Living with obsessive-compulsive disorder (OCD) can feel overwhelming and exhausting, but therapists trained in OCD and exposure and response prevention (ERP) therapy can help you learn to effectively manage symptoms.
Sometimes, it can feel like obsessive-compulsive disorder (OCD) is running your life. Between persistent intrusive thoughts and time-consuming compulsions, OCD can feel incredibly powerful. However, the condition is treatable. By working with the right therapist—trained in exposure and response prevention (ERP) therapy—you can regain your time and control over your life.
ERP is a specialized form of cognitive behavioral therapy (CBT) that works by helping you confront your fears, and teaching you to respond differently. It’s been clinically proven to significantly reduce symptoms in 80% of people with OCD who try it.
The first step toward recovery is finding an OCD specialist, who’s trained in ERP—but this can sometimes feel easier said than done. Read on for expert advice on how to find the best therapist for you, and embark on your journey toward getting better.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
What does therapy for OCD look like?
OCD can look similar to other mental health conditions, but its symptoms are unique—and must be approached accordingly. With OCD, intrusive thoughts, sensations, images, feelings, or urges cause significant distress—triggering a desire to perform compulsions (mental or physical) meant to reduce this distress, or prevent a bad outcome from occurring. OCD thrives on this cycle: Compulsions provide temporary relief, reinforcing the idea that you need them to respond to negative feelings—but the relief is only temporary, so the obsessions return.
ERP vs. other types of therapy
In order to break the cycle, you need to learn how to resist compulsions, without overthinking what is causing them. Traditional talk therapy is not recommended for OCD, because it often exacerbates symptoms, by focusing on why these thoughts have emerged. But, the content of your OCD obsessions don’t mean anything important about you. In fact, obsessions are typically ego-dystonic—meaning they go against your true values, and opinions. Talking a lot about these thoughts and feelings can result in inadvertent validation, or rumination.
“We don’t talk people out of OCD. We behave people out,” explains Dr. Patrick McGrath, Chief Clinical Officer at NOCD. That’s why ERP therapy is the best option for treating OCD. It teaches you how to tolerate uncertainty without resorting to compulsions, which in turn reduces the overall discomfort your obsessions cause. ERP works by gradually helping you confront fears, so you can learn new ways to respond.
While ERP falls under the umbrella of cognitive-behavioral therapy (CBT), not all CBT is effective for OCD. This is because many forms of CBT rely on reassurance, but reassurance seeking can be a common OCD compulsion.
Working with an OCD specialist trained in ERP is key—and ERP can be done both in-person, or virtually through a telehealth platform. Virtual ERP therapy can be especially helpful if you have a tight schedule, prefer the comfort of your own home, or live in an area that isn’t well-serviced by providers. Either way, ERP therapy with a trained therapist should be personalized and customizable to your needs.
Community discussions:
Do I need a diagnosis before seeing a therapist?
Diagnosis is the first step of treatment, but you don’t need a diagnosis in order to reach out to a therapist. An ERP therapist, general practitioner, or other mental health practitioner can provide you with a diagnosis, but it’s often best to go to an ERP therapist to get evaluated. These professionals know all the nuances of OCD, and are less likely to misdiagnose you. They can jump right into creating your treatment plan.
How to find an OCD therapist that’s right for you
Choosing the right therapist is a deeply personal decision, and starting therapy can feel intimidating. After all, it can feel scary to share your deepest feelings and thoughts with a relative stranger. Know that a therapist specializing in OCD has heard all kinds of intrusive thoughts—including the most taboo—and will never judge you. They know that these thoughts are not reflective of who you are, or your values, and they want to understand you to help you get better.
There are several types of licensed mental health professionals who are qualified to treat OCD, including licensed clinical social workers (LCSW), licensed professional counselors (LPC), psychologists, and psychiatrists. But, these titles aren’t as important as whether or not your therapist has specialized training in OCD and ERP.
“A specific degree matters far less than your therapist’s overall experience level and specific background in relation to OCD—and how comfortable you feel with them,” says Keara Valentine, Psy.D, a clinical assistant professor at Stanford University School of Medicine, who specializes in the assessment and treatment of OCD and related disorders.
Another important part of this process is determining if the therapist is a good fit for your specific needs. Trust here is crucial, especially since ERP can feel challenging at times. “It is okay to interview your therapist and make sure that they’re right for you,” says Dr. McGrath. “You should feel comfortable working with them, that this is a person who will challenge you, who will listen to you, and who you feel has your best interests at heart.”
6 questions to ask when choosing a therapist
If you’re not sure where to begin, here are a few questions you can ask a potential therapist to see if they are good fit for you.
1. “Do you use exposure and response prevention (ERP)?”
Because ERP is the standard—and most effective—treatment for OCD, this is the first question you should ask any potential therapist. If your therapist doesn’t mention ERP, consider that a red flag.
2. “How much experience do you have treating OCD?”
It is always good to assess a therapist’s experience treating OCD. If a therapist has only treated a few clients with OCD—versus dozens or hundreds of them—that’s important to know. It doesn’t mean you should rule out a therapist who is younger or earlier in their career, but it is something to be aware of.
Dr. McGrath reiterates that it is crucial to identify a therapist who has gone through ERP training. This might be through a behavioral therapy training institute, a treatment program, or lab/graduate program that specializes in OCD. Either way, hands-on experience is very important.
3. “What themes of OCD have you treated?”
OCD often fixates on specific themes. While all types of OCD share symptoms, if you’re dealing with a specific subtype, your OCD may present in certain ways. It can be helpful to make sure your therapist has experience treating the themes you’ve dealt with, so you feel comfortable sharing, and confident in their ability to help you.
4. “How would you describe your approach to the client-therapist relationship?”
Research shows that the biggest indicator of treatment success is the therapeutic alliance—the strength of the relationship between you and your therapist. Trust and collaboration are key here because OCD treatment can be hard. Make sure you like your therapist’s approach—whether that’s empathy and connection, or tough love. Everyone is different, so think about the most important qualities to you.
5. “Do you treat conditions that co-occur with OCD?”
OCD is an illness that often occurs alongside other conditions, such as anxiety, depression, body-focused repetitive behaviors (BFRBs), post-traumatic stress disorder (PTSD) and attention-deficit hyperactivity disorder (ADHD). If you’re dealing with more than one mental health condition, make sure your therapist feels confident addressing any and all symptoms you may be experiencing.
6. “Do you have experience working with people like me?”
Your identity can be key to understanding a lot of the stressors you face (both good and bad), so it is important to feel that the person you are working with can truly understand you. Maybe you want to work with a therapist who has experience working with people who share your gender, race, sexuality, religion, or other identity factors. It is also completely valid to search for a therapist who shares a similar identity to you, especially if this makes you feel more comfortable sharing your own experiences. A good therapist will understand why you want to know more about them and the people they have worked with. It’s a bad sign if your therapist is irritated by questions about this topic.
Bottom line
If you are signing up for therapy, or even taking initial steps—like searching for OCD therapists near you—be proud of yourself. This is a crucial move toward learning to better manage your mental health. ERP therapy isn’t always an easy journey, but it can be life-changing. With the right therapist, you can learn to live the life you want, not the life OCD demands.
Key takeaways
- Exposure response and prevention (ERP) therapy is the most effective treatment for OCD, because it was designed specifically for the condition, and disrupts the cycle of symptoms.
- It’s critical to seek out a therapist who specializes in ERP, and also respects your values, needs, and identity.
- Asking key questions when interviewing potential therapists can help you find a care provider that best fits your needs.