum and other associated areas of the brain have been implicated as causing or contributing to OC spectrum disorders. The disorders are for the most part chronic and can be significantly debilitating. Treatment involves medication, behavior therapy and other specialized interventions and can often be difficult and extended.
For some individuals with OC disorders, seeking treatment may be problematic due to the difficulties of travel and finding qualified practitioners. The OCD Recovery Center now offers two special options for OC spectrum disorders treatment. The first is an Intensive Outpatient Residential Program (IOP) where the patient can stay in a comfortable apartment near our clinic in Grand Rapids, Michigan and receive several hours of intensive outpatient treatment daily for a week or longer. The second is a specialized Housecall Program in which we travel to the home location of the patient anywhere in the world and deliver one to four days of highly intensive treatment in the home, office, school or community.
Unless indicated otherwise, all specialized INTENSIVE OUTPATIENT programs are conducted by Dr. Christian R. Komor, the founder of OCD Recovery Center. Dr. Komor is an American Psychological Association trained Clinical Psychologist and Board Certified Naturopath with seventeen years of clinical experience and twelve years of experience treating anxiety and obsessive compulsive spectrum disorders. Dr. Komor himself has OCD.
A special outreach program is available through which we make "housecalls" to individuals unable to travel to our locations for treatment. Through the Housecall Program we first gather detailed diagnostic information over the telephone or Internet and then arrange to travel to the home city of the patient. Once there we meet with the patient (and, if appropriate, his or her family members) to develop a specially-tailored treatment strategy. Using the Sixteen Keys recovery approach developed through our twelve years of experience treating OC and anxiety disorders, we then proceed to assist the patient in initiating a recovery program.
The following are some of the most important elements included in the Housecall program:
Our aim in the Housecall Program is to assist the patient in creating rapid change which will put them on an aggressive path back out of the wilderness of obsessions and compulsions and restore life serenity and optimal functioning as rapidly as possible. Working in the home and local environment is extremely beneficial to this process. While it is not possible to complete an OC recovery process during the several days of the Housecall, the goal is to lay powerful groundwork. With the assistance of an aftercare plan involving loved ones, local mental health support and other caregivers the patient need only continue with the process which has been initiated during the Housecall to achieve success and eventual recovery. While the Housecall cannot guarantee results, prior patients have tended to make good progress in this format.
The Housecall Program utilizes the "Sixteen Keys" approach developed by the OCD Recovery Center which include:
First Key: Accurate & Complete Diagnosis
Second Key: Information, Education & Understanding Including OC Cycles
Third Key: Assessing History & Damage from Disorder & Grieving Losses
Fourth Key: Understanding Core Family of Origin Patterns and Psychological Dynamics
Fifth Key: Identifying & Transcending Core Fears
Sixth Key: Identifying & Finding Alternatives for Unhelpful Self-Medicators
Seventh Key: Initiating and Refining Psychoactive &, or Phytomedicinal Medication Support
Eighth Key: Initializing Specialized Complementary & Integrative Healthcare (CIH) Tools
Ninth Key: Learning Stress & Anxiety Management Techniques
Tenth Key: Developing Lifestyle Management & Self-Care Skills
Eleventh Key: Developing Cognitive Restructuring & Obsession Inoculation Strategies
Twelfth Key: Conducting Behavioral Therapy
Thirteenth Key: Strengthening Family & Peer Relationships
Fourteenth Key: Reestablishing a Healthy Doing-Being Balance
Fifteenth Key: Repairing or Rebuilding Career & other Life Infrastructure Areas
Sixteenth Key: Developing Relapse Prevention Plan Including Emergency Plan & Ongoing Resource/Support Utilization
The Housecall Program is appropriate for children and adults who are diagnosed with, or believe they suffer from an obsessive compulsive spectrum disorder such as OCD, Hypochondriasis, Body Dysmorphic Disorder, Trichotillomania, Tourette's Syndrome. It is particularly helpful in cases of severe OC where the patient has difficulty leaving the home. Housecalls are not appropriate for persons with Schizophrenia, Bipolar Disorder, Borderline Personality Disorder, untreated substance abuse problems, Dissociative Identity Disorder, or primary Post-Traumatic Stress Disorder.
In considering the appropriateness of a Housecall in a particular situation, it is helpful to keep in mind that the Housecall is a significant investment of energy, time and financial resources. Housecalls are significant and life-changing events and we advise giving the decision careful scrutiny. During the Housecall we will be exploring together in-depth many different aspects of the OC disorder in the home environment as well (if appropriate) as in the school and workplace.
Housecalls generally achieve outstanding results in terms of setting in place a concrete pathway for recovery from the OC disorder being targeted. Results, however, are dependent on a variety of factors, many of which are not under control of the therapist. Most importantly, the patient must be willing to tolerate moderate levels of anxiety (or fear). If not the Housecall is likely to produce only lackluster results.
Special Note: Due to the expense of the Housecall (see below) we recommend that the prospective patient first consider our Teleconferencing Program. If, after several telephone or video conferences, the patient's condition is not improving the next step would be to proceed with the Housecall.
The purpose of the Housecall is to gather information which will lead to the development of a plan for OCD recovery tailored to the individual patient which will then be followed-up after the Housecall is over. On any particular day of the Housecall the visiting doctor may be meeting with the patient, conferencing with family, employers, friends and other treating professionals, conducting psychological testing, developing written handouts and aftercare materials, etc. Not all time is spent in consultation with the patient. Total patient contact time averages approximately 6 hours per day. Roughly the first half of the Housecall will be spent on information gathering and problem formulation and the second half on presentation and discussion of the implementation of strategies for recovery. At the conclusion of the Housecall detailed follow-up instructions for continuing the recovery process will be provided in the form of an Aftercare Plan. Telephone and e-mail consultations are scheduled as part of the follow-up programming.
The cost for each day of Housecall service is $1,200 per day which covers the doctor's time away from his or her home practice. For patients who are not already being seen at the OCD Recovery Centers there is an additional pre-treatment interview / post-treatment paperwork fee of $185. Travel and hotel costs (for one) are in addition to the per diem fee and are billed on the following schedule: $100 per hour for car travel, best available coach fare for plane travel, and $120 per night for hotel accommodations, car rental and living expenses. With the current air travel situation it generally takes at least half a day to reach a destination in the mainland US. Travel days are billed to the nearest half day at the rate of $800 per day (e.g. $450 if it takes half a day to reach your city and $450 for the half-day return.) as this is also time away from the doctor's practice.
Hotel, car rental and air travel arrangements are made by our office, but you may use frequent flyer miles to finance the air travel. Let us know if this is the case. Insurance will sometimes cover the direct service aspects of the Housecall Program, but never covers hotel, travel and other costs.
The Housecall Program offered by the OCD Recovery Center is designed for persons with significant disability resulting from an OC spectrum disorder who are unable or unwilling to travel to Grand Rapids for our Intensive Outpatient Program. The Housecall Program is generally somewhat more expensive, but has the advantage of working in the patient's own environment where most obsessions and compulsions occur. The Intensive Outpatient Program allows the patient to get away from life stresses for a while and relax in a hotel environment. We would be happy to discuss with you the advisability of these two options in your particular situation. Both programs have a high degree of success in goal attainment and reduction in obsessions and compulsions (as measured by the Yale-Brown Obsessive Compulsive Scale).
NOTE: YOU MUST ADVISE US TWO WEEKS IN ADVANCE TO CANCEL THE HOUSECALL OR YOU WILL BE CHARGED FOR 50% OF THE TIME SCHEDULED.
The OCD Recovery Center Housecall Program can be a wonderful opportunity to begin a recovery program or to jump-start a OC recovery process already underway. We invite your questions regarding this unique program and look forward to the possibility of working together to restore the self-ownership, freedom and joy that is your birthright. The article below describes some of the miracles we can experience as the result of the recovery process.