Report: #811038

Complaint Review: Wellington Retreat, Inc.

  • Submitted: Sun, December 18, 2011
  • Updated: Thu, October 18, 2012
  • Reported By: Stanley — Parker Kansas USA
  • Wellington Retreat, Inc.
    2200 Florida Mango Rd., Suite 201
    West Palm Beach, Florida
    United States of America

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THEY DO NOT TREAT MENTAL ILLNESS AS ADVERTISED!  BEWARE this company misrepresents themselves & they know how to con people who are emotionally vulnerable. Would not recommend this treatment facility for mental illness as they lead you to believe something other then what they will actually deliver.  They  treat addiction as well, but my experience was not with addiction so I cannot say whether their treatment plan is good for that; BUT BEWARE and cautious of what they are trying to sell you! I spent over $29000 on treatment for a family member and they refused to refund any of it when the treatment was worth about $10,000 based on experience with other treatment centers.  Here is what happened

Our experience with other Treatment Centers, including McLeans Hospital, Boston MA, which is the MOST RENOWNED IN THE COUNTRY, has been completely different and the cost!!  Director Micheal Jenike, MD, and has been for more than 25 years, discovered the best medical and behavioral treatment for Obsessive Compulsive Disorder. As soon as we found out THE TRUTH of what our sons treatment" was we had him discharged.

Upon discharge, we first met with Dr Barry Gregory (Clinical Director); who also did the intake 45 days earlier.  Who also told us at intake, we plan around his needs (individualized), we dont expect him to fit into  a mandatory treatment plan  Even held up a weekly schedule and said see we already have a treatment plan for him  I wondered at the time how that could be when we had yet to talk about his needs. (Although we had talked to the recruiter about some of his struggles.) 

RED FLAG we should have looked at it. 

Gregory wanted to know why we wanted our son discharged.  We told him we believed they

could no longer help our son and had another place for him to go.  We had found out just 4 days earlier, not only did our son NOT have an individual plan, that his calls to/from  had to be approved by Dr. Ian Silbert (therapist) and they were monitored and kept at 15-20 minutes.  But also, they led us to believe and we agreed no direct contact for first 2 weeks.  Even though we are his LEGAL GUARDIANS, they did not respect our authority over his treatment.  Nor had they initiated calls to our private psychiatrist (except Dr Moran, ONCE, who wanted to change meds the first week) as we had requested and they led us to believe they would.  As Guardians, we signed releases to/for our DR. to be our sons advocate.  Instead, Silbert kept calling our sons mother when he was upset about something, further traumatizing both our son and his mother who, at the time, was not emotionally equipped to deal with it (burned out after 25 years of being his primary case manager, etc.)

Our sons father actually had to get angry over the phone and remind Dr Silbert (and Dr Gregory earlier) that we have a legal obligation to talk to him.  (They kept asking what about, my husband kept saying none of their business) 5 min later our son called.  He told us Dr Silbert said he could use the Baker Act to keep our son there.   A threat.  We told our son we were coming to get him..

Dr Gregory immediately got up to get Dr Robert Moran (Owner and Director) as soon as we asked about treatment modalities for our sons severe OCD.  I guess Dr Gregory realized we actually knew something about proper treatment!

After Dr Moran joined the meeting, he proceeded to tell us that our sons true diagnosis was Schizophrenia, because of hallucinations, and Autism, because when someone talking to him, our son was not focused eye to eye, looked down.  (I wouldnt either, if I was distrustful!) Over 25 years and at least 20 treatment providers-this never happened.  In fact, TWO Drs who have recently assessed him agree with the original diagnosis of SEVERE OCD AND SCHIZO AFFECTIVE DISORDER.  We strongly disagreed; Dr.  Moran   gave us this blank stare as if he was trying to think of an answer).

Dr Moran explainedhisauditory hallucinations, paranoid thoughts.. Obsessional   ideationimpaired relatedness (he has many relationships in our local community)social withdrawal (he regularly does movies with a friend, shopping, Dr visits, etc).decreased motivation (major depression is what is called a spectrum disorder of OCD and often interferes with motivation).  The main difference between Schizophrenia and Schizo Affective is no facial expressions, very much in a different world without knowing what goes on around them and very BIZZARE behavior, i.e. being on a roof and believing they can fly and actually try it.  Our son is VERY expressive, etc,  

When we vehemently disagreed with this, Dr. Moran actually said to us they are all wrong, (the other Drs.) I am the only one right!!  Dr Moran had 2 or 3 interactions with our son before re-diagnosing (including tests) and drastically changed his meds the 2nd week, which took our son longer to stabilize.

The new medication does help, but has not been a complete resolution of our sons symptoms, as Dr Moran claims.  We have witnessed more anxiety than he had on his previous meds, and presenting of physical OCD rituals (checking, straightening, etc).  He still has delusional thoughts and paranoia however, the good part is, as time goes on, he has better control over how to deal with them.    Nothing has gone completely away as Dr. Moran claims.  Our son did tell him they had because he wouldnt listen to me anyway.

Dr Moran also told us he participated in groups and was consistently helpful to others.  Isnt that contradictory to Autism??

As treatment went on things got worse here is a just few of those issues:      

  • Said they would address IBS issue but was given lots of things that continued to

    irritate and caused pain, suffered for 6 weeks.        

  • Therapist that was supposed to see him every day (as told at intake) but saw him only 1 time

    a week. He displayed toward my son demeaning, belittling, humiliating & embarrassing behavior in front of my son & other patients which was very traumatic for my son and debilitating towards his treatment to get well.        

  • His meds were administered later then they should have been & he did not get enough rest        

  • We made every effort to voice his medical/psychiatric needs to the staff/owner at time of

    admission but was completely ignored.        

  • They have refused to give us some reimbursement, because they claim he received state of

    the art treatment,  when we, in fact, believe our son did not get the

    treatment promised from day of admission.  We paid for state of the art

    house to live in, not treatment.

Our son is currently in a facility receiving State of The Art Treatment for THE COST!!!!!


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This report was posted on Ripoff Report on 12/18/2011 02:54 PM and is a permanent record located here: The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content

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Updates & Rebuttals


#1 UPDATE EX-employee responds

Medication? Really?

AUTHOR: Matt Rivers - ()

The medication he advised Jill to keep for future patients because he wrote the script Dr. Moran feel some ownership to the controlled substance that are illegaling storing and dispensing to new patients. Let's start off by saying he charged my insurance over 100.00 because he wanted to experiment on me so I had to pay all these copays along with the insurance fraud he caused. Upon discharge I was advised by his tech you can't take controlled medication home. Who says that? I paid for them so they are mine. I really want this place to close down this is the absolute worst place to go to helling.

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#2 REBUTTAL Owner of company

Dr. Moran does a great job

AUTHOR: John Fitzpatrick - ()

My daughter has been in many rehabs and wellington Retreat is by far the best one!!!  Dr. Moran and his staff are caring, professional and dedicated.  They do not kick anyone out who is trying to recover and they work with the families and addicts to keep them in transitional living instead of halfway houses.  For the first time in years I have hope my daughter can recover because of Dr. Moran and Wellington Retreat!

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#3 UPDATE Employee

Notice of Lawsuit and Subpoena

AUTHOR: Timothy P. O''Neill - (United States of America)

 Please take notice that Wellington Retreat ("WR") and Dr. Robert Moran (MORAN) have initiated an action in the Florida Circuit Court, in and for Palm Beach County entitled  WELLINGTON RETREAT V WOLLARD and John Does 1-3; Case No. 502012CA007951XXXXMB due to allegedly false statements made by you (the "Action"). In the Action, WR and MORAN seeks to subpoena the records of Xcentric Ventures LLC for your contact information and any other messages
that you have posted on the website Rip Off Report,, under the pseudonym "Anonymous" or any other pseudonym or name, about WR or MORAN , to the North Palm Beach Office of Cohen Norris at:

Cohen,Norris, Wolmer, Ray,
Telepman & Cohen

712 U.S. Highway 1, Suite 400
North Palm Beach, FL 33408
(561) 844-3600
(561) 842-4104 (Fax)


If you do not respond within 3 business days with your true and correct contact information to the address,fax, or email above, we will subpoena the records as outlined above.
You may have a right to file and serve a response to the subpoena anonymously. If you intend to file and serve a response, please do so, or notify us of your intent to do so, on or before October 23, 2012
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#4 Consumer Comment

Police Report

AUTHOR: closedcircuittv - (United States of America)

If you post a fax number, you can get a police report that appears to show two overdoses.
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#5 General Comment

Police Report

AUTHOR: closedcircuittv - (United States of America)

If you provide a fax number, you can get a police report from August 2012 that appears to show two overdoses.
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#6 Author of original report

Consumers Reporting and Saga Continues


Stan Parker, KS   It is confirmation as I see continuing information from others who have had bad experiences with Wellington Retreat.  Humiliation and lack of seperation for mental illness and drug abuse.  This facility makes money on drug abuse patients and again I state they did not treat our son's OCD Anxiety Disorder.  He is taking a highly volitle drug that requires weekly blood test to make certain his white blood cell rate is not diminishing.  What a hastle doing this every week at the hospital and having it faxed to the Pharmacy to be filled.  His Psychiatrist, D.O. here would have taken other options versus this drastic medication.  Our Son has  more trouble with his OCD and he went there for treatment of that situation.  No we are working to fix that!

Wellington Retreat has made only "one" effort to defend themselves so I read this lack of defending themselves that they are accepting what is posted is in fact "true."   And it is!   Again I was asked by our son to return a call to Dr. Gregory when he called and I was not at home.  When I returned call and identified myself he hung up on me!  They have made no effort to balance our bad experience with a resonable refund of an exorbatant fee!!!  I also assume owner Dr. Moran is being shielded from these reports by his staff.  Be very careful and research institutions.  This is not a good one--and they will take anyone for anything.  For them it is all about the Money!   

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#7 Author of original report

Left a message to call and hung up on me when I returned call


Stan W. Parker, KS  Very interesting that while I was gone last week got a call from Dr.? Gregory.  Obvious they really wanted to speak with Aaron but asked I return a call.  aaron spoke just a few words.  He is doing better only because we have him being adjusted on meds and put under compentent care.  Well I returned that call today and after announcing who I was and returning his call line went dead.  Hung up on me is how I read it.  If you complain about them they want nothing to do with you.  I also suspect Gregory is shielding all the reports on RipOff and others from Robert Moran.   The truth is out and they do not like it.   
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#8 Author of original report

A Report to Florida Mental Health Consumer Services Low Rating


Stan W. Parker, KS.  Continuing our effort to make the lives of others better and avoid the poor treatment at this center we are moving to the next step.  We are reporting Dr. Robert A. Moran to the Florida Consumer Services for Health Care.   Moran did not aid us with our son's treatment and not licensed for Mental Health.  Even Drug Addiction Program, you can see reports from others here, was not supportive.  Facilities on web site misleading and our son reported the Hot Tub did not work.  So did not honor our guardianship, inform us or our local Psychiatrist of 6 plus years, did not have family counceling, therapist Sielbert intimated our son in front of thiear group indicating Aaron was leaving and could not handle the treatment.  At athe end of the day the list goes on and why would we want to spend thousands more dollars for the mishandling and treatment of our son--it was tramatic. 
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#9 Author of original report

Wellington Retreat Does Not Honor Guardianship


Stan W. Parker, KS  Our son was admitted to Wellington and legal court documents submitted to verify our guardianship.   Wellington and Dr. Moran and his staff did not honor our guardianship.  They did not contact us for drastic medical change nor our renowed highly educated Psychiatris during his treatment.  He was placed on a highly dangerous drug that causes drouwling and requires a weekly blood test to be certain his blood count balanced.   This was uncalled for and interesting in that Dr. Moran, owner of facility, is on a board who reviews guardianship for the mentally ill.   HE DOES NOT HONOR Guardianships.   They do what they wish and not interaction with parents or Doctors.  Now we are in the process of dealing with his OCD which the drug does not address.  We sent him there for OCD treatment and getting independent.  They did not even have any kind of a plan in place for him moving forward in a local independent living setting.  They just wanted to keep him longer--It is All about the MONEY!  We are now in the procaess of adjusting medications so he will be better.   
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#10 Author of original report

Misdiagnosis By Wellington Retreat


Stan Parker, KS  After 10 astute Psychiatrists over a 25 year period now Dr. Moran diagnosed our son with Schizophrenia and Autism.  He is the only one including other well known and honored treatment centers.  Other Dr.s have diagnosed him with severe OCD and only in the last 6 years Schizo Affective Disorder.  There is a vast difference between Schizophrenia and Schizo Affective.  Schizophrenia is a bazzar detachment from reality and personality change.  Autism is the in ability to concentrate and having a blank stare.  Our son is very very intelligent and communicative as are most with OCD.  Dr. Moran says "I am the only one who is correct."   WRONG.  Now we are in the process of adjusting his medications to correct them missing his OCD.  They did not treat him for this anxiety disorder and related Irritable Bowl Syndrome associated with the high anxiety.  He was miserable the whole time there.  Dr. Moran is so vain he even prints "Moran Dollars" used in his drug addiction treatment.  REALLY!  At the end of the day it is all about MONEY, taking your money and keeping your loved one at his facility.  They are not licensed for treatment of mental illness only drug abuse.  BE CAREFUL and do Google Wellington Retreat to see additional information confirming the same from others.
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#11 Author of original report

Wellington Web Site Smoke in Mirrors


The web site for this organization very very misleading.  They show pictures of large rooms in their residence houses and this is not where your loved one stays.  The rooms are small and my son reported very durty.  His sox would get filthy from waking on the floors.   Essentially, there are only two large rooms and the coordinator stays in one and a patient stayed in the other.   The rooms you see on the web site are the only two rooms like that the others are very small and double occupancy.  If you are taken to tour they will show you the big rooms leading you to beleive that is where your loved one stays.   NOT TRUE.  BE AWARE!!!!!     
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#12 Author of original report

Not Licensed for Mental Health


Stan W Parker, KS

In my efforts to report sub standard care and staff contacted Licensing of the facility.  Learn they are not licensed for Mental Health only drug dependency.   Therefore not able to share that they are "Smoke in Mirrows" advertising on their web site.   However, was able to find Florida agency to whom I found are able to review their treatment for drug abuse.  My son reported that clients did not take thier Suboxen so they could sell it to others and they could take more than prescribed levels to get their drug "high."   Now question Wellington management and staff that allow this to happen.  Not controlled and does not support the patients.   Have reported to agency that can review their practice. My wish is that others are not dupped and pay the high costs to get treatment that is ineffective.  Do share your stores on this site as I have.  I now see that if one Googles Wellington they will find these reports and can add their experience to help others.  Have even reviewed on Yellow Pages and this will appear in your seach as well.  BE CAREFULL and do not waste your money.  This organization works at keeping their patients as long as possible.  At the end of the day this is all about the money. I will be reporting more on the rooms in the facilities shared by my soon next post. 
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#13 Author of original report

Now Exposed to Tuberculosis


This report is an update on report 811038 filed regarding the overpriced services provided by this facility.   Review the details in this report.   Our saga of disappointment, discouragement, frustration, and being taken financially by this facility continues.  Now I report that our son tested positive for

tuberculosis.  Never in his entire life has he tested positive for this until after being at the Wellington Retreat.  Now he cannot take a job being directed by his current mental health advisors working to get him into a routine and independent life style.  Also, the Wellington Regret said they would do this but they never got a plan in progress.  They just wanted to continue to take our money as they will yours.  Be

aware if you are considering admitting a loved one to this facility.  There is a chance of getting Tuberculosis and no system in place to control or eliminate infection.  And we are on to reporting this to the Florida Health Administration.

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#14 Consumer Comment

Wellington Retreat is a Puppy Mill for the Mentally Ill and Drug addicted!!

AUTHOR: Bob S. - (United States of America)

Anyone who has any doubts about Wellington go try to visit your child or see how things are done there and you will get a rude awaking.  They claim to treat the individual but its hard to see how they can treat the large volume of patients who are both mentally ill and drug addicted with the ever rotating staff who don't even have time for ink to dry on their business cards.  

All the patients are mixed together and often times many patients who are severely mentally ill are placed together with those recovering from drug addiction. I truly feel sorry for those who are mentally ill but they should not have potentially dangerous patients unsupervised with the recovering addicts.  
Occasionally these patients over lap but often times they do not.

Patients with severe schizophrenia and other mental disorders need very specialized care and it traumatizes the recovering addicts to see a mentally ill patient screaming, humping the couch or talking to him or herself.  Wellington Retreat and Dr. Moran need to really think about how they care for these two very different and serious mental and medical issues.

The amount of individual attention Dr. Moran and his minions give to patients is extremely limited and the parents like me for the most part are kept bare foot and stupid.

When I finally found out how my child was being housed dirty, unshaven and unwashed in a halfway house with no access to any toiletries except what Dr. Moran would occasionally allow.  They expected my child to get a job but made no attempt to give him the tools to get a job.  

I am not sure how keeping my child dirty, smelly without a hair cut and without access to a phone or the internet was supposed to teach him how to get a job.  

Parents need to really ask the hard questions of the Wellington Retreat and their staff and  to demand to talk to their child privately once in while and also visit them at Wellington Retreat.

  Most importantly get a second opinion on your child's medication.

Dr. Moran over medicates the patients for compliance and you need to get an outside opinion before you just allow it.  

Wellington tries to completely isolate you from your child and while I agree to some degree it may be needed at the beginning.  Wellington exploits it and Dr. Moran is the center of the Wellington universe. Dr. Moran is so vain he actually has his own money with his picture on it called Moran dollars.  I am not sure if he has them to bribe the patients or he is just so vain he likes to see his own picture on the dollar bill.

Nobody can do anything without his express approval and interaction with the parent is severely frowned on.  On Wednesday night Dr. Barry tries to convince you that you need to let go and let Wellington take care of your child.  Have faith they tell you and everything will work out.  

You will find out very quickly how Wellington operates the first time you need something.  You wouldn't treat your sick dog or cat like Wellington treats our children.  If Wellington had nothing to hide they would have things like video conferencing so you could actually see your child and the councilors but believe me the last thing they want is transparency.   
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#15 REBUTTAL Owner of company

Now Exposed to Tuberculosis

AUTHOR: Stanley - (USA)

Wellington Retreat, Inc.  Tuberculosis Advisory West Palm Beach, Florida

This report is an update on report 811038 filed regarding the overpriced services provided by The Wellington Retreat, Inc.   Review the details in this report.   Our saga of disappointment, discouragement, frustration, and being taken financially by
this facility continues.  Now I report that our son tested positive for tuberculosis.  Never in his entire life has he tested positive for this until after being at the Wellington Retreat.  Now he cannot take a job being directed by his current mental health advisors working to get him into a routine and independent life style.  Also, the Wellington Retreat said they would do this but they never got a plan in progress.  They just wanted to continue to take our money as they will yours.  Be aware and we are on to reporting this to the Florida Health Administration.

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#16 Author of original report

Unneeded Drug Testing

AUTHOR: Heather - (USA)

Recently received Medicare Report and all testing was done for illegal drugs.  Had nothing to do with his OCD treatment.  Re affirmation that they do not treat mental illness and you will be vastly over charged for services you do not receive.  This confirms the re-diagnosis was incorrect and incompetent.

If you have had similar experiences with this organization report it to assure others do not get scammed.   
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#17 Author of original report

Wellington Retreat Rebuttle Update

AUTHOR: Heather - (USA)

**In his rebuttle to our complaint Dr. Moran (Owner) states "we provide a comprehensive..treatment program...neuropsychiatric disorders" Not for our son.  He "directs the care of each..patient..."  Dr Moran saw our son once a week and met with staff "treating" our son every day.  Our sons needs were not met.

After talking with our private psychiatrist about meds, he made a drastic change the 2nd week, instead of taking our Drs' recommendation and told him he wanted to try Clozerel as he had told us at intake.  So the 2nd week the change was made.  Our psychiatrist has seen our son once a week for more than 6 years and knows his illness quite well.  Dr Moran after 2 interaction, thought better.

Dr Moran goes on: "it is the psychiatrist who can determine by talking with you what parts of the brain are not working well."  He did not contact us as Guardians for 12 years (our son's brain is impaired). He did not discuss treatment options with anyone.

Dr Moran states "there are treatment programs,,,,have little to no valid research supporting their use...addiction treatment programs which do not integrate into treatment medicines...proven to be more effective than a 12-step approach alone."  If Dr Moran claims he treated our son for mental illness, there was no need to force him to attend AA and NA programs and told to work on steps 6 and 7.  I (his mother) was a facilitator in a 12-step program for 4 years. These 2 steps have to do with character flaws/shortcomings which are symptoms of his OCD intrusive thoughts-often about his character/shortcomings, which are controlled with proper medical protocol.

Dr. Moran then proceeds to (in my opinion) insult our private Dr. The best out of 20 in 25 years.  Has made more progress helping our son mange his symptoms (instead of his mother's help) than all the others put together, including Dr Moran.  He states "...people seek treatment from individuals without even knowing their credentials."

Our Dr. has several degrees, including McLean's Hospital in MA, Meninnger when they were in Topeka, Harvard Medical, Mayo Clinic, University of KS and of MO, I could go on.  He is certified by the American Board of Psychiatry and Neurology, as well as speaking nationally on tooics of psychopharmacology,  etc.,etc.,etc.

Needless to say our Dr has provided excellent psychotherapy, as well as medical and Behavioral Therpy

Dr Moran is correct when he states what CBT is.  Problem is his so called therapist did not use CBT.  However, to be fair, another Dr. did about once a week.  When our son was in McLeans-inhosptial-he received CBT every day and had some improvement over symptoms.

Dr Moran also mentions the medications for OCD.  The best being Anafrinil, which our son was  on for years and the symptoms almost not-existent.  They have increased in severity to the point he is too overwhelmed to make his bed.  Also, it helped with the depression and somewhat with the IBS.  Now we are in the progress of changing meds and/or dosage to reduce these issues.

The decription of Obsessive Compulsive Disorder is all correct and almost every symptom mentioned our son is stuggling with, some more than others.  In the case of our son, symptoms have often been so severe they have caused him to shutdown completely because his thoughts were too overwhelming to deal with.  As I said above the Anafrinil highest dose possible helped him to overcome those feelings, along with less depression etc.

Although the Clozerel Dr Moran put him on has helped a great deal with dispelling the Paranoia, which is a big relief, one of the side effect, according to the pharmacy cautions received, is "obsessive compulsive symptom".  I guess that was not an issue for Dr Moran, since his diagnosis, unlike anyone elses, was correct.  Our son has schizophrenia not OCD (read original complaint).

Dr Moran did not relieve our sons IBS, but he has been recently prescribed somethins that seems to be helping.  Zoloft is not working for the OCD.  Didn't the last time it was prescribed, which Dr Moran would have known if he had involved our Dr.

Interesting Dr Moran's rebuttal, since he called and offered 10,000 refund the day after it was posted, (to make us go away)?  It's not just about the money (for us) it's about no one else being traumatized by this "scheme".

At the end of the day we believe we received help for the paranoia and a fancy (although not always clean) house to stay in.  And we believe in light of this experience, we should be reimbursed at least 1/2

 the fee:  $14,500.  Still not enough considering the trauma for the whole family, but in our estimation fair.

We would, of course, report this settlement, if it happens

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#18 UPDATE Employee

Wellington Retreat

AUTHOR: Wellington Retreat - (United States of America)

Wellington Retreat where we provide a comprehensive  biopsychosocialspiritual treatment program incorporating services necessary to treat both addiction and other neuropsychiatric disorders. Wellington Retreat is unique among the national treatment centers in  that Dr. Robert A. Moran, our neuropsychiatrist/addictionologist, directs the care of each individual patient from admission to discharge.

Wellington Retreat understands that each individual has different  needs. To that end, the program is created around meeting those needs.  The comprehensive evaluation completed by the treatment team determines the overall treatment plan that is highly individualized. An individual may need Partial Hospitalization Treatment that provides a structure and highly intensive treatment path or if circumstances dictate, the Intensive Outpatient program which allows an individual to maintain work and family structures. Whatever the situation, Wellington Retreat can build the treatment plan around the individual so that it supports their recovery in and out of treatment.

Everyone should receive state of the art treatment. Psychiatry is the subspecialty of medicine which focuses upon how the brain expresses mood regulation, anxiety, thought process/content, and behavior. More and more research reveals how increasingly complicated brain function is. When people develop problems in any of these areas, it means that the part of the brain which controls that function is not working properly. It is the psychiatrist who can determine by talking with you what parts of the brain are not working well.

Once a comprehensive evaluation is conducted and a diagnosis is established, treatment can then be offered. It is very important that every individual seeking help is made aware of the available treatment options which have been proven by medical science to be effective. This is what is referred to as evidence-based medicine. To obtain this description, multiple medical studies have been done and scrutinized by researchers and clinicians before being accepted as effective treatment.There are very many so-called treatments/treatment programs promoted in our country which have little to no valid research supporting their use. We see this very commonly in addiction treatment programs which do not integrate into treatment medicines which have been proven by research to be more effective than a 12-step approach alone. When the science is ignored, people suffer needlessly. As a result, I think that evaluation and treatment recommendation should always begin with the psychiatrist. Far too often, people seek treatment from individuals without even knowing their credentials. Often, people have problems with mood, thinking, and behavior, which are caused by underlying medical problems that have not yet been diagnosed. Since the psychiatrist is also a physician, he/she can determine the further evaluation/medical testing that should be done to identify these other problems.

The treatment recommendation may include psychotherapy. If so, it would by a type that has clear evidence supporting its efficacy, such as cognitive-behavioral therapy, psychodynamic therapy, or motivational enhancement therapy. Just talking nicely to someone is not the same as therapy. When conducted properly (with the experience of formal training and supervision), these psychotherapies can be just as powerful as medicine. Knowing when they should be combined with medicine or used in place of medicine is the art of psychiatry.

The goal of treatment in general is to help you feel much better. This includes resolving distressing/disabling symptoms and improving overall level of functioning. I never give up until I have helped you to achieve those goals.

In CBT, the individual identifies all of the obsessions and compulsions he/she has and creates a list which can then be ordered in terms of severity (that is, the degree of difficulty to resist). The therapist then helps the individual to experience the obsession without giving in to the compulsion. Properly done, these exercises can be very effective and usually the individual is surprised with his/her success. Medicines which are used involve those that act on the serotonin system in the brain, such as Prozac, Zoloft, Paxil, Anafranil, and others. They can be very effective but tend to take a number of weeks to work. Overall, the combination of treatments is most effective in most cases.

Obsessive Compulsive Disorder is considered a form of anxiety disorder. It is characterized by  obsessions, which are recurrent, intrusive thoughts which lead to anxiety; and compulsions, which are repetitive behaviors which have developed in an effort to reduce the anxiety. Examples of obsessions include thoughts of having left a door unlocked or the stove on. This then leads to the person having to check these things (the compulsion). In OCD, there is temporary relief of anxiety, but the individual soon returns to having the obsessions which create the compulsion to check again. This may then happen a number of times, consuming hours of ones time. Obsessions may take other forms, such as thoughts of having to order/organize; thoughts of having been dirtied or contaminated; and thoughts of having to ward off something bad from happening. In addition to checking, the compulsions which follow the obsessions may include organizing, making objects symmetrical, washing, counting, repeating, etc.
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