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As Good as It Gets 1

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As Good As It Gets
Overview

Melvin Udall, from As Good As It Gets, presents today in your clinic. He has a history of obsessive-compulsive disorder (OCD). Although past attempts at treatment were unsuccessful, Melvin wants to try again. He has just begun a relationship with Carol Connelly, a waitress, who has urged Melvin to explore treatment that will help him abandon some of his rituals, improve his social skills, and ultimately manage the anxiety and obsessions that cause his behavioral and interpersonal difficulties.

Client name: Melvin Udall
Psychiatric diagnosis: Obsessive–compulsive disorder
DSM-IV-TR criteria:
Client has either obsessions or compulsions:

Obsessions:
1. Recurrent and persistent thoughts, impulses, or images that, at some time during the disturbance, are intrusive and inappropriate and cause marked distress 2. The thoughts, impulses, or images are not simply excessive worries about real problems. 3. Client tries to ignore, suppress, or neutralize with some other thought or action such thoughts, impulses, or images. 4. Client recognizes that the thoughts, impulses, or images are a product of his or her own mind.

Compulsions:
1. Repetitive behaviors (e.g., handwashing, ordering) or mental acts (e.g., praying, counting) that the client feels driven to perform in response to an obsession, or according to rigidly applied rules 2. The behaviors or mental acts aim to prevent or reduce distress or some dreaded situation; however, they either are not realistically connected with what they are designed to neutralize or prevent or are clearly excessive.

Client recognizes the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.

Obsessions or compulsions cause marked distress, are time-consuming (more than 1 hour a day), or significantly interfere with occupation, education, activities, or relationships.

If client has another mental disorder, the content of...