In 1981, after I had been working with OCD for 3 years, I realized there was a need for a place for OCD sufferers to meet and work together on their problems. So, Gayle Frankel, an OCD sufferer, and I started GOAL (Giving Obsessivecompulsives Another Lifestyle), the first support group for OCD in the country. The GOAL model has been a powerful and effective way for individuals to help themselves and others in the OCD community. Below are some FAQs about GOAL support groups.

All support groups allow members with similar issues to find comfort and support from sharing; however, an unstructured group can often deteriorate into a destructive complaint group (or what one of our members referred to as a “pity party”), where members spend their time comparing symptoms and medication side effects. The GOAL model results in a support group plus where members not only find mutual support, but a way to free themselves from their OCD.

Meetings are broken into three phases: The Question GOAL Planning Socializing There are many different ways in which a support group can help and empower individuals and each of the three parts is necessary B each fulfilling important function for every member. When you come to a support group you hope to share ideas and thoughts about a common problem and maybe even come away with new ways of looking at your problem. However, without a specific focus, a number of problems can arise: a meeting can ramble aimlessly; it can become monopolized by a single individual’s issues; or become a repetitious comparison of symptoms and medication side effects. This is where The Question comes into play. Before the meeting, leaders choose a topic to discuss; (e.g., how do you cope with uncertainty and how does that affect your OCD?). The Question provides members a stimulus for examining their situation from a different angle, which helps to focus their ideas, thoughts and feelings about different aspects of OCD and its effects upon their lives B or in other words, a good question helps everyone learn from one another and grow. Of course, this depends upon the question; sometimes we will come up with great questions and other times not. We save the good ones and over time have developed a pool to draw from. The heart of the meeting is the second part, GOAL Planning, because it keeps our meetings a place of hope and progress. In the GOAL planning phase members break into small groups, each lead by the more experienced members. With their guidance members choose behavioral GOALs to work on between meetings. Usually they will be some form of exposure or response prevention. In this way the focus of the group is always positive as it reflects our belief that everyone can help themselves and others to move forward. Finally, there is informal socializing. The heart and power of a group resides in the friendship and trust people develop towards one another. These kind of relationships depend upon the sharing that best occurs without a structure beyond providing a place to meet. Fighting OCD is hard work and having friends who can help is the defining feature of what makes a support group work.

The GOAL concept is very flexible. Providing support to one another is more than just words – providing support can be helping individuals help one another. The idea of people empowering one another in a support group is not original with us. In AA meetings, the support is not simply people getting together and saying they have a biological problem and their only hope is depending upon a higher power. They also encourage members to take very active steps and make life changes (e.g., taking responsibility for what each individual can control by supporting positive non-drinking behaviors and confronting one another when they engage in at risk behaviors). Similarly, GOAL encourages members to do the same with their OCD. On the other hand, the GOAL approach can be adapted to a variety of formats and could be incorporated into a programmatic group therapy program or into the obsessive-compulsives anonymous format. GOAL is about empowering individuals and enabling them to take some control over their OCD.

The first rule of choosing a GOAL is picking something you are willing to do, because we want the individual to be successful. It doesn’t matter how small the GOAL is, because anything achieved is a start. If someone doesn’t want to choose a GOAL at our meeting, that is fine. For such individuals, we believe that over time they will change, because they will see others coming to the meeting and making changes and seeing improvement in their lives. You may ask why would anyone voluntarily submit to this: the answer is the desire to overcome OCD and the hope that comes from seeing the success of others who do take GOALs.

The group’s primary stated purpose is to help sufferers to gain some control over their OCD through the use of self-chosen behavioral GOALs. There are three groups of sufferers we try to support: Exposure and Response Prevention (ERP) is a challenging treatment. In reality, it is not harder than the suffering imposed by OCD. Despite this truth, there are many sufferers who are too afraid of the process to immediately commit to treatment. For these sufferers, the meeting provides a gentle, self-paced introduction to ERP that allows them to see they can cope with the process and, more important, that they can make progress. I always say to my clients, Ayour OCD never rests, so why should treatment? For those in the middle of an ERP treatment program, the group provides encouragement and supports that sufferer’s efforts to persevere and find freedom. Freeing yourself from OCD isn’t like overcoming the flu, that once conquered it is gone. It is much more like a garden reclaimed from an overgrown weed patch. The garden is beautiful, but without maintenance it can go back to what it was. In the same way, for those who have overcome their OCD, the focus on relapse prevention and goals make it harder for the individual to ignore small slips; this is a critical part of relapse prevention, because small slips can blossom into major relapse if unchecked.

Family involvement can be a very important part of recovery and, obviously people could choose to run a GOAL group with family and friends present. One of our rules in choosing a GOAL is the individual chooses something they are willing to do – not something to try, but something they will do. And if they choose nothing, they are not overly pressured. In allowing a potentially coercive family to be present, the meetings could lead to greater discord at home. We are also concerned that this may discourage sufferers from returning to the meeting. At our center, we run a separate meeting for families and friends that meets at the same time as GOAL. Obviously, this isn’t a rule that must be followed. There are GOAL groups that do include family members.

My goal is to have meetings therapist assisted as opposed to being professionally run. This means I or one of my staff is present at every meeting, but rather than running the meeting, we leave that to our more experienced members. We jump in and comment as needed. I think sufferers running a meeting with a professional present is the ideal. GOAL is really a system of recommendations of how to run a support group and to keep it positive. With that in mind, it is almost irrelevant whether it is therapist run, assisted or run without a therapist. We actually call ours therapist assisted, because although my staff and I attend meetings and help out, the actual meeting is run by our more experienced members. If you are reading this and there are no GOAL support groups near you, I would encourage you to start one. Obviously, If you’re a professional starting a GOAL support group, it will take some time for members to be experienced enough to take over. On the other hand, we realize that there are many areas where there are no professionals experienced with OCD available; if you are an OCD sufferer in this situation, we hope that the GOAL manual we wrote for the International OC Foundation (IOCDF) will enable you to start and run your meetings. The manual is available for download at the IOCDF website or at my book’s website, FreedomFromOCD.com Click on the articles tab and this will take you to the download for the manual. You may also be interested in the 13 Excuse Modes download also under the articles tab.