The goals of therapy are to diminish symptoms and to ameliorate or reverse their effects on the patient's interpersonal, work place and social functioning. A modest proportion of patients will achieve freedom from significant symptoms. The clinician can use the Y-BOCS symptom checklist to obtain a record of the patient's current and past symptoms. Treatment planning depends on the careful evaluation. As noted earlier, comorbid depressive and anxiety disorders will commonly be present.
Treatment approaches to such cases, including several kinds of psychotherapy, are also available.
If a patient is abusing alcohol to reduce anxiety, this problem must be addressed. The presence of a tic disorder, schizotypal or borderline personality disorders, or a personal or family history of hypomania or mania should be explored, since these would influence therapy choices. A comprehensive treatment plan evolves as one gets to know the patient. Experienced clinicians will exercise their clinical judgement in tailoring the plan to their patients' needs, preferences, capacities, situation and history. For a patient with isolated, mild to moderate OCD, a combination of an SRI and exposure and response prevention in vivo is a reasonalbe initial strategy in most cases.