Compulsive Disorders and Behaviors
The Compulsive Behaviors Program at River Oaks Hospital offers mental health services for a variety of dysfunctional and/or destructive behaviors including sexual compulsion/addiction, paraphilias, addictive relationships, kleptomania, compulsive spending, embezzlement, gambling and self-injury.
Many clients co-present with related issues such as substance abuse, eating disorders, depression and interpersonal difficulties. Treatment is based on systemic, cognitive-behavioral and psychodynamic approaches. The model supports the belief that compulsions come from an identifiable source (i.e. family dysfunction and/or trauma), operate in a predictable pattern, and can be alleviated through a process of recovery.
Compulsive Behaviors: Symptoms
Compulsive disorders can serve an idiosyncratic function in a person’s life by filling a void, becoming a means of escape from stress, creating an illusion of power and control, and/or providing relief from difficult aspects of life. Some common features of compulsive behaviors include the following:
- A sense of powerlessness
- Use of distorted thinking (i.e. denial, rationalization and minimization)
- Impaired relationships with other adults (fear of intimacy)
- A faulty, impaired sense of self
- Leading a double life and feeling like an impostor
- Continued acting out despite consequences and repeated attempts at control
- Escalating behaviors involving increased risk
- Time mismanagement and faulty resource allocation
A highly nurturing milieu creates a safe environment in which individuals can acknowledge destructive behaviors with full ownership while exploring influences from the past. Patients are protected from daily stressors and responsibilities in order to focus attention on the healing process. The clinical staff provides both the necessary support and confrontation to challenge each patient to maximize their healing potential. Patients learn to identify, modify and control behavior patterns that have negatively ruled their lives.
Compulsive Behaviors: Healing Process
Internationally recognized, the River Oaks Compulsive Behaviors Program provides an integration of treatment methods identifying factors that influence or impact the patient’s acting out while replacing compulsive behavior with non-addictive adaptive coping responses. Behavioral reconditioning, relapse prevention planning and twelve step approaches are utilized to maintain control over destructive behavioral patterns. Treatment is individualized to meet the specific needs of the identified patient and may include:
- Ownership of the compulsive behavior
- Breaking the denial (facts, awareness, responsibility, impact)
- Accepting responsibility for the impact on self/others
- Affect regulation of healthy expression of mad, glad, scared, sad
- Shame reduction
- Identification of acting out cycles and interventive strategies
- Behavioral reconditioning
- Relapse prevention planning
- Resolving issues related to family of origin and learning healthy intimacy skills
- Identifying and resolving trauma issues
- Developing a balanced plan for living with new life skills
Compulsive Behaviors: 12-Step Work
12-Step Groups are offered on campus and attendance is encouraged. 12-step work is integrated into compulsive behaviors group. Additional addictions work is available on the Dual Diagnosis Unit.
Compulsive Behaviors & Trauma-Based Disorders: Treatment Components
An individualized mental health treatment program is developed with input from the patient, referring professionals and the River Oaks treatment team. Through multidisciplinary team interaction (psychiatrists, psychologists, social workers, licensed professional counselors and nursing personnel), the goal of providing numerous perspectives is achieved.
Individual therapy provides the opportunity for information reprocessing, identifying and challenging distorted thinking, developing a positive set of core beliefs, ego strengthening, stress management, regressive-reconstructive healing, anger management, trauma resolution and behavioral reconditioning. Individual treatment occurs five times weekly and addresses cognition, affect and behavior through support and confrontation. EMDR trained therapists are available.
Group therapy provides opportunities to create a positive self image, develop social skills, provide education, challenge distorted thinking, provide support for behavioral reconditioning, and process trauma.
Trauma Resolution Group meets four times weekly where patients explore the impact of trauma, identify losses, address grief resolution, challenge cognitive errors, address victim to victimizer concepts, and develop post trauma positive schemas.
Compulsive Behaviors Group meets four times weekly to process the patient’s acting out timeline, identify and challenge distortions and potential grooming behaviors, focus on powerlessness and unmanageability, and explore healthy alternative behaviors.
Relapse Prevention Group meets six times weekly to develop a plan that includes identifying triggers, high-risk situations, lapses, apparently irrelevant decisions, adaptive coping responses (non-addictive), balanced living, plans for aftercare, boundaries, and positive accomplishments.
Behavioral Reconditioning Group meets twice weekly to focus on identifying and understanding the cycle of acting out behavior. Specific treatment techniques are prescribed for individualized treatment which could include covert sensitization, ammonia aversion, satiation techniques and imaginable desensitization.
Sexual Healing Group meets twice weekly to address relationship interfering behaviors, the fear of intimacy cycle, and ingredients for intimacy with healthy sexuality.
Dialectical Behavior Therapy Group meets twice weekly to enhance interpersonal skills and to address life, therapy and relationship-interfering behaviors.
Spiritual Integration Group meets weekly to address issues of spirituality. This group identifies spiritual interfering beliefs and behaviors with a focus on healthy challenges and choices.
Specialty Groups are available to address substance abuse and eating disorders.
Didactic Expressive Modules focus on such issues as pacing and containment, ego states, balanced living, interpersonal effectiveness, mindfulness, inner child healing, healthy versus dysfunctional families, and grief resolution.
Expressive Therapies are an essential component of patient care. Activities are structured specifically to address the unique needs of the compulsive behavior and trauma patients involving art, movement, music, psychodrama, and recreational therapies. Expressive therapies are part of daily treatment.