By C. Alec Pollard Ph.D.
Saint Louis Behavioral Medicine Institute
St. Louis, MO 
 
                                         
The Behavior Therapy Institute (BTI) is a training program that was initiated by the OC Foundation in 1995 to help address the shortage of psychotherapists skilled in the cognitive-behavioral treatment of OCD. The BTI was designed to provide a level of training beyond that which is typically provided by workshops. Each BTI participant reads assigned material on the treatment of OCD, conducts an assessment of an individual with OCD, attends three days of live instruction from BTI faculty, and receives follow-up case consultation by phone from a faculty member. BTI faculty members include leading experts in the cognitive-behavioral treatment of OCD. Only licensed healthcare professionals can attend. Since the first program was held in Lakeville, Connecticut, in December of 1995, several hundred therapists from various parts of the USA and other countries have attended. In addition, a one-day advanced BTI is conducted each March cosponsored by the OCF and the Anxiety Disorders Association of America.

The enrollment for each BTI is limited to 30 in order to promote an informal, interactive atmosphere and to help ensure the quality of the training. The first day of the program concentrated on the fundamentals of diagnosing, assessing, and treating OCD. This section of the BTI was taught by Dr. Edna Foa, a pre-eminent OCD researcher and clinician, Director of the Center for the Treatment and Study of Anxiety, and Professor at University of Pennsylvania’s Department of Psychiatry.

The second day of the program covered special issues and populations. The first presentation was by Jeffrey Staab, MD, Assistant Professor of Psychiatry and Director of Psychiatric Services at the Hospital of the University of Pennsylvania. Dr. Staab reviewed the latest advances in drug treatments for OCD. He was followed by Martin Franklin, Ph.D., Assistant Professor and Clinical Director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania Department of Psychiatry. Dr. Franklin discussed special considerations in treating children and adolescents with OCD. In the afternoon, Jonathan Grayson, Ph.D., and Charles Mansueto, Ph.D., reviewed the implications of comorbidity for the treatment of OCD and discussed how treat- ment principles are adapted for the treatment of OC Spectrum Disorders such as Hypochondriasis, Body Dysmorphic Disorder, Tourette’s Disorder, and Tnichotillomania, Dr. Grayson is Director of The Anxiety and Agoraphobia Treatment Center in Bala Cynwyd, PA, and Assistant Clinical Professor of Psychiatry at Temple University. Dr. Mansueto is Director of the Behavior Therapy Center of Greater Washington in Silver Spring, MD, and a Professor of Psychology at Bowie State University. At the end of the second day, I led a discussion of ways to address common practical problems (e.g., dealing with managed care, dealing with limited resources, etc.) therapists encounter as they attempt to implement CBT in various clinical settings.

On the third day, participants divided into six breakout groups to discuss their training cases and receive individual consultation from faculty. The primary objective of the third day is to refine the ability of trainees to use the cognitive-behavioral treatment model to conceptualize cases and develop individualized treatment plans. Each attendee came with a work-up for a case on which s/he was presently working. Drs. Franklin, Grayson, and Mansueto returned on Sunday to join me as leaders of the clinical breakout groups. We were also fortunate enough to be joined by Fred Penzel, Ph.D., Executive Director of Western Suffolk Psychological Services in Huntington, NY, and Christina Taylor, PhD, Associate Professor of Psychology at Sacred Heart University in Fairfield, CT. Five  trainees were assigned to each of the six group leaders. This gave the trainees the opportunity to learn from four other cases in addition to their own. At the end of the program, trainees returned to their communities equipped with a treatment plan tailored specifically for their training case.

The final step of the BTI is for trainees to implement the treatment plan developed for their training case. At the time this article was written, most cases were still being treated. The fee for the BTI includes three phone consultations with the trainee’s faculty group leader. It is up to trainees to decide when they need to call their faculty consultant. Trainees in my group have had some challenging and interesting cases to discuss. When trainees complete the phone consultations to the satisfaction of their faculty consultant, a certificate of completion is awarded by the OC Foundation.

This year’s BTI was well received by participants. According to one participant, the BTI “was an incredible experience and extremely beneficial....Not only did I gain a deeper understanding of the treatment process, and have an opportunity to apply it, I was able to meet others with a passion for OCD that I have.” Another attendee wrote: “Reading books and manuals doesn’t compare to seeing and hearing experts. All I can say is WOW. This weekend was at the top of the SUDS scale for ‘AHA’ experiences.” As always, we also received suggestions for ways to improve the program in the future. Participant feed- back is invaluable and helps us continue to improve the quality of the BTI. The Philadelphia BTI was filled to capacity and there was a waiting list. So if you are interested in attending, call Jeannette Cole, Deputy Director of the OCF, at 203-401- 2069 or email to cole@ocfoundation.org.

Dr Pollard is the Director of the, Anxiety Disorders Center at Saint Louis Behavioral Medicine Institute and a Professor of Community and Family Medicine, Saint Louis University, in St. Louis, MO. He is a member of the OCF Scientific Advisory Board and Director of the OCF’S BTI Program.