This summer I have had the opportunity to work at the Houston OCD Program (HOP) as a graduate student intern. The HOP provides residential, intensive outpatient (IOP), and outpatient level services for patients with OCD and other anxiety disorders. Most interns at the HOP work a couple days a week for an entire year. Because I relocated to Houston, TX only for the summer months, I work Monday-Friday 8:30-5ish.
Throughout the day I mostly work as a "RC" or residential counselor. RCs work as the primary support system for the patients during exposure and ritual prevention (ERP) time and are involved in milieu engagement. RC's are responsible for engaging the patient in ERP time appropriately, reinforcing the learning process in the moment. Patients at the HOP work hard all day long throughout the day. During the week, patients attend 2 hours of group therapy, 4 hours of exposure therapy and multiple individual therapy and behavior planning sessions. RCs do "hands on" exposure work with the clients during exposure time and in the milieu.
As an intern I also sit in on and co-lead each of the weekly groups. The HOP provides a wide range of groups including: treatment contract review group, treatment motivation, CBT for anxiety/depression, mindfulness, relationships & communication, acceptance and commitment therapy, and progress monitoring groups. Each morning we also have a short goals group where patients set a goal for the day and review their goal from the previous day.
Finally, I help maintain and streamline the HOPs research and data collection. We collect data on each of our patients at intake, discharge, weekly intervals. I also have helped develop two posters that we will present at the International OCD Foundation conference in Los Angeles, CA next week. See the Publications & Presentations page soon for more information about the posters!
Overall, my experience here at the HOP has been one of my most memorable experiences thus far in graduate school. I wanted to share some of these experiences/what I have learned here on the blog.
1. Balancing Clinical & Research Interests: I had glimpses into what it is like to balance clinical and research interests in my first two years of graduate school, but I had a large reality check once arriving in Houston. Balancing these two interests equally is HARD. I'm not sure how people do it and still find time to sleep at night. I think in reality I will have to place a greater emphasis on research OR clinical work in my future. I believe that it is possible to do some of both, but for me it probably will not be an equal split.
2. Communication is key! The HOP truly works as a treatment team. RCs must communicate with behavior therapists and administrative staff in order to optimize patient treatment. If the team is not on the same page, the patients will notice, and things will not go well.
3. I like working on a treatment team. The HOP works as a team of RCs, behavior therapists, administrative staff, psychiatrist, nutritionist, and our fearless leader (Throstur Bjorgvinsson). It is great to have multiple perspectives on the same client in order to better form case conceptualizations and treatment plans.
4. You have much more time to do creative exposures in IOP or residential treatment than in Outpatient. In the clinical center on campus we provide outpatient services for community members and university students once per week for 50 minutes. With 4 hours of exposure time here at the HOP we are able to go into the community and stay at an exposure location for much longer then we would be able to in outpatient. This allows time for the patient to repeat exposures and habituate to previous exposures before the session ends. Patients seem to maintain more momentum and motivation when they complete structured exposures daily, rather than weekly individual sessions when clients may loose steam throughout the week. It is rewarding to see how much the patients here change in just a few short weeks!
Long story short... this has been an invaluable experience and I look forward to seeing what my remaining 4.5 weeks brings!