TOP for OCD can be maintenance therapy for someone who has stepped down from an IOP level of care, or if a person does not require a higher level of care, it could be the only type of therapy he or she needs.
Most people are familiar with TOP from television shows or movies with scenes showing therapy sessions (though most of the time the therapists are portrayed as unethical dolts who either sleep with their patients or have no idea how to help them).
In TOP sessions, therapists work on exposures with their patients, assign homework exposures for their patients to do, and assess how their patients are performing in their daily lives, giving advice if needed or acting as a sympathetic ear in other instances. As time goes on, the sessions can be spaced out over the course of weeks or months until a person sees his or her therapist only on an as-needed basis.
A typical TOP session lasts forty-five to fifty minutes. The first session usually involves a lot of paperwork and an interview to get any pertinent background information (such as history of OCD symptoms), as well as establish a diagnosis. Subsequent sessions involve reviewing how things went in the last week, what stressors occurred, how many times a person experienced obsessions or compulsions, and how he or she challenged these.
Then, the therapist may have the person do some exposures in the session, or they may go together to do some exposures in public. Finally, the therapist will assign some homework for the patient to do before the next session.