Critical Review

The Focus Of The Study

Children living with Obsessive Compulsive Disorder (OCD) have in past been neglected. Not because no one cares. But the parents are most afraid to open up to the fact that their child is suffering from a disorder. Most of the working class parents prefer staying with the children indoors instead of allowing such children to interact. In one of the cases witnessed, a father disowned his child and accused the mother of infidelity. This was because the father was an upper-class economy parent who worked as a bank manager. He could not hold the thought of having a child suffering from obsessive-compulsive disorders. Such parents make the focus of our study and how to inform them accordingly about this type of special needs disease.

The study aims at informing the parents, teachers and the public the real causes of the obsessive behavioral disorder. It also needs to access the various treatments that this child can undergo so that the family can help them in the healing process rather than neglect them. This study also aims at making the public understand that the disorder is not meant for a specific social class or social group. Anyone’s child can suffer from such a disorder.

The study will focus on the evidence or particular specific behaviors that are likely to be symptoms of obsessive-compulsive disorder. The evidence will help the public know how to identify with such cases. When they are identified it easier to perform the different treatment at early stages, even from home and not waiting to get to the hospitals. The behavior that the study will identify, can also help us understand the various types of the disorder that can be manifested in an individual. The study also identifies the various treatment that can be administered to obsessive-compulsive disorder patients. The psychological disturbance that these patients undergo and the psychological therapy that can administer for each. The study will also focus on adaptation and rehabilitation process as a way of curing the disorder. The study also focuses on the roles of nurses and their input towards ensuring that the disorder is well managed in the all of India. The study will then conclude by showing how the study will help achieve the aims.

The study was facilitated by an outburst cry by the agencies that support children and women rights. Their concern was the high numbers of women that reached for help, complaining that their husbands had abandoned them due to their children showing early signs of the disorder. Teachers in school also demanded the study sighting that increased cases of such disorder were registered in school (Andersson et al. 2015). But when they informed the parents about their children disorder and asked them to take different healing mechanisms. The parents showed rebellious signs accusing the teachers of undermining their intelligence. These lead to the outcry of teachers in requesting to conduct the study that will help inform the general Indian public about the disorder (Angelakis, Gooding, Tarrier and Panagioti 2015).

The Aim Of The Study

According to previous studies carried out in the country. The prevalence of the disease in India is about 2-3%. This is a very high prevalence rate compared to most countries, especially in Europe. Some countries have shown low prevalence up to about 0.5% rates. The global conservative rates of prevalence according to the WHO is 1%. This shows how the country has high prevalence rates (Aspvall et al. 2018).  Of the total infected population, 26% are the only adults. The rest 64% are children under the age of 15. These statistics show the way most school going children are suffering from this disorder. Of the population, 9% are the ones suffering due to natural causes. The rest percentage are suffering due to inherited or genetic causes. The generic cause percentage explains why the parents have to be bitter when told that their child could be suffering from the disorder (Boedhoe et al. 2017).

The nation has been doing well in catering for people with various special needs. There has been good recognition of this type of people. The schools have set aside special programs in the curriculum to help them. The problem that the nation is facing is the new rates of the obsessive-compulsive disorder that keeps rising, therefore demanding for all the stakeholders to go the extra mile and care for such people in the country (Brakoulias et al. 2017). As much as other stakeholders are doing their part from teachers, health practitioners to the government. The major challenge comes from the parents of the individuals that are suffering from this disorder. They neglect their children (Burguiere, Monteiro, Mallet, Feng and Graybiel 2015). They deny them their fundamental rights. They even go as far as selling them out to orphanages and other mental facilities. They do all this with the fear that when people know about their children with the disorder they will judge them harshly. This is the main problem identified by the study.

Obsessive-compulsive disorder is comprised of two characterizes derived from the name. The two characteristics are made up of; obsessions and compulsions. The behaviors though differ from one patient to another. But their ones that are most common among most of the infected individuals. Because it is quite difficult to identify most of the people do not realize the early signs until it has become fully seen (Chen et al. 2016). They then would rather live with it than seek medical intervention. The WHO recognizes this condition as one of the most handicapping, since it is very difficult to read or identify the behaviors. Looking into the behaviors in the study will help the parents identify various signs manifested by their children (Collins and Coles 2017). So they don’t have to blame the teachers or themselves for identifying the condition in their children. The study will also help them know the right time to seek early intervention for their children. The intervention could even come from the parents themselves and not necessarily the nurses (Davies 2017).  Obsessive Compulsive Disorder (OCD) In India Essay Paper

Causes

This is the first sign of the condition. It is defined by unwanted intrusive thoughts, doubts, images, scenes, urge, feelings that repeatedly manifest in the individual’s mind. The obsession is repulsive from the person’s personality. This means that each time the person feels the obsessive urge, they try so much to resist it. The individual regards them as unreasonable and very excessive (Fonzo et al. 2017). These obsessions, however, do not regard the day to day stresses or illusions. They are very specific. They are therefore not triggered by general anxieties or the daily worries. Many of the individuals undervalue these obsessive urges. They are categorized by an underlying fear behind the mind of the individual. The obsessions are also not categorized by perceived defects (Ghassemzadeh et al. 2017). Perceived defects are fear that is caused by seeing particular things. For example, someone who has witnessed an accident and fears to drive vehicles because of the accident they witnessed. They also do not include health anxieties. Health anxiety is the fear of being infected by a particular disease.

Mental obsessions are not seen but the person might open up about them if they visit a therapist. The mental disorder is normally very grave. The common ones are;

• Living in fear that one will commonly harm someone
• Always thinking that they about to commit mistakes either at home, school or even at the workplace.
• They fear that they are about to utter particular words that are annoying to other people.
• The fear that their behavior is irrational but they fear controlling it might make people notice.

These are some of the mental disorder that goes through the mind of the individuals who are affected. These signs though vary from individual to another.  The observable characteristics are the ones that are manifested externally and we are able to notice them from the individual (Grøtte et al. 2015). They too vary from individual to another but there are others that are very common across most of the individuals. The common ones include;

• Constant irrational worry about dirt, germs, and contamination.
• Excessive concerns with the order of particular things. They feel things should be in a certain arrangement and should therefore not be altered. For example, the coats on his cloth line should be in the order of green, black and then red. If anyone interferes with that arrangement they react.
• Fear of negative thoughts. These manifest themselves when they think that any blasphemous thoughts will lead to harm to any of the people around. They do this too especially the ones they loved.
• Preoccupation with losing or throwing away objects that will seem have little or no value to us but of so much value to them.
• Distasteful religious thoughts. Sexual thoughts and images that do not excite other people but they make such individuals very happy.

Compulsions are related to the obsessions. Most of the compulsions are as a result of the obsessions. A compulsion is a repetitive act that the individual does to gratify an obsession. These behaviors are normally done each time the obsession occupies the mind of the individual. The acts are involuntary, the individual does them unknowingly (Halter 2017). They have a problem resisting them. They cannot control these activities. They are not normally pleasurable to the individual but brings out a little period of gratification. Some people might refer to them as rituals if it’s the first time they are meeting the individual. Just like the obsessions they too are divided into mental and observable (Halter 2017).

They are very difficult to control. The individual does these activities without their knowledge. It is not observable by the people around but the person feels them. They are also referred to as covert mental act (Ivarsson, Saavedra, Granqvist and Broberg 2016). An example of such an act is a mental repetition of a phrase that has been used by a person minutes after they have said it. They are very difficult to heal because they cannot be monitored even by a professional. Instead of referring to these mental activities as rituals, they are instead referred to as ruminations (Jaisoorya et al. 2017).

Statistics

The compulsion that takes overt forms. Overt forms mean they are external and people can see them manifest. They can be resisted under proper medical and treatment forms. They, just like the mental are difficult to resist. Since they are motor acts, they are referred to as rituals. The compulsions include:

• Cleaning – an individual keeps on going out from a class to the washrooms to wash the face.
• Checking – Another person who keeps on checking the laboratory door, to confirm it is locked.
• Repeating- verbal repetition of a phrase severally.
• Hoarding – keeping old items for a very long time. These include old newspapers and magazines.
• Mental rituals- praying almost every minute, even when there is not any need to.
• Combination of both obsession and compulsive behaviors

These are thoughts that hit the individual and then he immediately follows with a ritual or an activity that is compulsive. The obsession compulsive behaviors normally take more than an hour in a day (Jaisoorya, Reddy, Thennarasu, Beena, Beena and Jose 2015). The obsession consumes the individual and takes a better part of their day. The compulsions could be very difficult to identify if they are stigmatized. The individual will hide the behavior if they think the behavior is so shameful. When they hide it can be very difficult to diagnose the individual of the condition (Kameg, Richardson and Szpak 2015). The people observing such individuals should, therefore, open up to them so that they don’t feel intrusive.

The following cycle can be used to explain what goes on in an individual who has obsessive-compulsive disorders. The cycle is developed from the systems of the disorders,

Obsessive thought …………… anxiety…………..compulsive behavior …………………gratification and temporary relief.

The following questions were developed to help one in identifying if they or another person are suffering from the condition. The question can be tested anywhere without having to search for an expert.

• Does the person affected wash or clean a lot
• Does the person check things a lot, even the simple things?
• Is there any thought that keeps bothering the individual that the individual feels they cannot rid of?
• Does the person take a long time to clear their daily activities?
• Is the individual concerned about a special order? They feel that the order should not be changed whatsoever.
• If the issues that have been discussed are affecting the mental stature of the individual.
  

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These questions not only help discover if one is really suffering from the condition. But also helps in determining the extent to which the condition is. The condition could mild, moderate or severe (Koujalgi, Nayak, Pandurangi and Patil 2015). Other conditions that could be related to OCD. The conditions include depression, social phobia, excessive use of alcohol (especially for adults) and other anxieties.

The drug treatment for this condition is Serotonin reuptake inhibitors. The drugs are referred to as SRI in its short form. This is the first line of drug treatment normally administered to such patients. The drugs were introduced in the late 80s. They were initially used for treating depression but later proved worth it in treating OCD condition. Presently it is developed into five other forms (Lissemore, Nordahl and Benkelfat 2015). The five forms are fluoxetine, paroxetine, fluvoxamine, sertraline, and citalopram.

Though some doctors have tried anxiety and depression drugs for OCD it has never worked. This proves that the best medication for OCD is the SRI. It is not scientifically clear how SRI works to cure this disease. Some earlier theories explain that the drug causes a decrease in neurotransmission. Therefore as the patient receives the mental obsession, the drug slows down the effect (Mattheisen et al. 2015). The patient will not, therefore, perform the ritual. This theory was not sufficient since drugs like aspirin could, therefore, be used to treat the condition. The theory was later developed and explained (McGuire et al. 2015). The SRI is believed to operate to dysfunctions the neural circuit as they transmit impulses. The impulses are therefore not able to trigger a communication to the brain so that the ritual is performed. In this case, the condition is treated.

Problem Identification

SRI is the best medical form of the treatment because it is safe, tolerable and very efficient. There are really no exact predictors on how long they take to heal. This is because healing depends on the individual response to the drugs and the level to which the disease has reached (McKay et al. 2015). The test, however, has shown 40%-60% efficiency in all the cases it was used. It is very likely that a patient who hasn’t responded to the SRI drug will not respond to other forms of treatment. But if they do respond they are likely to respond to still another form of the SRI drug. It is advisable to try at least three forms of SRI treatments before moving to another (Morein-Zami et al. 2016.).  However, the following have to be looked upon keenly to make sure the drugs work exceptionally well;

This form of treatment is more difficult to give. The management of the patient can be very difficult. It is due to the attitude they have about taking such drugs. Generally, the patients want to be in control. By nature of their illness when they are obsessed they want to prevent it so that they feel they are in control. Taking drugs to them, make them feel they are not in control. Both the patient and people surrounding them should help them monitor drugs (Nakajima et al. 2018). The patient also develops magical thinking towards drugs. They, therefore, take medication for a very short time hoping that it will cure within a very short time. When they realize the drug doesn’t take effect. They lose hope within a very short time and therefore stop taking their drugs.

The drugs should also be properly monitored so that it doesn’t become part of the individual’s ritual. To help this problem the patient should take the drug within the speculated duration. They should take it on certain days and specific days. These patients can also have an obsession with the drugs (Nathan and Gorman 2015). The color of certain pills can make it a ritual for them to drink. The patient can also develop side effects. The side effects can lead the patient to drop therefore the patient should be monitored all through the sickness period. The patient should also be assessed early during the treatment. This is to prevent somatic illnesses that may come due to drugs medication (Nuttin et al. 2014). Even as the patient continues to take drug medication, they should frequently visit a clinician to look at their condition.   The last thing to consider while administering drugs is the latest developments about the same disease. Some patients will find awkward information from the internet and instead use it. These might be very dangerous to the patient as it exposes them to dangers (Öst, Havnen, Hansen and Kvale 2015).

The recommended dosing are levels are separate from adult to children patient. The children patient are half the levels of the adult. The treatment begins with a low dose before they are increased gradually. This is done so as to help in monitoring any side effects.

Main Body

10-mg of paroxetine is given then increased slowly. The increase of dosage is done after a period of 10 to 14 days. Previous reports have shown that if the drug is hastily increased the results are not very productive. For example, if the does are increased after 5 days, the effects are not faster as expected. The drug is gradually increased until the first symptom of anxiety fades away. This requires keen observation of the patient.

If there are signs that the obsessive thinking has been reduced it is then advisable to stop increasing the dosage. The dosage is not increased but maintained at that particular point. The stopping of the obsessive thoughts is usually monitored by a doctor after six weeks of continuous dosage (Parker 2015). Full treatment is normally realized at the 12th week. The medicine has no effects, even when used after the obsession has gone down. Lasting benefits will be realized when the medicine is taken for an extra duration of time.

The medicine has side effects. The side effects are manageable. Side effects of the treatment include; feeling of insomnia, nausea, morning severe headaches, sedation, and insomnia. The effects vary from patient to another. They should, therefore, be considered as per the patient. A patient can gain weight while another on the same medication loses weight. This variation of side effects is normally very common. The serious side effects that require management are sexual side effects. These side effects include; anorgasmia, loss of libido and delayed orgasm especially in men (Pauls, Abramovitch, Rauch and Geller 2014).

Side effects can only be managed by regulating the drugs into fewer dosages. This should be done by a practicing doctor. Side effects should not be confused with healing signs. Side effects normally have undesired effects.

Psychological therapy and counseling. These are treatment methods that target the mind of the infected person. They hope to heal by dealing with the psychological effects of the disease. There are several methods of psychological healing as will discussed.

Exposure and response prevention. These methods were one of the most successful methods that were used in history. It is still used up to contemporary times. The founders of this method performed a control experiment using a dog. When the result was good. They then tested it on human patients and it turned out overwhelmingly well. This made it possible to be used for the healing purpose up to today (Pietrabissa, Manzoni, Rossi and Castelnuovo 2017).

The use of cognitive theory is the second type of psychological therapy and counselling. This type was developed from the failure of the ERP method. Instead of some patients healing from exposure, they even showed more compulsive signs. Therefore researcher developed the cognitive therapy. The cognitive therapy is normally developed from the cognitive behavioral theory. The theory explains that the obsessional fear was once just normal thoughts but they have since developed into fears. These fears are normally developed due to the person accusing themselves (Prisco, Perris, Iannaccone, Fabrazzo and Catapano 2017). These developed fears then lead to activities that try to resist the thoughts. These activities then become compulsive disorders. For example, a normal fear of harming a loved one might develop into a fear of killing them. The fear then leads to a compulsive behavior that one tries to avoid their loved ones (Ruscio, Stein, Chiu and Kessler 2010).

Behaviors Of Obsessive-Compulsive Disorder

The therapy, therefore, operates by a specialist using methods that will return the patient into looking at the feeling as normal. The patients are first labeled as pure obsessions. The counselor then tries to make them feel the things they are feeling are normal. For example. A perfectionist who always wants to do things right because they think the world will judge them. The nurse should explain to them how at times being wrong is not a bad thing and that people cannot be right all the time (Ruzzano, Borsboom and Geurts 2015). This type of method is active when the counselor presents a rationale to the patient. The rationale then helps the patient to heal. The patient can be exposed to movies and journals of the same cases to prove how the feeling they have is very normal.

They can also be presented with a pie chart. At the pie chart, they draw their feared consequences. He then is asked to identify who would be responsible for the issues in the chart. At the end of the therapy, they would realize they are not responsible for most of the activities that are talked about in the chart. The obsession will then begin leaving them slowly. The last method that could be used, is the use of group peers. Allow the peers to share stories with the individuals about different experiences. These experiences are supposed to help the individual realize that these things are normal. When the individual realize that the fears are normal, they are likely to resume normal behavior than compulsive behaviors (Schwartz and Beyette 2016).

A combination of psychological therapy and counselling is essential.  The two techniques can also be used and the result could be good for the patient. These methods involve providing a talk to the individual about the condition being normal (Scott and Cervone 2016). After the talk until they are sure they are not to blame for the condition, they are then allowed to some minutes off. The same patient is the exposure to the obsessional fear to read his reactions. After the exposure, they again talked to depending on the reaction they gave. This method is most effective. The combined method only works when the cognitive approach comes first before the ERP method. Results have shown that most patients drop out if the ERP method comes first before the cognitive method. Cognitive theory should, therefore, accompany the ERP method rather than replace it. Combination of the method is quite accurate. This is because the distorted cognition belief is first rebranded. Then the patient is presented with the same belief so that his mind doesn’t distort it anymore. The methods of discerning that one has heal remain the same for all the psychological healing. The psychological healings therapies are the same for all the ages. They do not separate children from adults (Snyder, Kaiser, Warren and Heller 2015).

Rehabilitation includes organizing programs that the patients participate in that will lead to their healing after a period of a particular time. Rehabilitation leads to adaptation of the condition, therefore, helping the individual heal. The activities involved in during rehabilitation include; social work, family come together and community helping activities. These activities are aimed at making the impatient get out of effects like; social withdrawal, increase the need for self-care and should improve partake in the family, care about children, increase in professional life and improve interpersonal relations (Stein and Viswasam 2016). This method of treatment is very effective for adults but can also be used for children. The following methods of rehabilitation can be used in the treatment of OCD.

Obsession

When the individual is made to interact with others and do one thing they will begin to forget the fear. When they forget the obsessional fear then the compulsive behavior is also suppressed. For an adult male allowing to watch football matches with friends. By doing that they will forget the fear of being a bad person who wants to commit murder and therefore cannot be near people. The compulsive behavior is the suppressed.  For children allowing them to play field activities with friends, make them forget. For one that cleans a lot, the fear is taken away when the friends touch and hold them during the play. They might even fall down as they play and not leave the game to go and clean. When they resist the compulsive behavior due to the activity, it is a good sign of healing through rehabilitation.

Family interactions. Allowing the person to be with family fades down the obsessive fears. For example, one that keeps checking the door. When with family they forget checking the door, therefore the compulsive behavior is suppressed. The action is therefore frequented to yield the expected result.

The other form of rehabilitation is done through collaborative work to the community. The social work could be visiting the needy children in the society and visiting orphanages. The collaborative out of office work reduces stress. The reduction of stress, therefore, a form forgetting the obsessional fear. The change of the environment also reduces psychosocial fears. When psychosocial fears are reduced, the patients are therefore able to reduce the stigma. With the reduction of the stigma they are able to suppress the compulsive behaviors.

Peer support also reduces stigma among the mates. The mates, therefore, view the patient as one of them. Through this, it is now easier to help the patient out of the problem. Peers also give support to the patient by acting as regulators of the compulsive behavior. With time the behavior is compressed completely, therefore a healing process. The peers could also be part of the individual family members.

Participation in the help groups like orphanages is also essential. It helps the patient stop thinking of oneself each time. They think of others. When they think of others the fear of guilt takes away the obsessional fear that will therefore not trigger compulsive behaviors. This method is the best for use with a perfectionist.

The following are the steps that are involved in the adaptation and rehabilitation to help in healing the patient:

The first of the activities is identifying the rehabilitation diagnose. These are deriving the real problem which the individual should be cured of. The specific action that makes it necessary to have to participate in the rehab. Example the patient need rehabilitation problem from being a perfectionist.

The second step is to identify the rehabilitation goals. The rehabilitation has to be specific as possible. For example, for an OCD patient, the goal would be. At the end of two weeks, the patient should be to take a whole day without cleaning the hands as a way of compulsive behavior. The goal will help set out a proper plan that will help achieve the desired outcome. There are general goals that could be set for the whole group. But for efficient healing individual goals are set for people to know the direction they need to take with the specific individual.

The Obsessions Are Further Divided Into Two;

The planning of the activities. These involve the set out of specific activities that will be done during the period. Example, Training with fellow children. Sweeping the streets every evening. Visiting the children’s home every weekend. These activities should be in line with the objective that is desired to be achieved. The duration should also involve the duration and the specific intensity of the activity. Some will take up to 14 weeks and should be conducted daily.

Lastly is the implementation of the program. The rehabilitation program should be observed by everybody; the trainers, rehabilitation center workers, the family and all the other members.

Unlike the drugs and therapy which are stopped immediately, there are signs of healing.  Rehabilitation is done until the end of the specified period. All the stages are followed to the letter and not even one stage is skipped. The rehabilitation can even proceed for several months or even years. The best method to use for rehabilitating OCD patient is medical-social rehabilitation. This type of rehabilitation enhances the improvement of the life of the individual. The individual, therefore, is supposed to heal while improving his social life. The method also ensures that the healing takes place without the patient struggling so much. Rehabilitation and adaptation is the only method that doesn’t have side effects when compared to the other healing methods.

Nurses play a very vital role in the caring of the OCD patients. Considering the stigma these patients go through nurses take a very vital role in acting as a second god to them. They are supposed to guide the patients through various roles. The also meet different types of patient. Some are very difficult while others are easy to deal with. The nurses deal with these patients without judging them in any of those situations. The following are the important roles that nurses play in making sure that OCD patients receive high-quality care. These are most specific to Indian nurses.

Nurses help the patients identify the anxiety trigger of their obsessional fear. The OCD patients are triggered by particular anxieties that lead to obsessional fear. These fears will then reflect compulsive activities. The compulsive activities are normally the end observable features. The features are seen by everyone are not important for a nurse. The nurse should identify the trigger and make sure the patient avoids at all costs. The nurse after identifying the trigger simply stays patient until the patient proceeding into performing the ritual. The role of a nurse is, therefore, to remain as patient as they can as the patient takes the ritual. It doesn’t matter how many times the patient does it?

Secondly, it is also the nurse’s role to gently ask the patient to speak about his condition. These involve making the patient state the obsessional fear that goes own overtly. The nurse should also make the patient concentrate on the conversation and focus less on the compulsive act. These the nurse does through collaboration with the patient. The nurse can also do this by encouraging the patients into positive reinforcements. The nurse can also begin limiting the time given to perform the rituals and give time to the function of the conversation.

The nurse should also not judge the patient. They should not in any way criticize the behavior of the patient. The nurse should allow the patient know that they have noticed there anxiety. This can be done through sparkling a conversation with the patient that allows them expressing their feelings. Example a nurse would say.  “I notice you have wiped your hands thrice, is there anything wrong with them”. These will also help in reducing their anxiety.  A nurse can, therefore, provide another optional activity to lower that patient’s anxiety.

The nurse should keep the OCD welfare in mind. The patient could perform a ritual that goes further to cause harm to them. A patient that keeps on scrubbing the hands is likely to injure the hands (Yoshinaga et al. 2014). The patient could be switching on and off electric lines so many times until they are about to blow off. The nurse should guide the learner in identifying the acts that will not cause him harm. The nurse should also be aware of activities that cause exhaustion to the patient and therefore offer rest and nutrition.

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The nurse should make reasonable demands to the patient. Any demands that provoke anger from the patient should be avoided. The demands too that not only cause anger but anxiety to the patient should also be avoided.

The nurse should know the patients preferred patterns. This is in relation to patients that identify with particular arrangements and symmetries. The nurse should, therefore, create a way of knowing the preferred pattern of the patient (Yan et al. 2016). They can do this by interfering with the pattern and allowing the patient to arrange them again. The most important patterns are the ones that lead to a specific compulsive behavior. Obsessive Compulsive Disorder (OCD) In India Essay Paper

Listen to the demands of the patient carefully. These demands help to determine the obsessional fear.

If the patient is upset, it is good for the nurse to design activities that will breed happiness to the patient. The nurse should discourage activities that encourage loneliness and isolation of the patient. The patient is encouraged to the fear when they are lonely.

The patient should always be in high spirits and happy. The nurse can achieve this through. Setting accomplishments that when the patient does, increases and raises their self-esteem. These will also impact their confidence (Wheaton, Huppert, Foa and Simpson 2016).

The nurse should also discourage any topics that make the patient feel disturbed. These topics could act as anxiety triggers. The patient should, therefore, be protected from such activities. Such activities include viewing films that have the trigger topics.

Encourage other pleasurable activities as a way of diverting attention. When the nurse realizes that the anxiety trigger is near. They can begin doing other pleasurable activities. These activities include; singing, humming or even whistling. These are aimed at diverting the attention of the patient from the trigger. When the trigger is avoided the compulsive behavior is also impacted on.

Assisting the patient with diverse ways of making solving problems. This is helpful in the sense that. Whenever the patient is faced with fear they can use another method of diversion instead of the compulsive method. That way the patient will have a variety of things to do when faced with fear. The patient can also be helped to focus on other behaviors (Westermann et al. 2016).

Reduce as much as possible, gradually, the time taken for the behavior. For example, if the patient keeps spreading the bed, discourage any movements towards the bed during the day. This can be done by fixing a timetable. The timetable should not allow for any little time into the compulsive behavior.

Identify any slight improvements and appreciate them. Example a nurse would say. “You didn’t wash your hands the whole morning that is very lovely of you.” This helps in the general evaluation.

The nurse should observe any of her chosen methods that really don’t favor the patient and reorganize them. The favor should be honest and not faked by the patient (Tibi et al. 2017).

The last important role of a nurse is monitoring. Monitor that the patient takes all the drug treatment. Some patients miss their schedule. Another patient will reduce the dosage. The nurse and should be aware and monitor both the schedule and the dosage (Tibrewal et al. 2010).

Conclusion

Research has shown in India that more diagnosed with this OCD do not know where to get help. They seek help in the wrong places or do not seek help at all. These are due to fear of stigma and shame that they will be viewed as people who are suffering from mental health problems. Some who undergo sexual obsessions would prefer not to open up at all. The discussion has shown various treatment options that one can take to control the OCD condition. The method involves therapist guided activities that trigger the obsessional fear. The fear will then automatically trigger the compulsive behavior.

These are done through repeated durations. The exposure is first done with low-risk experience then later the risk is increased. This helps to reduce the fear in the person for the action. An example is a person who closes the door frequently and keeps checking it. The door is left open for sometimes until they are able to keep up with the situation. The expert guiding through therefore helps the patient in refraining. The refrain is one of the most important aspects of healing. It is the prevention of the particular response. The patient is allowed to stay in the fear situation until the compulsive fear decreases by itself slowly. The refrainer does not remove the situation but monitors as the patient cool down.

These above options are only successful when there is the use of the correct procedure. The procedure. The correct procedure have include proper observations to try and identify the obsessional thoughts that one might have. It is difficult to be exact but anticipations are done until one is identified. The second procedure is exposing the patient to the fear. Exposure to the fear though is done in varying amounts. At the start, the exposure is less but after sometimes the exposure is increased. It is advisable that before doing all this method.

Psychoeducation is conducted to the patient. The patient is educated about the benefits that the method will have to his condition. This method has two benefits; it corrects the dysfunctional belief. It also helps to make the patient feel they are in control.  When we use this method there are three ways to find out they are healed; when the fear has gradually diminished. When the exposure is done and the patient continues with other activities. Lastly, when the exposure is done and the patient smiles or laughs.

The above study covers various topics.  These topics help to identify, treat and care for OCD patients who are within us. We can, therefore, use the study to reduce the stigmatization of OCD patients in the Indian society. The article should help us see that these people are normal, just like any other person in our midst. The notion that children born with this infection are from lame parents should also stop. The Indian society should also provide a caring heart to this patients. These patients are not in any way lesser human beings, therefore they should not be stigmatized. The only thing they need is special care. Therefore Indian schools should find a way of endorsing them into the system. The Indian government should also give attention to the disease. This is after the WHO identifies it as one of the most handicap diseases in the world.

References

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Halter, M.J., 2017. Varcarolis’ Foundations of Psychiatric-Mental Health Nursing-E-Book: A Clinical Approach. Elsevier Health Sciences.  Obsessive Compulsive Disorder (OCD) In India Essay Paper