Breaking the Rules: A Clinician's Guide to Treating OCD - podcast cover

Breaking the Rules: A Clinician's Guide to Treating OCD

Dr Celin Gelgec and Dr Victoria Millerwww.melbournewellbeinggroup.com.au

Breaking the Rules is a show for mental health professionals designed to help you build confidence in treating Obsessive Compulsive Disorder (OCD). Effective treatment of OCD requires commitment, creativity and the recognition that things can sometimes get a little … messy. And on the show, you’ll hear from a range of leading professionals and learn everything there is to know about OCD and other related mental health concerns. This podcast is brought to you by Melbourne Wellbeing Group, a psychology practice based in Melbourne with a special focus on treating OCD.

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Episodes

The dangers of suicidal OCD and how to recognise it

With suicide remaining a leading cause of death for people aged between 15-44 in Australia, clinicians in the OCD space need to ask the question: How do we differentiate between suicidal ideation and obsessive intrusive suicidal thoughts? In this episode, we discuss how to work with a client when they come to you with suicidal thoughts, why it is critical to take all mentions of suicide seriously, and how to determine whether a person with OCD is presenting with suicidal ideation consistent with...

Jun 23, 202526 minEp. 60

How “skinny-tok” is feeding eating disorder content to teenagers

Felicity Phillips is the Founder of Weight of the World, a community-driven organisation supporting people with eating disorders and their carers through recovery. Weight of the World aims to provide peer support and education while challenging diet culture and promoting body neutrality. In this episode, Felicity shares her personal journey from pre-professional ballet to developing an eating disorder and ultimately finding recovery, explains the alarming rise of "skinny talk" on social media an...

Jun 09, 202536 minEp. 59

Is it ROCD or is there a real problem in the relationship?

It’s normal to have doubts and questions about our relationships sometimes. Am I in love with my partner? Am I spending enough time with my parents? Are my friends mad at me? But what happens when those normal, passing concerns turn into an obsession? In this episode, we explain the difference between ordinary relationship concerns and relationship OCD (ROCD), how to identify when ROCD is showing up, and what the next steps are for helping clients manage it. Resources and links: Webinars, books,...

May 26, 202530 minEp. 58

Supporting new parents with OCD

This is the final part of our two-part chat with Dr Bianca Mastromanno. In the last episode, Bianca discussed how she works with parents to process their childhood experiences and help them navigate parenthood themselves. In this episode, Bianca opens up about her personal experiences with parenting anxiety, digs into the challenges faced by parents with OCD, the impact of OCD on early parenthood, and how clinicians can support parents during the vulnerable early days of new parenthood. Resource...

May 12, 202533 minEp. 57

Why revisiting a parent’s own childhood can help them as a new parent

Dr Bianca Mastromanno is a Clinical Psychologist who works extensively in the perinatal space. Bianca uses a trauma-informed, evidence-based approach to support parents and children living with mental health concerns. In this episode, Bianca explains how she works with parents with OCD or other mental health challenges to explore and process their own childhood experiences to help them navigate the emotional challenges of parenthood. She also reflects on what she’s learnt from the parents she wo...

Apr 28, 202528 minEp. 56

The value of self-awareness, trust, and non-accommodating support

This is the final part of our two-part chat with Lindsay and Emily Stetzer. In the last episode, Lindsay and Emily opened up about their early experiences with OCD and how their lived experiences led them to create Presently Bracelets. In this episode, Lindsay and Emily discuss the household dynamics of living in a family with OCD, the significance of non-accommodating support, and the role of exposure therapy, self-awareness, and trust in the recovery process. Resources and links: Presently Bra...

Apr 14, 202526 minEp. 55

How these sisters turned their OCD into a thriving jewellery business

Lindsay and Emily Stetzer are sisters living with OCD and the Founders of Presently Bracelets. Presently Bracelets offer a range of bracelets to help you navigate intrusive thoughts and embrace the present moment. In this episode, Lindsay and Emily share their individual experiences with OCD and treatment, what helps them between sessions, and what they think therapists need to know from the perspective of someone with OCD. They also share how the phrase “my thoughts are passing clouds” led to t...

Mar 31, 202526 minEp. 54

How clinicians can provide better OCD treatment (from someone with OCD)

This is the final part of our two-part chat with Chrissie Hodges. In the last episode, Chrissie shared her early experiences with OCD before embracing the challenges of OCD peer support and advocacy work. In this episode, Chrissie reflects on her experiences with OCD treatments and what clinicians can and should be doing better. She also emphasises the importance of acknowledging the impacts of different OCD themes on the individual and how some themes might result in more trauma and stigma than...

Mar 03, 202536 minEp. 53

Peer-to-peer: A frank conversation about OCD

Chrissie Hodges is an OCD Advocate, Peer Support Specialist, and Author of ‘Pure OCD: The Invisible Side of Obsessive-Compulsive Disorder’. For over a decade, Chrissie has worked closely with individuals living with OCD, as well as providing training to government agencies to enable them to better support people with OCD. In this episode, Chrissie shares her powerful personal journey with OCD starting from age eight, describes how religious scrupulosity and emetophobia shaped her early experienc...

Feb 03, 202527 minEp. 52

Helping someone with a hoarding disorder takes more than throwing away their stuff

Is tough love the right approach for people struggling with hoarding disorders, or is there another way? In this episode, we explain how to recognise hoarding disorder and how it differs from having a collection or even hoarding-themed OCD. We explore how to navigate the intense shame experienced by people with a hoarding disorder or hoarding-themed OCD and how to sensitively and responsibly provide intervention. Resources and links: Celin discussing hoarding on The Conversation Hour on ABC Radi...

Jan 06, 202524 minEp. 51

How to support mothers with mental health difficulties

This is the final part of our two-part chat with Emily Crawford. In the last episode, Emily highlighted the importance of building supportive networks for mothers and the challenges mothers experience before and after birth. In this episode, Emily discusses how to support mothers with mental health difficulties throughout pregnancy and after birth and how to provide interventions to mothers who are struggling. Resources and links: Nest Psychology website Webinars, books, and training by Melbourn...

Dec 02, 202422 minEp. 50

Why strong support networks are vital for mothers throughout and after pregnancy

Returning guest Emily Crawford is the Principal Psychologist at Nest Psychology and has more than 20 years of experience as an Educational and Developmental Psychologist supporting adults, children, adolescents, and their families with various mental health issues (including OCD). She is also a 'Tuning in to Kids' facilitator and a mother of four. In this episode, Emily discusses the postnatal period for mothers and opens up about her experiences after childbirth. She explores the challenges mot...

Nov 04, 202426 minEp. 49

Tackling ambivalence with commitment, creativity, and curiosity

We’re continuing our discussion about ambivalence. Ambivalence is when a client feels conflicted about treatment, either consciously or subconsciously, and can throw up stopping blocks in treatment. In the last episode, we looked at how to spot ambivalence and tackle it when you see it. In this episode, we discuss the importance of motivational interviewing in exploring patient emotions and understanding how OCD plays into a patient’s identity. We also examine the role of patience and adaptabili...

Sep 30, 202420 minEp. 48

Identifying ambivalence and how to tackle it

What happens when a client wants to change but doesn’t know where to start, doesn’t want to do the work, or is in some other way conflicted? Ambivalence. Ambivalence is normal during therapy but can hinder a client’s progress if left unaddressed. In this episode, we discuss some telltale signs of ambivalence in clients, understanding where ambivalence comes from, and how to work through it when it happens. Resources and links: Webinars, books, and training by Melbourne Wellbeing Group Connect: h...

Sep 02, 202422 minEp. 47

The crucial role of parents in treating anxiety and OCD in children

This episode is the final part of our two-part chat with Natasha Daniels. Natasha is a Therapist specialising in anxiety and OCD in children and created AT Parenting Survival to help the parents of children living with anxiety and OCD. In our last episode, Natasha shared how she got into working with children, how to adapt ERP for young people, and the importance of rapport, fun, and play in therapy. In this episode, Natasha opens up about why she loves working with the parents of children with ...

Aug 05, 202425 minEp. 46

Building rapport and having fun is crucial for treating children with OCD and anxiety

Natasha Daniels is a Therapist specialising in anxiety and OCD in children. Natasha is the creator of the AT Parenting Survival website to provide parents with advice for helping their children living with anxiety and OCD. Natasha has drawn on two decades of experience to create a YouTube channel and a podcast and has also written several books. In this episode, Natasha reveals what drew her to working with children and teens with anxiety and OCD, as well as their parents. She discusses how to a...

Jul 01, 202429 minEp. 45

Perfectly imperfect: Spotting perfectionism in OCD treatment and how to address it

Perfectionism. It’s a complicated trait that shows up a lot when working with OCD. It can present in a range of ways and can look like self-loathing, anger, people-pleasing, or even a strong sense of doubt and uncertainty in clients. In this skills episode, we dig into how perfectionism can manifest in a client, how it might present in a session, and how to address it when it does. Connect: https://www.melbournewellbeinggroup.com.au/ http://www.drcelingelgec.com.au/ This show is produced in coll...

Jun 03, 202425 minEp. 44

How to find the right balance in discomfort during ERP

This is the final part of our chat with Associate Professor of Psychology and convenor of the clinical psychology program at the University of Melbourne, Dr Brett Deacon. In our previous conversations with Brett, he explained safety behaviours, accommodation behaviours from family and clinicians, and how accommodating behaviours that reduce discomfort can limit the efficacy of treatment for clients with OCD. In this episode, Brett expands on how clinicians can balance moving too quickly or too s...

May 06, 202425 minEp. 43

Unlocking flexibility in OCD therapy

George Habib is a Clinical Psychologist and Associate Director of Wellbeing Services at the University of Melbourne. Alongside this role, he's been working in his own clinical practice for over 25 years. His work, deeply rooted in trauma support and symptom interpretation, has shaped his leadership in health services and legal aid. In this episode, George tackles the clinician’s role in structured OCD treatment, highlighting the necessity of addressing deep-seated triggers. You’ll discover how a...

Apr 01, 202430 minEp. 42

The impacts of accommodating safety behaviours on OCD treatment

In our last episode, Associate Professor of Psychology and convenor of the clinical psychology program at the University of Melbourne, Dr Brett Deacon, explained the concept of safety behaviours and how to manage them in OCD treatment. In this episode, Brett dives into the data behind safety behaviours and accommodations. He expands on how making more accommodations can impact treatment and how clinician accommodations can be as limiting as parental or familial accommodations. Resources and link...

Mar 04, 202420 minEp. 41

How to manage safety behaviours during exposure therapy

Dr Brett Deacon is an Associate Professor of Psychology and convenor of the clinical psychology program at the University of Melbourne. Brett has worked in the field of psychology for over 15 years with a focus on exposure therapy for anxiety and OCD. He has published many papers on therapist barriers to exposure therapy and strategies for overcoming them and is a co-author of ‘Exposure Therapy for Anxiety: Principles and Practice’. Throughout the next three episodes, Brett explores the role of ...

Feb 05, 202424 minEp. 40

Getting unstuck: How to address guilt and shame and move forward

Guilt and shame are a normal part of the human experience. Where it can become a problem is when clients are unable to overcome, or even identify, guilt and shame they may be feeling which can lead to a “stuckness” in treatment that can be frustrating and upsetting. In this skills episode, we’ll explain the difference between guilt and shame, discuss telltale signs to look for in clients, and how to address these emotions if they are impacting treatment. Connect: https://www.melbournewellbeinggr...

Jan 01, 202426 minEp. 39

How genetic counselling can impact patient care

Joanne Isbister is a Certified Genetic Counsellor at the Royal Melbourne Hospital. Jo has over 15 years of experience as a genetic counsellor and has clinical experience in perinatal, paediatric, and adult genetics. After Identifying a gap in local services, Jo is developing a clinical service at the RMH to provide equitable access to psychiatric genetic medicine for those in need. In today’s episode, Jo will explain what genetic counselling is and how it helps patients. She talks about the comp...

Dec 04, 202329 minEp. 38

"The Joy Thief": A practical, personal guide to navigating OCD

Penny Moodie is a Co-founder of So OCD and the Author of "The Joy Thief". Penny is a passionate OCD advocate and her book, “The Joy Thief” is a deeply personal exploration of OCD along with practical advice from mental health professionals. In this episode, Penny describes the experience of writing "The Joy Thief", the effect it had on her own OCD, and the things she learnt along the way. She also shares her hopes and wishes for others with OCD who want to reclaim their happiness from their cond...

Nov 06, 202327 minEp. 37

When does psychoeducation become reassurance?

One of the main roles of a clinician is to provide as much knowledge as possible when supporting clients in treatment. But when does knowledge and education, or psychoeducation as it's known, become a reassurance trap when treating OCD? In this skills episode, we'll explore how to detect if psychoeducation is bordering on reassurance, and how to navigate that with your client. We'll also discuss the importance of transparent conversations, how sometimes providing a little bit of reassurance is a...

Oct 02, 202325 minEp. 36

Using deep brain stimulation for treatment-resistant OCD

Dr Luca Cocchi is a Group Leader and Associate Professor at QIMR Berghofer, who is currently working on ways to improve TMS for its usage in OCD treatment. Dr Philip Mosley is a Psychiatrist and Clinician-Scientist at QIMR Berghofer, where he is currently researching DBS for treatment-refractory OCD. In this episode, Phillip explains deep brain stimulation (or DBS) and how it's being used to treat severe and treatment-resistant OCD. Phillip and Luca also discuss the outcomes of recent clinical t...

Sep 04, 202324 minEp. 35

The neuroscience behind OCD

Dr Luca Cocchi is a Group Leader and Associate Professor at QIMR Berghofer, where he is currently working on ways to improve TMS for its usage in OCD treatment. Dr Philip Mosley is a Psychiatrist and Clinician-Scientist at QIMR Berghofer, who is currently researching DBS for treatment-refractory OCD. In this episode, Luca and Phillip explain the neuroscience behind OCD, as well as what treatment-resistant OCD means and why it happens. Plus, Luca breaks down the exciting possibilities of transcra...

Jul 31, 202330 minEp. 34

How to implement mindfulness in ERP

Welcome back to another skills episode! Today, we're covering something you may have heard mentioned a few times in our previous episodes: meditation. Mindfulness-based strategies can be incredibly useful for clients and clinicians alike, and there are many ways they can be helpful when integrated with ERP. In this episode, we'll explain why mindfulness is so important, and share how you can best teach it to your clients. You'll also hear us discuss why it's important for all of us to learn to f...

Jul 10, 202331 minEp. 33

Navigating nerves as an early-career psychologist

Hannah Gersh is a Psychologist and Clinical Registrar at the Melbourne Wellbeing Group. As an early-career psychologist, Hannah understands how nerve-wracking it can be to start in the industry, and is here to share her experiences to help ease the nerves of any other early-career psychologist. In this episode, Hannah shares how she found her way into working with OCD, as well as how she deals with nerves and feelings of inadequacy. She'll explain what she's found most useful for her development...

Jun 26, 202332 minEp. 32

Creating ERP tasks for Pure O and POCD

Welcome back to our deep dive into creating ERP tasks, where we're continuing to explore the ways you can get creative in treatment, regardless of the presentation or the subtype. In this episode, we're exploring different ways to create ERP tasks in the context of pure OCD, and paedophilic OCD. We'll share the ways to help your clients interrupt mental compulsions, as well as how to create safe and appropriate tasks for managing paedophilic intrusive thoughts. Plus, we'll share how you can take...

Jun 12, 202322 minEp. 31
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