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The Trustwide OCD/BDD service operates a stepped care model. Its remit is to provide local Trustwide treatment to sufferers of obsessive-compulsive disorder, body dysmorphic disorder and complex anxiety disorders. The treatment offered is patient-centred and collaborative. The treatment options include Cognitive Behavioural Therapy (CBT), medication advice and clinical management of specific disorders. Additionally, treatment will include advice to General Practitioners on physical health monitoring and management of specific issues. Treatment is delivered by appropriately trained staff within an agreed framework. Treatment is underpinned by principles of NICE guidance for OCD and BDD. The team manager for the community service and the Consultant Psychiatrist are responsible for the management of the service. The Service is managed by the Specialist Services Directorate within the Trust. The service is based across the five boroughs on a hub and spoke model. We offer CBT for each of the five boroughs: Wandsworth, Sutton, Merton, Kingston and Richmond.
- Service Type: Specialist Services
- Service Contact: adminocdbdd@swlstg.nhs.uk
- Service Category: Community
- Disabled access: lift access to building and accessible toilets
- Address: National and Trustwide OCD/BDD Service, Morrison Building, Springfield University Hospital, Jupiter Way, London, SW17 0LL
- Reception hours: Monday to Friday 9am to 5pm
- Reception phone number: 02035136961
About our care
We aim to deliver a compassionate and professional service to our patients at all times. Following the acceptance of the referral, we will offer an assessment which will include completion of some self report measures. The recommendations are made, after this and a team discussion. Treatment sessions, if recommended by us, will initially comprise of a trial of 5 sessions to ensure that the plan is suitable. We focus on agreed treatment goalstreatment is collaborative and focussed on goals. Treatment sessions usually last one hour but can last 4 or 5 hours if clinically indicated.
Patients can expect to receive written correspondence from us, using their preferred mode, such as an assessment report and a discharge report. Patients can expect the course of treatment with us to be time limited. In keeping with the CBT model, the emphasis for treatment is on the patient working on between session therapy goals.
Who is this service for?
• Adults aged 18 and above, living in the boroughs of Merton, Kingston, Wandsworth, Richmond or Sutton with a registered
GP in the borough
• Main presenting problem : Obsessive Compulsive Disorder, Body Dysmorphic Disorder, Panic Disorder with/without Agoraphobia,
Health Anxiety Disorder, Emetophobia, Specific Phobias, Social Anxiety Disorder, General Anxiety Disorder and Hoarding Disorder
• Previous treatment required: At least one previous trial of CBT for the anxiety disorder(s) that the person is being referred for – CBT should include at least 10 sessions with an emphasis on behavioural change. At least one trial of appropriate SSRI medication at maximum dose for OCD or appropriate medication for the anxiety disorder they are referred for. If patients can not take medication by virtue of their diagnosis or intolerable side effects, we welcome discussion first.
For young people transferring from CAMHS to adult services, we request that the person is already under an adult CMHT. Exclusion criteria are :
- A body mass index (BMI) of under 18. We welcome discussion about this prior to referral to evaluate the reasons for a low BMI. • Current and active alcohol or drug dependency/harmful use. A 6 month period of stability is recommended if the use has recently ceased.
- Significant acute unmanaged risk issues requiring stabilisation prior to therapy.
- Active psychotic symptoms – unless the referral is for OC induced or worsened by clozapine, which will be
discussed on a case by case basis - Primary diagnosis of an untreated personality disorder
- Organic conditions such as dementia.
- Patients who are detained under the Mental Health Act.
Once the section has been lifted we would consider a referral, assuming the patient is in agreement.
Referrals and access
We accept referrals from colleagues working in Primary, Secondary or Tertiary care. We do not accept self-referrals. We ask that all referees complete our referral form. GP's can refer using eRS and also need to complete our referral form.
Patient information
We use an evidence base to guide the interventions. This is often Cognitive Behavioural Therapy (CBT), and more specifically, Exposure and Response Prevention (ERP). Interventions are usually delivered on an individual basis, We offer group treatments for BDD and Hoarding Disorder, depending on availability of staff and patients. Where appropriate pharmacological recommendations are provided as per NICE Guidance.
Resources:
Hoarding Disorder V6 SWD227 [pdf] 2MB
