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PESI Italia srl and Scuole di Specializzazione in Psicoterapia Cognitiva (APC & SPC) offer to you the opportunity to participate in the 2024 edition of the Obsessive-Compulsive Disorder Summit, a two-day event focused on the most up-to-date intervention models related to OCD, with leading international experts in the field.
Individuals with OCD experience very low quality of life (QoL): OCD can wreak havoc in interpersonal relationships, leading to marital discord, separation and divorce, and can interfere heavily with an individual’s ability to study or work. Indeed many obsessive-compulsive patients are unable to work, or are underemployed, have problems in performing household tasks, have impaired social and marital relations. Studies showed that the QoL in OC patients was worse than that of the depressed, schizophrenic, and heroin-dependent patients.
According to The Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM American Psychiatric Association 2013), suicidal thoughts are present in half the individuals with OCD, and 25% of patients have attempted suicide at some point in their lives. Comorbidity with Major Depressive Disorder increases this risk.
OCD is considered today a curable disorder, with cognitive-behaviour therapy being the first-line treatment. Nevertheless, some obsessive-compulsive patients are “treatment resistant”. Moreover, there is generally a long delay, up to 15 years, between the onset of OCD and treatment being received. During this time, patients who suffer from OCD endure disruption within their functioning in all the important areas of life.
Thus, it is pivotal that awareness on OCD and its effective psychotherapy’s techniques are disseminated among mental health professional.
The OCD Summit 2024 has a twofold objective:
By the end of the Summit, participants will be able:
Francesco Mancini
Director of the Graduate Schools of Cognitive Psychotherapy of the Association of Cognitive Psychology (APC) and the School of Cognitive Psychotherapy (SPC).
Davide Dettore
Professor of Clinical Psychology at the Department of Psychology, University of Florence, Head of the Master’s Program in Clinical and Health Psychology and Neuropsychology.
Amitai Abramovitch
Associate Professor of Psychology in the Department of Psychology at Texas State University, research fellow in the Department of Psychiatry at Massachusetts General Hospital (MGH).
David Veale
Consultant Psychiatrist and Visiting Professor in Cognitive Behavioral Therapies at the Institute of Psychiatry, Psychology and Neurosciences, King’s College London.
Guy Doron
Associate professor at Baruch Ivcher School of Psychology, Reichman University (IDC) Herzliya and director of the Obsessive Compulsive Disorder (ROCD) Research Unit (ROCD-RU).
Andrea Pozza
Ph.D., Associate Professor of Clinical Psychology at the University of Siena, psychotherapist trained in cognitive behavioral therapy and executive psychologist at the Psychology Unit of the Santa Maria alle Scotte University Hospital in Siena.
Kimberley Quinlan
Marriage and family therapist, specializing in anxiety, obsessive compulsive disorder and eating disorders. Founder of CBTschool.com.
Jedidiah Siev
Associate Professor of Psychology at Swarthmore College, Associate Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine and clinical psychologist.
Patrick McGrath
Head of Clinical Services for Obsessive Compulsive Disorder, leading tele-therapy services in the United States to help people with OCD and related disorders. Lead psychologist at AMITA Health.
Angelo Maria Saliani
PsyD, psychologist-psychotherapist, lecturer at the Schools of Specialization in Cognitive Psychotherapy SPC, AIPC, SICC and professor at the School of Specialization in Life Cycle Psychology at Sapienza University of Rome.
Alessandra Mancini
Cognitive Behavioral Psychotherapist, PhD in Cognitive and Social Neuroscience,Trainer and Supervisor in Schema Therapy recognized by the International Society of Schema Therapy (ISST).
Barbara Barcaccia
PhD, Cognitive-behavioral Psychologist and Psychotherapist, chairperson of the special interest group on Obsessive-Compulsive Disorder of the EABCT.
Francesco Mancini & Barbara Barcaccia, from 9am to 9.15am (Italian time)
Francesco Mancini, from 9.15am to 10.15am (Italian time)
Guilt plays a significant role both in the genesis and in the maintenance of obsessive–compulsive disorder (OCD). Two major types of guilt have been identified: one deriving from the transgression of a moral rule (deontological guilt), another (altruistic guilt), based on the assumption of having compromised a personal altruistic goal. Clinical evidence suggests that OC patients are particularly sensitive to deontological, but not to altruistic guilt.
This presentation proposes a psychological thesis, according to which the underlying cause of obsessions and compulsions is an intense fear of guilt. The role of morality has been widely recognised in the history of OCD: there is an age-old tradition that sees exaggerated moral preoccupations as the root of the disorder. The thesis proposed here is an attempt to advance this tradition and define more accurately the type of guilt feared by obsessive patients, i.e., deontological guilt, and to illustrate how the fear of guilt can account for the numerous questions raised by the obsessive-compulsive manifestations.
In this presentation I shall illustrate how the obsessive mind works and how to understand the proximal determinants of the disorder.
David Veale, from 10.15am to 11.15am (Italian time)
Body Dysmorphic Disorder (BDD) is defined as a preoccupation with a perceived defect in one’s appearance, which is not noticeable to others. The preoccupation is associated with a distorted felt body image with many “safety seeking” behaviours such as mirror gazing, skin-picking, ruminating or constant comparing of one’s perceived defect to others. People with disfigurements and BDD use strategies to camouflage and avoid situations and activities. They may have a poor quality of life, are socially isolated and people with BDD are at high risk of committing suicide. Cognitive behaviour therapy and SSRI medications are recommended for treating BDD. CBT can be used for the body image problems in disfigurement and eating disorders. Habit reversal is recommended for skin picking.
Learning Objectives
Alessandra Mancini, from 11.30am to 1.30pm (Italian time)
One of the central themes in Obsessive-Compulsive Disorder (OCD) is guilt. Francesco Mancini’s cognitive model identifies the fear of deontological guilt as the driver of compulsions. The fear of having transgressed internalised moral norms, or of being exposed to moral degradation has roots in the early maladaptive experiences of OC patients. The translation of Mancini’s model into the language of Schema-Focused Therapy (SFT) has the usefulness of integrating the understanding of the dynamics of the disorder with the explanation of how it developed throughout the patient’s life. The imaginative techniques of SFT allow us to intervene on the historical vulnerability to the disorder, showing patients the connections between their past experiences and current symptoms and, through rescripting, promoting acceptance of the possibility of feeling guilty.
Learning objectives
Patrick McGrath, from 2.30pm to 4.30pm (Italian time)
ERP is the gold standard treatment for OCD, and has recently undergone a bit of an overhaul. Following the COVID-19 Pandemic, the way that ERP is delivered has radically changed. From how far we take ERP to if we are even in the same room as a patient! In this talk, we will review innovative ways to deliver ERP both in person and via a telehealth setting. Through the use of technology, we can go almost anywhere with our patients and be with them as they navigate their world. Via a phone in a breast pocket and earbuds, we can have a window into their world that we have never had before, and we can direct ERP in ways we only imagined. We will discuss ways to utilize ERP that go beyond the four walls of the therapy office and discuss new technologies as well, such as Virtual Reality. Further if you treat not just OCD, but also OCD related conditions, we will touch upon the use of ERP treatment for those as well. Save time driving to the home of a person with Hoarding Disorder – meet virtually, or work remotely with someone who is working on Habit Reversal Training for Body Focused Repetitive Behaviors right where the majority of their behaviors occur.
Learning Objectives
Jedidiah Siev, from 4.45pm to 5.45pm (Italian time)
Scrupulosity is a manifestation of OCD with religious or moral core fears. Although exposure and response prevention (ERP) is an effective first-line treatment for OCD, scrupulosity is associated with several clinical challenges and poorer outcomes. Patients often feel trapped between choosing their faith on the one hand and their mental health on the other. Scrupulous patients may either abandon religion altogether because they cannot reconcile religion and mental health, or reject potentially effective treatment options after being encouraged by clinicians to violate basic requirements of their faith. Both are unfortunate because they are not necessary. Instead of pitting religion against mental health, ERP can be tailored for scrupulosity in a way that respects patient values without sacrificing treatment efficacy. This talk will review modifications related to assessment, the therapeutic stance, motivation and treatment rationale, addressing uncertainty and risk related to sin, and ways to collaborate effectively with clergy, as well as specific adjustments in the execution of cognitive-behavioral techniques.
Learning objectives
Davide Dettore, from 9.00am to 10.00am (Italian time)
Obsessive-compulsive disorder is a condition that causes considerable suffering in those who suffer from it and involves significant treatment difficulties both for psychotherapy and psychopharmachology. In a significant number of cases, it can present itself in comorbidity with various other psychopathological conditions, not least personality disorders. The association between obsessive-compulsive disorder and personality disorders, in particular, constitutes a significant challenge for psychotherapy, as numerous studies indicate that in these cases treatment is more difficult with even stronger obstacles to intervention, which, as has been said, is already in itself very difficult and complex, even when only obsessive compulsive disorder is present.
In this presentation, the personality disorders most frequently comorbid with obsessive-compulsive disorder will be mentioned; the topic of the consequences connected to this association will be addressed and the solutions that have been developed to deal with this eventuality will be presented, referring to international literature but also to the professional experience of the author and to empirical studies conducted by his research group. A part of the presentation will be dedicated to comorbidity with a specific personality disorder, obsessive compulsive one, which is the most often comorbid personality disorder and must be addressed with some specific procedures, sometimes capable of overcoming the obstacles posed by the co-presence of the two conditions.
Learning objectives
Guy Doron, from 10.00am to 11.00am (Italian time)
In this session, we introduce the DID IT protocol, a transformative approach for treating Obsessive-Compulsive Disorder (OCD) that focuses on mental habits. This protocol is based on the understanding that while mental habits initiate complex, maladaptive Type 2 thinking patterns in OCD, they do not sustain them over time. The session emphasizes the role of these mental habits in starting processes such as catastrophizing, self-criticism and rumination, and the importance of intervening at this initiation phase for effective OCD management. We explore five key assumptions, including the engagement with maladaptive thinking patterns and the conditioning process that links these patterns to mental habits. The protocol involves distinguishing between controllable narratives and automatic thoughts, identifying the transition point between these processes, and strategies for delaying and disengaging from these narratives. This insightful session aims to equip participants with the knowledge and tools necessary for disrupting the cycle of OCD symptoms by targeting the initial mental habits.
Learning Objectives
Angelo Maria Saliani, from 11.15am to 1.15pm (Italian time)
Individuals living next to a person with OCD, especially family members, often play a crucial role in maintaining the disorder. Scientific literature highlighted that family members adopt two main attitudes towards their loved ones with OCD, ranging from extreme compliance, so called accommodation, to its opposite, characterised by antagonism. Accommodation appears to be a negative prognostic factor and a large bulk of studies show its associations with a worse response to treatments and with more frequent relapses in the long term. Equally negative effects are associated with the modes of interaction that can be placed on the polarity of the antagonism. Clinical observation, however, suggests that the accommodation-antagonism continuum only partially captures the complex system of interpersonal reactions to the compulsive symptomatology. Indeed, each of these reactions triggers a specific interpersonal trap that contributes to maintaining the symptom and fueling a large spiral process that typically culminates with the patient’s blaming and the strengthening of his sensitivity to deontological guilt.
Learning objectives
Andrea Pozza, from 2.30pm to 3.30pm (Italian time)
In the scientific literature on psychotherapy, it is well established that the emotional experiences that psychotherapist and patient experience towards each other in the therapeutic relationship can predict a positive outcome of the psychotherapeutic path. In the study of cognitive-behavioral psychotherapeutic treatment of OCD, the available data suggest a moderately close link between therapeutic alliance from the patient’s perspective and outcome of the therapeutic process, with an associated lower risk of abandoning therapy and a higher probability of positive therapeutic response.
Data on the experience of clinicians who use to treat patients with OCD is still relatively lacking, but increasing. A further aspect that is not entirely clear is how the contribution that specific sociodemographic and psychological characteristics of the therapist can contribute to the alliance with the patient with OCD. Among these features, a role could be played by the personality functioning of the therapist. The emotions that the therapist experiences towards patients with OCD can be analyzed as useful sources of information on the patient’s interpersonal functioning and on the progress of the psychotherapeutic process. This material can also be the object of analysis in clinical supervision sessions, since such emotional reactions in a psychotherapist could concern their attachment history, and if shared and analyzed with the therapists, the supervisor could help to monitor monitoring the therapist’ functioning with the patient, preventing the risk of dropout or optimizing the response to treatment.
In this work I will present the empirical literature and theoretical models on the therapeutic relationship from the perspective of the therapist who has experience in treating OCD in cognitive-behavioral psychotherapy, analyzing which factors linked to the therapist’s personality functioning can correlate with a better or worse relationship with the patient, therefore become the object of analysis in clinical supervision.
Learning objectives
Kimberley Quinlan, from 3.30pm to 4.30pm (Italian time)
Self-compassion is often misunderstood as simply candles and bubble baths. While self-care is a component of self-compassion, it is actually a much more robust practice that can supercharge OCD recovery.
The practice of self-compassion is one of the most helpful tools to assist with OCD treatment and recovery. Research shows that self-compassion is not only highly effective at reducing anxiety, depression, and stress, but it also improves motivation, self-esteem, and an overall sense of well-being. The practice of self-compassion has also been shown to help people with OCD navigate the distress of intrusive, repetitive thoughts, and painful waves of emotion.
This interactive presentation will help you utilize self-compassion as an essential tool for your emotional & professional toolkit. Kimberley will teach the foundations of self-compassion & demonstrate how powerful self-compassion can be in breaking the cycle of obsessions and compulsions while also managing self-judgment, self-criticism, and self-punishment. Kimberley will also review the common OCD roadblocks to self-compassion and outline skills and practices that can be used at home to help navigate any thought, feeling, sensation, urge, or image.
Learning Objectives
Amitai Abramovitch, from 4.45pm to 5.45pm (Italian time)
Valid and reliable assessment is essential for evidence-based treatment. To enhance accuracy and efficiency, self-report measures are frequently subject to revisions and updates. Since recent developments in our understanding of OCD and related disorders (OCRDs) have established that hoarding is not part of OCD, our group developed and published revised measures of the OCI-R and the OCI-CV (the OCI-12, and the OCI-CV-R). Furthermore, although OCD is a prevalent disorder (1-2% lifetime prevalence) the majority of people with OCD do not receive proper interventions primarily because of the failure to properly recognize this condition in non-specialized settings. For example, although OCD is regularly encountered in non-psychiatric medical settings such as primary care, obstetrics, and dermatology clinics, measures of OCD are seldom administered at such sites because of their length, lack of usefulness as a diagnostic screener, requirement of clinician administration, and cumbersome scoring schemes. Accordingly, there have been calls for the development of ultra-brief self-report screening instruments for OCD that can easily be used in medical clinics as the disorder lags far behind depression and anxiety-related disorders when it comes to proper detection, identification, and referral in direct health service settings. To this end, our group developed and published two new ultra-brief screening measures for youth (OCI-CV-5), and adults (OCI-4) with OCD, intended to be incorporated in non-specialized medical settings.
In this talk, I will present cutting-edge psychometric work anchored in each of these considerations. First, I will review the two main methodological/conceptual approaches to the assessment of OCD. Then I will present the above-mentioned new measures and their psychometric properties and discuss their strengths, weaknesses and utilization.
Learning Objectives
Francesco Mancini & Barbara Barcaccia, from 5.45pm to 6.00pm (Italian time)
The Summit is held on Friday 10 and Saturday 11 May 2024, for a total of 14 hours of specialized training.