"CBT for OCD"

Dear Jaspud,

Thank you for sharing your experience - it sounds like overall it was a very positive one. It's always so heartening when we read phrases like 'game changer' and I'm so pleased we were able to help you make those changes!

Thank you also for the constructive feedback; it is wonderful to know when we are doing well and providing good support, but equally it is helpful to know when there are some difficulties.

I will feedback to our partners who provide the online video consultation that Jitsi wasn't as reliable as we would hope; it's the system that is built into our patient database and whilst it's a very secure way of doing remote sessions, it's helpful to know that there are areas for improvement. I'm glad that the Microsoft alternative worked however.

With regards the questionnaire, it can be a tricky one to get right. The questionnaires that we use are the ones that the national team have indicated are the most useful, so locally we have little option. I hear what you say about frequency over intensity. Many of our patients score those questionnaires on intensity because, quite frankly, it makes more sense to people to do that. If I've had a particularly bad couple of days, it feels more satisfactory to score that as a 3, rather than a 1.

The difficulty comes when you're measuring progress (as you quite rightly point out). If when I start therapy I'm having bad days 5 out of 7 days a week, then that would be a 3 (most of the days). But as I progress, my bad days become less and the better days become more - as such, the scores should start to come down to a 1 or a 0.

If I score it on intensity however, no matter how many good days I have, it would only take one really bad day (or even half a really bad day) for me to want to score that as intensity 3. So even though therapy might be really helpful, and I've gone from 5 days a week down to half a bad day, I'm still scoring as a 3. This is why we use frequency rather than intensity - as although it feels less satisfactory at times, it actually tells us a little more about improvement.

Thank you so much for giving me the opportunity to explain this - so many of our patients have the very same question about the questionnaires, so I hope your question will help them understand it a bit better too.

I wish you all the very best with your continued progress,

Mark