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Hi, everyone. Dr. Patrick McGrath, Chief Clinical Officer for NOCD. If you're looking for help for OCD or related conditions, check us out@nocd.com that's n o c d dot com. We work with all sorts of insurances and we do work in Australia, Canada, the UK and right here in the US of A, too. We'd be happy to meet with you to help you deal with what we know is an overwhelming experience of OCD and related disorders because we want to help you live the life that you want to live and not the life that OCD wants you to live. Today's episode is about why some therapists really thrive in this work. And I'm passing the mic back to Barbara and Alexi, who are going to share their firsthand experience from the learning curve of starting out to what really helps clinicians stay engaged and grow long term. If you're trying to figure out whether this kind of role aligns with your strengths and your career goals, this conversation is for you. So, Barbara and Alexi, take it away.
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A
Hi, Alexi. Good to see you again.
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C
Hi, Barbara. How's it going?
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Good, good. I'm excited to talk about some of the stuff we have going on today. So last time we kind of approached a little bit about how therapists thrive here. What kind of therapists would be good at nocd? So I just want to start off with that and kind of get your initial take.
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C
Yeah, totally. Yeah. I think today we're going to dive more into like retention, you know, what kind of background or professional work that we've done before. It really translates well at working at ocd. And I'm trying to recall, I remember you were saying you were working like in prisons or probationary places.
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I work a lot of different things, so I've worked with sex offenders. I've worked with substance use. I've also worked private practice, so also couples, so a couple different things. Churches. I've done quite a bit of things there.
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C
Wow, that's wild. I guess. How, how has that helped you stay stay as long as we have it at NOCD? Because I think we, we started off with over 20 people. Did we even have like 30 people in our cohort?
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We had a lot and we were in the same cohort and there's not that many of us left. I think we were looking at it and it's maybe 25% from our specific. I think for me, having the background and all the different variety of things allowed me to kind of get a good understanding of how to stay with things when they're hard, kind of keep at things. And also I think also the biggest difference for me was noticing how doing ERP is so different. It's structured, it has a purpose and that's very different than kind of the other short term therapy I was doing with solution focused and things like that. But having that difference there really allowed me to dive into how to stay focused with ERP and make it interesting and keep it going and keep working with the member as they get better. What about you?
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C
Yeah, definitely, I will say, you know, what have I done? Let's see, I've done some residential, some iop, php, community mental health and within the community mental health, you had some substance use. I wouldn't say I worked at a substance use like facility, but I know when it comes with working with like the homeless population or just rehoused population, it comes with a number of like mental health and substance use concerns. And I think overall like summarizing those experiences. I definitely agree. I think especially like with residential PHP and IOP in the state of California, it's so expensive, I can't call for or talk on what it's like in other, other states. But I think because of how pricey it is, insurance, not necessarily always being open to covering it, a lot of our members or members wouldn't be able to receive treatment. And I think the fact that we can still provide specialty care is so helpful. Right. For those who can't access that. But I think just the experiences themselves though, being in those other forms of specialty care, we're working with really high acuity, high risk patients or members, clients, I'm getting all of them mixed up. But yeah, working in those different communities, I mean I, they were, they were kind of challenging, you know, and I think not, not to say therapy itself was challenging, but I think working with members whose wherewithal wasn't really there, the high risk, really just focusing on building that core foundation. I think just having learned patience, having learned those specific tools and addressing just high risk, high acuity, absolutely translated. And being able to work with individuals who might not need necessarily that foundational tool but take that next step and actually addressing the core situations where it's like no, the anxiety, the OCD is getting in the way, we can actually do that work and ERP is able to really let us facilitate that. Whereas I'm trying to remember there's so many, there's so many stories. I'm trying to think of one that might, might like be a good example. What I think back to, like when I was sitting in an actual therapy room with some of my clients of higher risk, you know, one of them one day just picked up a. Not a lamp, but maybe like a candle that was in the room and threw it across the wall because they didn't have any self regulation. And so the fact that, like, if I could survive that, I think I
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could survive remote work and working through erp Absolutely. I think another big change is motivation and also the length of time we get to see people, to actually see them get better.
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Yeah.
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So I know before a lot of my populations that I worked with, they wanted to get better, but their motivation to actually do the hard work wasn't always there. Whereas I've noticed here at nocd, because we're a specialized treatment, by the time people get to us, they tend to be very motivated to put in whatever work necessary to get better.
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Yeah.
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And because we have those tools and ERP really works, we're able to actually see them get better in a timely fashion. It's really great to see people actually be able to reach those treatment goals, whereas before populations, you know, you wouldn't ever know how somebody's life's going to turn out in two or three years from then because those goals that we had were so big. So this is a big change for me to be able to see that motivation constantly and work with those members to get better. And then I feel really great when I get to see people get better every day. Like, all week I've been moving members down in treatment because they're doing better, they need less treatment. And that is so motivating for me as the clinician.
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C
Yeah, no, I. I like that point. Right. That of the members being so motivated coming in. It. It definitely is a different change of pace. And I think there's a part of me that feels like, you know, I needed to experience members who weren't as motivated because I could definitely see a world in which someone might maybe get. Take that for granted or. Cause it's. Yeah. Working with members who are. Who might, again, like, might have schizophrenia and really are not mentally there.
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Right.
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Like, they're trying so hard to connect, but there's something. Right. Getting in the way. And it's not. And it's. And it's hard to, like, fight. Right. With that other. Other side of them. Or, you know, working with personality disorders, there's a version of them being like, well, I just don't want to be here. I'm like, okay, well, I do. So, you know, how do. How do we work with that and constantly. Right. Challenging motivation. And so I definitely agree that, you know, having worked with that population moving over here, where I want to say every member I come in is constantly telling me, like, I want to get better. I just want to be able to reclaim my life. And I. I definitely can roll with that. I. I mean, I don't want to speak for all therapists, but I know, I'm sure, at least for myself, there's a sense of, like, the energy that a member brings in. I thrive off of that. So if they're feeling excited, I'm feeling excited too. And so it's hard not to, you know, roll with that feeling. And so it feels good just even having that connection kind of moving forward with working at NOCD and our members.
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Absolutely. I think that's a great point. And I also. While you were talking, I was thinking about how having the background we do and the clinical skills we do for seeing all those different personality disorders or schizophrenia or any of those things that sometimes clinicians don't always have the most experience working with, when we come in with those skills, we're very confident in our diagnosing and what things actually look like. Yeah, I find that makes a big difference treating here at nocd because, you know, right off the bat, we're going to be looking at what. What do we need to rule out and what do we need to rule in that way we can treat appropriately. So being able to have that background of like, I know what schizophrenia actually looks like versus this fear of what have schizophrenia. Right. So the obsession of it, that idea of being able to see both clinically is. Has made a big difference. Same thing.
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Right.
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I've treated sex offenders. Yeah. We have so many people that come in with what if? Thoughts of, well, what if I am that person? Well, I've really seen it. So it makes it a lot easier for me clinically to be able to know what's what and feel confident treating the member. And, and I feel that that confidence is. Often they tell me back that they feel better in treatment because they can tell I'm confident treating them. And I think that component also helps our members get better quicker.
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No, you make such a great point. And I'm so glad you brought that up. Cause that, that's so true.
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Like the light bulb even went off
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in my mind of like.
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Oh, yeah, we.
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We have seen that, like legitimately. We've seen what that diagnostic looks like. And, um. No, it is interesting. I know many therapists look at kind of different themes that you're working with. And right now I, so far I have a good number of members where their theme is specifically like, going manic or going crazy, as they might say. And there's a part of me that's like, that sounds like OCD a lot more because I. A manic person doesn't know that they're going manic or like, they're not questioning if they're manic. They're just doing the thing. And I think you're totally right. Being able to have firsthand at least see this and work with members who have had those diagnoses versus, you know, what men might report within, like, the OCD scope definitely helps us identify or differentiate. And I think also along with being able to better treat them, I think just better empathize because I, I've there, I have so many members who have felt a sense of, I don't know, shame, guilt, because other. Other providers would misdiagnose it. And, and so I think the fact that we can also provide that insight from our previous jobs helps helps them feel more better connected with themselves.
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I agree. And I, I want to make another point here because we have that background which I think has really helped us, but not everybody's going to come in with that background. And I don't think that's an automatic rule out for a therapist being able to do well here. I think another component here is the willingness to learn. So we have lots of consult groups where you can learn from therapists that are leading those groups. You can learn from therapists that are joining those groups. You can reach out to anyone on your team that, you know, has an experience in a certain thing. I know for me, I, I've talked to a couple other clinicians who have, like, asked questions about, well, what does schizophrenia actually look like and what does this really look like and being able to have that connection. So if we're willing to learn, someone is going to thrive here as a clinician as well.
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Yeah, no, I totally agree. I, Yeah, I want to, I want to say, right, you're, you're totally right. Not everyone's going to have that specific experience. But I think something that, or a skill that transferred most for me is just being able to just learn or try. Right? Like, no one is one size fit. All right? Even different diagnostics look very different. And I think just having that space and openness to learn and then jump into the consult groups and being able to ask questions definitely is going to help, you know, helps me stay engaged for sure. Because I know, I've, I want to say I mentioned this, I think in the first podcast where like I had a bunch of emetophobia fears, right. And every one of them was so different, even though the theme itself were the same. And so I think being able to get that support on, like, how can I help provide, you know, what's more targeted for each of these members, even though the themes are the same through those console groups and through, through the Slack channel?
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Yeah, you know, I had a question for you. I was wondering if you could touch on what it was like to initially come in to NOCD knowing you didn't have a background specifically in OCD and how to learn that specialized treatment.
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C
Yeah, I, I, well, I guess during the whole interview process I knew I didn't have the specific training. I actually, it's funny trying to. Long story short, when I first started out as a therapist, my supervisor even told me, he's like, you're such an anxious person. Like, you know, anxiety sometimes just doesn't need a solution. And a part of me is like, I need a solution, solution. I always need a solution, right? I need something. And it's, it feels ironic that I, you know, got connected into, you know, working with OCD and anxiety related disorders and being able to have the company train us. Like, and I won't say, and I'm not saying it's like a one day, four hour training that you might get off of, you know, a, I don't know, one of those websites that, right. For CES, like it's a whole 16 week, you know, intensive training where you get to learn all about ERP. I think. What was the number that Dr. McGrath said? Is it like 10% of providers now here get actual like specialized training for oc, whereas you know, it everywhere else. You don't get that. And so I think the fact that we're able to, you know, be, get something of that echelon of training is really cool because I, I do feel like I have the knowledge now to help, help more individuals and help them be seen. And so, so as I tangent coming back, I, yeah, you don't have to come in with this training because they're going to train you anyways and to the end the way that is actually going to work because I know in grad programs they talk about like, oh yeah, use cbt, but of what extent, you know, sometimes even CBT might not be as effective because a part of what we talk about is embracing those thoughts, not changing them. Right? That's our cognitive TRIAD model there. Knowing that we're going to get trained definitely helped ease my worries of coming in. I also just felt really open to learn, though. Like, I think I've always had this mentality, like having a student. Right. Student mentality and not coming in thinking like, I know everything, because I don't. And I know OC smacks back that every day too, because there was always going to be something different with my members. We're like, oh, yeah, we did really
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well with this one theme, but we're
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jumping onto another one. And so I think just being able to go with the flow has helped me stay engaged and really find the importance of how, you know, effective the ERP and OCD trainings has been because, you know, of that openness and staying with it. I feel like I lost a question. We're going back to you, Barbara. I'm going on.
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You're doing great. No, I was kind of really touching on that point of that willingness to learn when we jumped into not knowing what ERP was, not having that specialized training. And you're totally right that the universities and other trainings don't really dive into erp, which is why it hadn't been as widely available to people to get better. So what I love about the training here is we do really dive into it. We practice it as if we're in grad school. That's what it feels like. It feels like a grad school class where we are practicing with other people, we are getting help from our professors, we are doing all the things that we need to do to really dive into what ERP is before we ever see a member. So that training part I found to be really key because I felt like no matter what, I was walking away with something phenomenal. To be able to understand and know how to treat something I didn't previously know how to treat felt great. And then when I started implementing it, to be able to then see how members got better, that was like what I thrived off of and what I continue to thrive off of now. And I think it's another important aspect that we are constantly learning. There's no price stop point at nocbe where clinicians, oh, you've learned it all. We're learning all the time. Whether it is we're learning more about ERP or response prevention, or how to apply this specific exposure to that trigger for that member, or maybe we're learning about HRT for excoriation, or maybe we're going to get into some PTSD treatment or how to treat Depression, we're learning all these different things. So, yes, our main focus is going to be ocd, but we treat a variety of other things, and so we learn those as well, which is really, really cool. I. I think. What do you kind of think about the other options of what we're treating here at nocd?
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C
Yeah, I. The fact that we have the ability to do an array of things outside of OCD definitely helped me stay more engaged, too, because there was. There was a few, I'll admit, like, you know, going into specialty care reminded me back of. Back when I was working at another one where it's like, okay, it's just going to be that. It's like, okay, I. I think I could wrap my head around it. But then as we went through the training, and I don't know if they, like, explicitly shared this in the interview process, but when we. When I looked through the different things that we'd be learning, there's like behavioral activation and habit reversal training. And I was like, oh, I haven't had training specifically for BFRBs. And that's something I actually really resonate with. And so I thought that was really cool. And then depression. Working with, like, depression and related disorders for behavioral activation was also another component where. Okay, that's. That's nice. Very well have some kind of breaks in between the OCD part, but I know that they're both kind of comorbid. And so it might not be like, cut and dry where we have one member, just this, this, and this. But it's like, with one member, one session we're working with OCD, then the next session we're working on depression or one session OC, one session VFRBs. And so I think sometimes knowing that some members will come in with those comorbidities help break up that monotony too. But I mean, I think just generally speaking, a lot of these tools really focuses on exposure. Exposure work, right. Behavioral activation is a type of exposure. We're simply activating the member to do the things that they aren't doing. The BFRBs, right. Exposure to let that really, like, itchy you. You want to scratch that itch kind of thing. Be present without actually, you know, engaging in the. The behavior. And so I feel like, really, like, common themes that really help therapists stay engaged is just, are you passionate about exposure therapy? And I will say for myself, I love it. I think I actually talked about this with a. With another member the other day where they asked me about, like, yeah, exposure to therapy is not a new concept. But I think the fact that nursity really just hones in on it and does such a great job in teaching their therapists on how to do them effectively because, you know, they could, they
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can, people can do them wrong.
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But how to do them effectively has shown so much more grip, growth and getting back to people's lives that it's, it's really cool to see how quickly that form of therapy works. And I think a part of me is like, yeah, that's why I love it so much. And I think actually just today we have like our little Fun Friday polls. It's like, what's your OCD therapist power? And I think for me, mine was being able to find exposure in anything. So if someone, if a member says, like, yeah, I've been really not liking such and such, and I'm like, hmm, time to do an exposure, I'm bad. They're like, no, I shouldn't say these things. And I'm like, no, but you should, because that's what's going to help us grow. But what about you? What are some things that help you stay engaged?
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I love how creative it is and how active ERP can be if you choose to. And we've noticed Also the more NVivo exposures we do, the better that members get. So sometimes we'll start with like the imaginal scripts and things like that to help people get used to it, the concept. But then when I move into the NVivo exposures, I might be, you know, taking my computer with me around the house to go to the stove to work on stove related stuff with a member. I might have a member with social anxiety who doesn't want to eat on camera. We're going to go ahead and eat a snack together. It's like, you can be so creative with all these different things with emetophobia, the fear of, you know, vomit and throwing up. We're going to mix up oatmeal and go to the toilet. Or maybe I'm going to have my member go take a walk around the neighborhood and do an exposure. Like how creative we can get. I find to be so fun because it not only engages my creativity, but I involve the member in that. And then they feel like they're the one picking out their exposures. They're the one that's deciding what they want to do. And I find that to be very empowering for them. So then they're more motivated to now do that exposure itself. And so we constantly keep it going. And then sometimes I'll Use one idea, I'll be like, okay, that one might actually work for this other member too. And I'll even get surprised sometimes when it doesn't. And I'm like, oh, wow, I really thought that was gonna trigger the member. And it didn't. And that tells me, hey, we need to deep dive more into this feared outcome. And then once we do that, I'm able to kind of open up a whole other world of exposures so that I find to be really engaging and fun.
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C
That's awesome. Yeah, I, I love the creativity aspect and it, it makes therapy. I, I don't know, maybe, maybe this
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is, this doesn't work for some therapists,
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but I love how fun it is to try to think of these creative things, because I think just yesterday one of our exposures as a member was reading off a script using silly voices to t. To target social anxiety. And so we just, you know, we pulled up a movie script and I was like, all right, I'm gonna have you practice doing, like, serious dad voice while I have a high pitched little girl voice. And, you know, we're gonna sit with that discomfort. And, you know, it's funny, the fear wasn't even of doing the voice itself was the fear of their parents listening. Oh, okay. We got an unplanned, you know, kind of complex exposure. Let's, let's keep going, you know, And I think it's cool that even through this process of what might seem very strange or odd is so meaningful because they, you know, the members start to kind of figure out too, like, oh, that's what I'm feeling afraid of. I totally thought it was this, but then I'm noticing these other aspects that are coming in which can help, you know, add to the core fear that we start to, you know, work through. So very cool. Especially with the creativity. I think I've had a member ask me, yeah, what does your Google browser look like?
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And I'm like, we're not going to talk about that.
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But I know it's going to be fun to do like a. Oh, my gosh. You know how Spotify does your annual yearly. I feel like no CD should have
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like a little Google.
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Like, what did you look up yearly list of things. So funny.
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Yep. I know. I always, I always tell the members, like, yeah, if you're going to prison, I'm going to prison, because you wouldn't imagine the amount of things I have to look up on a daily basis. But on like, that note of creative exposures, even going into some of the like social anxiety stuff. The amount of restaurants and ice cream shops we've called, whether we're asking about the actual ice cream or asking about something completely unrelated maybe, and doing those different things to engage with the members or the poems that occurred for members because they were so socially anxious to share it, or music that they made. Oh, I love that. I feel like I get to see a whole other side of them. And then in the weeks to come after that exposure, they're sharing it with their friends, their family, they're going to poetry slams, or they're doing other things. But I think really just that gives me like a breath of fresh air to be like, wow, you really got to lean into the thing that you really enjoy out of life, but you were just too nervous and scared to beforehand. So getting to do that and see that I find to be so rewarding as a therapist here. So I wanted to just touch on that and then I know we've kind of looked at a lot of different things today so far, but what advice would you give to new therapists joining the team? Yeah.
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C
Oh, let's see, what would I say? My gosh, you have so many great questions and I'm always caught off guard when you asked because a part of me, right. Just wants to say, like, you'll love it, but I know that, you know, that's just my opinion. I would say for new therapists coming in, just have an open mind, tapping into your own fears. I think as good, right, as good as we are kind of stuffing out members fears, it goes both ways, you know, and I, I, they can tell when I'm feeling anxious or they can tell when I'm feeling a little on edge. And I think part of leaning into that fear as an exposure itself can really help, help you stay engaged and stay involved. Because it's knowing, like, it's not a mark on like your ability to do therapy. I think it's just being able to connect in, in this community. Because I will admit I, and I admit this to members all the time too. I think the other day we were doing spider exposures and I, I, I think as you were talking, like, I felt myself kind of shudder and so I would share that experience with them of like, yeah, I'm, I'm feeling a little nervous too with you, like, how are you feeling and being able to connect well. Whereas I know in other modalities or other places they might say like, oh, don't, don't share anything. Right. Like, be very kind of stoic with the therapy session. Whereas I think there is a little bit more of kind of empathizing and being honest. Like. Yeah, I feel that way too. And so I think some people coming in thinking it's going to be more the first or the, the former versus the latter, being open to knowing, like it's probably going to be the latter. Right. We're going to probably have a little bit more of that of yourself being like in, in these sessions and letting them know, because that's, that's, I think, very helpful in normalizing their experiences and know that they're not alone. And I think just that connection piece. Yeah, I think that's kind of my, my overall kind of theme of just openness and feeling willing to, to share, share parts of you. But I guess what, what do you think for kind of new incoming clinicians?
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A
I would say for new clinicians here, if you are willing to be direct, honest with our members, if you are willing to learn and want to learn, and if you put effort into getting to know other clinicians and ask questions and get experiences, you're going to get that back. So I highly recommend any new therapist coming in, reach out to your cohort, reach out to your team, put a little slack message in there and say like, hey, I, I'm wanting to hear about your experience with this or that because there's a whole wide variety of us clinicians at home that want to and are willing to connect because we love what we do, we love seeing members get better, and we just, we want someone to throw that line out so that we can, you know, reach back out to them. So if we're kind of those things, honest and direct and ready to be held accountable, willing to learn and open to engaging with other people, even virtually as well as in person, because sometimes we do some in person stuff, then you're going to do great here at NOCD and you're going to really thrive in that creative environment of learning new things and trying out new ideas.
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C
Yeah, no, absolutely. Thank you for, for reminding me that. Yeah, you're. Even though you're working from home and it feels alone, you're really not alone because there's going to be people in your state in your area. And I know Barbara and, and other colleagues have met up in person, which was really fun. But even online, like my, my comm has like a cozy corner where I'll just open up her zoom room and we'll just get to hang out. And it doesn't have to be about therapeutic things, it can just be about fun. Hobbies that we do. And sometimes it's nice to not just always talk to your com about clinical stuff.
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Right.
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It's nice to have that little bit of a break. There's really awesome opportunities to connect here as well that aren't therapy related. I think there's. I don't know if it's like Family Feud, but I know they have like game nights, trivia nights. They have the book club. Yeah.
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We have exercise.
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C
Oh, that's right. Yeah.
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And that's like 15 minutes, 20 minutes. And you're gonna just pop in and do whatever you can. And I like the components that they do there where you could be on camera, off camera, wearing your work clothes, wearing other stuff, whatever you need to do in that moment of break you have. Right.
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C
Yeah, there's, I will say, kind of leaning back into the. The clinical side of things. It's hard to, you know, out of your day while you're doing notes and such. It's hard to make time. But when, like, when you do and you find the one, especially a group that like, you really enjoy, like the console groups that you enjoy, it's nice to feel seen, I think, sometimes. Right. Again, like this sense of I'm on my own. Right. I feel stressed out because, you know, I don't have anyone that I can quickly talk to. But there's. Oh, my goodness. How many. How many console groups are there? Like 20. I can't count, but there's at least. At least eight, five to eight a day throughout the whole week that you can just hop in on. And I was definitely having a sense of like, ah, this that I have a member that's pretty avoidant. I'm, you know, doing that jumps look, a gentle confrontation. And I hop into the group and you're like. I hear everyone else saying how their members are avoided. I'm like, I'm not alone. Okay. How. How can I learn? And so it's really cool to be able to connect in that way as well and help. Help me learn some ideas as others do. Similar experiences. But yeah, I think the biggest engagement activity or fun cool thing that we've done was going to nola. I. That was the first work trip I've ever been on. And it was just such a cool opportunity to really connect. And I think we talked about this before, right. Where it's like on our first podcast where it's like, just because we're remote, I was anticipating us kind of being like, I don't know, I'm picturing, you
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know, in movies or it's like the
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C
accounting team or the accounting firm. Is that their work trip? And they're all like, hey, Bob.
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Hey, Bob. You know, they're very kind of like,
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but when we arrived, everyone's like, screaming
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and arms are up.
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C
We're like, oh, my gosh, I've seen you at this. You've been in my right. Like, we were so engaged, even though we were, like, thousands of miles apart. And I think it just helped really tie everything together. Like, no, I'm glad that I stayed. I'm glad that I'm connected doing the work, because everyone else is feeling that same way. And it's just so empowering to be in the same room with others who have that same same vision. But what do you think?
- [33:18]
A
You know, I love that you bring up the NOLA trip, because one thing I really valued about that trip was how it was set up to integrate everyone together. So other clinicians, we got to know the intake specialists, we got to know the member advocates, we got to know people on all sides of no city spectrum. And that made a big difference for me. I got to see the people's personalities and why they do what they do and why they enjoy their job and their role here. And we got to mingle with supervisors. But it felt more like it was just a coworker, more like a friend. And that difference of getting to understand who people are and why they love what they do made a big difference for me and just continued that motivation. Because then when we got back from the trip, I was able to reach out more. Like, hey, remember we went to this thing? Remember we did this thing? How's everything going? And kind of give even some personal life updates and keep in touch at a whole different aspect other than just the clinical aspect.
- [34:16]
C
Right. No, it. It was a really cool trip, but I guess as we're kind of wrapping things up, I think don't want to ever. I guess some things to talk on, touch on, too, along with, you know, the specialty care of, like, European ocd. You do have other opportunities as well here to expand on learning about, like, body disposal, morphic disorder, hoarding, or ptsd. And I finished the. The PTSD training just about a month ago, and it's been really cool being able to now balance or kind of fill up my caseload with OCD and ptsd. And there's often a comorbidity as well of them both kind of being intertwined. But it's. It's been really cool to have, or it's cool to expand on my caseload rather than just always working with ocd. And so that's been a nice little change up. But I think something, you know, for new clinicians know that this is something that you could, you could pursue after, after 16 weeks of training.
- [35:16]
A
Absolutely. I think that is a huge component here is there are other options and the option to only specialize in ocd. So, like, for me, I haven't gone out to those other trainings yet because I'm super into what I'm doing right now. But I could decide at any point to sign up for those trainings. And I feel like the ability to have that flexibility of like, what we want to work on is another key component here. So I'm really glad that you brought that up.
- [35:44]
C
Yeah, it's. It's cool to have room to grow. And I think just even as a company itself, there's a demand like I. And that's something I think I took away from nola, like from where NOCD started to where nocity is now. So many people are wanting this type of treatment and wanting this type of care that, like, how can they not expand on it? And it's cool that that that opens up opportunities for clinicians to then dive right in. I think they also were expanding IOP care. Right. We were an outpatient specialty, but now we're in outpatient IOP specialty care, which is so cool, especially when there's not a lot of higher levels of care for ocd, particularly in person in different states. And so I think that opportunity is a great, great one as well for those who want to dive into that, to that work.
- [36:38]
A
Absolutely. And we're a growing company constantly, so things are going to shift and change all the time. So if you're willing to be flexible and open to new things, there's a whole other world of things you can discover here at nocd. And I find that to be exciting. Every day we come to work and there might be a whole new thing that we can try or do or implement into how we do treatment.
- [37:00]
C
Yeah.
- [37:01]
A
And I find that to be really helpful and enjoyable to kind of keep my learning cap on all the time.
- [37:07]
C
Absolutely. Well, I guess what, what do you think, kind of closing this out. What kind of therapist would love this job?
- [37:16]
A
Great question. I wanted to add kind of to my earlier answer. Somebody who is also willing to incorporate humor. I have found to be a huge component of treatment at ERP to help not only build that connection with the member, but also use it as response prevention to the ocd. And I think any clinician therapist who is willing to do whatever they're telling their member to do. I know for me, I do a lot of the same stuff. Like if, if member has to lick a, a Starbucks cup because of contamination, I'm licking the Starbucks cup with them. So I never want to give an assignment to them. That isn't something that I would be willing to do. And so same thing in using humor and being willing myself to go to consultation groups. That's how I know to encourage members to go to support groups, because I also go to groups that I know
- [38:11]
C
are going to be helpful.
- [38:12]
A
So I, I take that component about it. It's like, be the person who's willing to do the same thing as your member and you'll walk alongside them and really just enjoy that creativity and difference.
- [38:24]
C
Yeah, no, I love that I, I actually tell my members that specifically I'll do these exposures with you. And often, more often than not, they're very surprised. They're like, but why? And I'm like, well, I'm going to practice what I preach.
- [38:37]
A
Right.
- [38:37]
C
I'm not going to give you something I wouldn't do myself. And I definitely agree with the humor and doing them with them. And I've eaten food off the floor, touch of shoes, you know, watch scary movies, you know, find ways to, to talk back to OCD and, but make it, make it in a way that it feels doable and doing it with them. And so absolutely, I think a therapist who would love this job is being able to put themselves in that, through, through all of that. And it's hard. It's definitely hard because, you know, it feels odd or, you know, things might not feel like typical therapy or, you know, I, I would assume people think of it as like that Freudian approach where it's like, I'm gonna sit while you just talk. You know, it definitely feels way more involved, way more engaged. And yeah, definitely don't want anyone looking
- [39:33]
A
at my Google search, but here we are. Here we are.
- [39:40]
C
But yeah, no, I think anyone who is open to learn, willing to try these cool activities and work with the member will definitely love it here. I think also just anyone who's passionate to do therapy will also thrive. I think that is just kind of an overarching advice.
- [40:00]
A
Yeah, absolutely. And I would say anyone who's made it through these three podcasts we've done so far, and everything we've said has interested them or made them more curious about NOCD to reach out, because this is what we're looking for, is getting more people involved, so that way we can help members continue to get better.
- [40:19]
C
Definitely.
- [40:21]
A
Thanks.
- [40:22]
B
If you're someone who enjoys structure, who values collaboration and support, and who finds motivation in seeing clear progress with your members, this is a role where you can really thrive. Barbara and Alexei, thank you both for sharing your experiences and giving such an honest perspective on what it takes to be successful at nocd. And to everyone listening, if you're considering specializing in OCD or related conditions, I encourage you to keep learning, stay curious, and explore whether this path is right for you. Thanks for being here and we'll see you next time.