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Mental contamination in OCD: A cognitive approach to identification and treatment
Mental contamination in OCD: A cognitive approach to identification and treatment
Mental contamination in OCD: A cognitive approach to identification and treatment

Mental contamination in OCD: A cognitive approach to identification and treatment

Dr. Maureen Whittal, Dr. Roz Shafran

Professionals: $100.00 CAD +tax
Students: $80.00 CAD +tax

Introduction

On June 14th, 2024, Dr. Maureen Whittal and Dr. Roz Shafran delivered a half-day workshop on Mental contamination in OCD: A cognitive approach to identification and treatment. This on-demand workshop is a recording of that presentation.

Workshop Outline

Mental contamination (MC), defined as feelings of dirtiness or pollution in the absence of physical contact, has been found to be in present in almost half of people with obsessive compulsive symptoms and overlaps with contact contamination (CC). People high in MC are often those with the most severe overt compulsions (e.g., hours in the shower, scrubbing themselves to the point of the skin being raw, chapped and bleeding) as well as avoidance which can be extreme.

A substantial amount of theoretical and empirical work has been completed on MC and its relationship to trauma, disgust and other manifestations of obsessive-compulsive disorder (OCD). However, work on the treatment of MC has not kept pace. One of the aims of this presentation is to provide an overview of the assessment and treatment strategies to use with clients with different forms of MC. This workshop will begin with the description of the clinical manifestation of MC in OCD and its core characteristics, including a comparison between CC and MC. Information will be presented on how to identify MC and measures will be provided that can be used in assessment and tracking of progress. 

Building on the phenomenology, we will provide an overview of establishing a shared formulation of MC and how to engage clients in interventions. The main components of treatment will be presented, including psychoeducation (e.g., the role of the human source in MC, mislabelling of mood states), monitoring of specific episodes of MC and the role of appraisal. The meaning of contamination will be discussed through the use of surveys and behavioural experiments. Experiences associated with feelings of betrayal and humiliation are commonly associated with the onset of MC. The role of imagery and imagery rescripting to combat these upsetting precipitating events will be discussed. People with MC can experience a high personal moral code which is often imputed on others and in turn contributes to an explanation of how a stimulus becomes a trigger. Strategies will be presented to contain and limit the imputation of morals on others as well as decrease the individual’s own moral code.  Treatment strategies will end with a discussion of relapse prevention. The session will be interactive with role-plays, videos and experiential exercises.

Content

Learning Objectives

Attendees will learn to 

1. Identify mental contamination

2. Understand the relationship between mental and contact contamination

3. Be aware of techniques to help assess mental contamination

4. Derive a shared formulation of the maintenance of mental contamination

5. Have an overview of specific techniques that can be used in mental contamination

About the Presenter

Maureen Whittal is a private practice psychologist in Vancouver, Canada and Associate Clinical Professor in the Department of Psychiatry at the University of British Columbia. Her research work centred on the development and testing of cognitive treatments for OCD. She had the honour of working with Jack Rachman for 35 years in both research and clinical work. It was in this clinical work that we identified mental contamination which initiated Professor Rachman’s further exploration. She is also co-founder of Anxiety Canada and is now co-chair of its Scientific Advisory Committee. She is a co-Director of Bespoke Mental Health Canada. 


Roz Shafran is a Professor of Translational Psychology at the UCL Great Ormond Street Institute of Child Health and Director of Bespoke Mental Health. Her clinical and research interests have focused on developing, evaluating and disseminating evidence-based psychological therapies across the age range. She has published over 300 research papers in areas such as OCD, Perfectionism and Eating Disorders. She had the privilege to work with Professor Rachman for over 30 years. She is a co-Director of Bespoke Mental Health UK and Bespoke Canada.

Training Modalities

Didactic content, Q&A, video/live role play and experiential components will be used. 

Who should attend

All levels of experience are welcome with some experience of OCD and cognitive therapy beneficial.

Continuing Education (CE) Credits

Bespoke Mental Health Canada is approved by the Canadian Psychological Association to offer continuing education for psychologists. Bespoke Mental Health Canada maintains responsibility for the program. 
After viewing this workshop, participants have the option to complete an evaluation form and a workshop knowledge quiz in order to be eligible to receive a certificate confirming the number of credits awarded. This certificate will be sent via email.
Participants who complete this workshop, submit a completed evaluation form, and score a minimum of 8/10 on a content-related quiz are eligible to receive 2.75 CE credits

Fees

Professionals: $100 CAD + tax
Students*: $80 CAD + tax
* Proof of student status may be required in order to qualify for a student rate.

Key References

Coughtrey, A. E., Shafran, R., Lee, M., & Rachman, S. (2013). The Treatment of Mental Contamination: A Case Series. Cognitive and Behavioral Practice, 20(2), 221-231. https://doi.org/10.1016/j.cbpra.2012.07.002 
 
Millar, J.F.A., Coughtrey, A.E., Healy A., Whittal, M.L. & Shafran R (2023). The current status of mental contamination in obsessive compulsive disorder: A systematic review. Journal of Behavior Therapy and Experimental Psychiatry 
 
Rachman, S., Coughtrey, A., Shafran, R., & Radomsky, A. (2014). Oxford guide to the treatment of mental contamination. Oxford University Press. Oxford. 
  
Melli, G., Bulli, F., Carraresi, C., Tarantino, F., Gelli, S., & Poli, A. (2017). The differential relationship between mental contamination and the core dimensions of contact contamination fear. Journal of Anxiety Disorders, 45, 9-16. https://doi.org/10.1016/j.janxdis.2016.11.005 

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