Most OCD patients and their families benefit from a psycho-educational group, primarily because this disorder is often misunderstood and misdiagnosed for years prior to finding appropriate treatment. Since the group can be like a class in nature, most patients learn something new about the nature of their disorder. Some people may feel that they are sufficiently educated about OCD so that the group is not necessary; after all, you may have had the problem, in some cases, for a long time. However, many of the family members may not be so well educated, since OCD is a disorder that usually includes high degrees of secrecy, shame and guilt on the part of the sufferer. Learning that you are not alone, that others have had experiences and anxieties very similar to yours, can be very reassuring and validating. This is true whether you are one of the OCD sufferers or a family member whose family experiences are necessarily different in some ways that those of people whose family dynamics do not include OCD. Learning to discuss these difficulties in an environment of like-minded people, and getting to know the people with whom they will soon be sharing their behavior therapy experience, make compelling arguments for attendance. Many people that have not first attended the six-week psycho educational group feel left out during the later groups, and many choose then to attend the six-week group after all. Additionally, the last two sections of the psycho-educational program illustrate the building of your hierarchy, the primary tool of this behavior therapy program. Few patients will have produced this on their own, and without the hierarchy you will not be able to proceed in the behavior therapy portion of the program.

Although some patients will choose not to involve family members in this group, the education of the family is a crucial element of the psycho-educational group. Here, the term "family" refers to members of the nuclear family (including children old enough to meaningfully participate), members of the family of origin, significant others, close friends or anyone of the patient's support system from whose involvement the patient believes he/she would benefit. A usual group size is 4-6 patients plus their families, each section lasting about 90 minutes. It is important to recognize that some sections may not start on time, as OCD patients often find it difficult to terminate their rituals in sufficient time to arrive promptly.

At the end of the six-week psycho-educational group, everyone will be educated about their options for continued treatment. These involve stopping treatment at that point, choosing medication therapy only, choosing individual therapy (either supportive or behavioral in nature), family therapy (if indicated), or moving into group supportive or behavioral therapy. It is the aim of this educational program that the patient will learn skills that can be applied after group ends for continued self treatment. Some programs then offer 9-week group behavior therapy that is structured, but is partly process-oriented and partly designed to continue to develop individual exposure and response prevention skills. Many patients choose to repeat the behavior therapy group if they feel they have not sufficiently learned the procedures, or if later they require a "refresher" section.

This manual contains the material you would experience in a psychoeducational group, in the form of scripts used to discuss the important information, along with diagrams and work sheets. Most of it is written in the rather informal way that we present the group, so you may actually "hear" the therapist speaking as you read. Because many of the points you will find to be most important to your understanding of this problem and its resolution will come in the form of questions during the group, we do not recommend that this manual be used to replace coming to group. However, we recognize that groups such as this are not yet available in all areas. We encourage you to seek out such a group if available in your area, as being part of a group makes the therapy that much stronger for both you and the other group members. We also encourage feedback to the author on content and presentation of this material.