Specialized Services for Severe OCD and Related Disorders
Services for Severe and Impairing OCD
We are focusing our services on those who have significant OCD symptoms that impact their ability to function in day to day life and have not responded to previous treatment.
Eligibility Criteria, Referral Process & Forms
To initiate the referral process, please review the eligibility criteria and submit the referral form(s) included below:
For MD to MD Phone Consultation & Psychiatric Consultation and Care
Eligibility Criteria for MD to MD Phone Consultation & Psychiatric Consultation and Care
- Age is between 18-65 years
- Principal diagnosis is OCD (if there are comorbidities, OCD must be disorder that causes the greatest amount of daily impairment)
- Symptoms must be judged as severe
- Patient's functioning is severely impaired
- OCD symptoms must be treatment resistant. Specifically, the illness has not responded to:
- 1 or more SSRIs AND
- 1 or more trial of clomipramine or SNRI (Effexor, Pristiq) OR
- 1 or more augmentation agent (atypical antipsychotics, memantine, or topiramate) * AND
- 1 trial of evidence-based CBT* OR
- Inability to access CBT locally
- Patient must have GP and ideally a therapist in their community willing to provide ongoing medication management and therapy
*If your patient does not fit our criteria but you feel they should be seen by the Thompson Centre, please explain in the form as indicated.
Exclusion Criteria:
- Current psychotic symptoms
- Current active suicidality
- Current active trauma-related symptoms
- Current active anorexia nervosa
- Active substance dependence/abuse (within the last 6 months)
Application for Referral
- Referring physician to review and complete
- Referring physician to provide consult note
For referral forms, visit Referral Information and Forms.
For Residential Program and Day Treatment Program
- Age is between 18-65 years
- Principal diagnosis is OCD (if there are comorbidities, OCD must be disorder that causes the greatest amount of daily impairment)
- Symptoms must be judged as severe
- Patient's functioning is severely impaired
- OCD symptoms must be treatment resistant. Specifically, the illness has not responded to:
- 2 or more SSRIs AND
- 1 or more trial of clomipramine or SNRI (Effexor, Pristiq) AND
- 1 or more augmentation agent (atypical antipsychotics, memantine, or topiramate) * AND
- 1 trial of evidence-based CBT*
- Willingness and motivation to challenge OCD symptoms
- Patient must have GP and ideally a therapist in their community willing to provide ongoing medication management and therapy
*If your patient does not fit our criteria but you feel they should be seen by the Thompson Centre, please explain in the form as indicated.
Exclusion Criteria:
- Current psychotic symptoms
- Current active suicidality
- Current active trauma-related symptoms
- Current active anorexia nervosa
- Active substance dependence/abuse (within the last 6 months)
Application
Only referral packages with both the client and physician referral forms completed will be reviewed. Referring physician to submit both completed forms at the same time.
- Referring Physician to review and complete:
1. Physician Referral Form
2. Residential or Day Treatment Supplementary Referral Form - Referring physician to provide consult note
- Applicant to complete Client Information Package
For referral forms, visit Referral Information and Forms.
Please note: We are continuing to accept referrals during the COVID-19 pandemic, however, there may be delays in processing and responding.
MD to MD Phone Consultation
Any physician can request an expedited phone consultation with one of our psychiatrists to discuss a patient's condition and treatment options, without formally referring the patient to us for consultation. This is a one-time conversation and the referring physician remains responsible for the patient's care. The referring physician will be contacted to set up a phone appointment with one of the psychiatrists on our team and will receive our recommendations directly during the call.
Psychiatric Consultation and Care
This service is available to patients across the province with severe/treatment resistant OCD. Patients will meet with one of our team psychiatrist to complete a comprehensive evaluation, and determine appropriate treatment recommendation. This is a one-time appointment for approximately 1-1.5 hours. The referring physician remains responsible for the patients care. Recommendations will be sent to the referring physician who can then determine with the patient if they wish to try the treatment suggested. Prior to their appointment, the patient will first be sent a detailed self-report questionnaire about their psychiatric and medical history to complete. The Psychiatric Consultation may also include a 'follow-up' appointment if needed. An optional annual reassessment is available if requested by the treating physician.
Residential Program and Day Treatment Program
These services are intended for those who have not responded to more extensive treatment and who have very severe and impairing illness.
The Intensive OCD Treatment Program model integrates psychological and psychopharmacology interventions to provide a comprehensive approach to care for people with severe and impairing OCD. The model includes medication management, individual CBT and group treatment. The key feature of the program is Exposure and Response (or Ritual) Prevention (ERP), the gold standard for treatment of OCD, which will occupy a significant portion of treatment time each day. Additionally, participants in the program will benefit from occupational therapy, comprehensive discharge planning, family therapy, and recreational activities.
Residential Program:
The program is grounded in the gold standard for OCD, Cognitive Behavioural Therapy (CBT). Residents receive this treatment within a group setting, as well as with individual therapists. The program model includes many types of treatment that will support the delivery of CBT, such as acceptance and commitment therapy, mindfulness techniques, and emotion regulation strategies. Individuals accepted into this program will be living at the Bellwood Health Services facility, which is an independent living environment located in Toronto, Ontario.
Day Treatment Program:
Individuals admitted in our Day Treatment Program will be receiving treatment at Bellwood Health Services, located in Toronto, Ontario. They will receive individual and group programming alongside residential clients but will return home at the end of each day. The program is intended as a transition from residential treatment towards full discharge, although in some cases may be considered a program option for individuals whose OCD symptoms will not interfere with their attendance in the day program.
Peer Support
The monthly peer support group is open to people who have completed or are currently participating in the residential program, as well as those who have attended residential OCD programs in the US. It is facilitated by trained peer facilitators. For more information, connect with our Peer Support Specialist at thompsonpeersupport@sunnybrook.ca or call the Thompson Centre main line at 416-480-4002.
FAQs for Residential Program and Day Treatment Program
Services for Related Disorders
We offer Cognitive Behavioural Therapy (CBT) group treatment for related "spectrum" disorders, including:
- hoarding;
- hair pulling (trichotillomania) and skin picking; and
- body dysmorphic disorders (BDD).
For more information about related disorders, please go to disorders we treat.
Prior to being offered one of our groups, an assessment with one of our team members is required. This consists of a telephone screen as well as a face-to-face assessment (approximately 2 hours). The assessment process determines which group (if any) will best meet your patient's needs.
Related Disorders Groups:
- CBT groups run for 12-16 weeks straight.
- Groups are led by 1-2 trained facilitators with 8-10 group members.
- Members are expected to attend at least 90% of the sessions, and to do regular homework between sessions.
- There is a cost for parking onsite (approximately $13 for 4 hours).
Cognitive Behavioural Therapy (CBT) focuses on the way people think (cognitive) and act (behavioral). The concept behind CBT is that our thoughts about a situation affect how we feel (emotionally and physically) and how we behave in the situation. Exposure and Response Prevention is the most commonly used form of CBT for OCD and related disorders.
Referring physician to complete the Thompson Centre Referral Form and submit to fax 416-645-0592 or email ThompsonCentreClinic@sunnybrook.ca.
