Obsessive Compulsive and Related Disorders

  1. James, a 24-year-old senior computer engineering student, is referred to the

college’s Positive Coping group by his engineering adviser when he fails to

attend most of his classes. At the first group meeting, James refuses to shake

hands with anyone, awkwardly stating that he has been sick and does not want

to pass his germs on to anyone. Initially, he stands, but when the group leader

politely asks James to take a seat, he ignores the upholstered chairs forming the

group circle and instead pulls a hard wooden chair over on which he precariously

perches on the edge. He is careful not to touch his back or his arms to the chair.

After the group meeting ends, when the group leader asks James to meet with

him privately, James admits that he has a problem with being outside around

other people. He states, “I don’t like to leave my room. There are so many

germs out here! People have no idea. Just being around other people coats your

skin with germs; you breathe them in, you take them back to your apartment,

and then it’s a lot of work to get rid of them. That’s the reason I can’t go to

class. The cleaning takes so much time. But you have to do it, and you have to

do it right; otherwise, you’re never going to be clean.” (Learning Objectives: 3

and 4)

a. What education does the group leader need to provide to James?

b. What treatment option(s) might the group leader suggest for James?