No two cases of OCD are alike: there are countless subtypes and triggers, it impacts people of diverse backgrounds, and it can change as they age. Considering other complex factors like co-occurring conditions and family support systems, it’s crucial for therapists who treat OCD to create highly personalized, evidence-based treatment plans for everyone in their care.
While OCD is a very serious condition and greatly impacts the lives of everyone who lives with it (despite popular misconceptions, nobody has “just a little OCD”), it also impacts people’s lives to varying degrees. Some might find that their symptoms only interfere with certain parts of their lives, while others may be entirely incapacitated by their obsessions and compulsions, leaving them housebound, requiring full-time caretakers, or at risk of suicide.
NOCD’s mission is an ambitious one: to restore hope for people with OCD through better awareness and treatment. This means better treatment for everyone with OCD, no matter how severely it affects them at the time. Here’s how we’ve built a treatment model that allows us to serve those who need help the most.
Our outcomes for people with severe OCD symptoms
Data lies at the core of what we do at NOCD. By measuring the impact of our treatment—not only on OCD symptoms, but on holistic measures of health and well-being—we ensure that we’re following through on our commitment to serving the OCD community.
Since OCD is considered a severe mental illness (SMI), what exactly do we mean by “severe symptoms”? In order to understand the individual needs of every NOCD Therapy Member, we learn how much distress their symptoms cause and how much their lives are impaired as a result. This information is gathered using the DIAMOND interview process, a comprehensive assessment of OCD severity using a scale from zero to seven. When a Member’s distress or impairment is rated six or higher, their symptoms are considered severe.
Now, let’s take a look at the results people with severe OCD achieve through NOCD Therapy.
We measured the treatment outcomes of every NOCD Therapy Member who began treatment with severe OCD symptoms and completed at least 12 therapy sessions over the past year. They experienced a median decrease in OCD symptoms of over 48%—results closely comparable with Members who started therapy with mild or moderate symptoms.
As you might expect, such a significant reduction in symptom severity can make an even greater impact for the people whose lives are affected the most by OCD. Our data offers proof of this: Members with the most severe symptoms experienced a 39% improvement in overall quality of life, compared to 21-24% for Members with mild to moderate OCD.
The bottom line: when people come to NOCD, we’re able to deliver truly life-changing, accessible, and affordable care—and those who are struggling the most achieve the most significant results. This can mean regaining the ability to care for their children, spending time with loved ones after years apart, or building a career after years of instability.
What allows us to treat severe OCD effectively?
Decades of research have shown that exposure and response prevention (ERP) is equally effective for all forms of OCD. But ERP is administered in a highly personalized way: just as a treatment plan focused on Relationship OCD will likely differ from a plan to address religious obsessions, treating Members with especially severe OCD symptoms often requires a different approach from mild or moderate cases.
We’re able to adapt our treatment approach to help people with severe OCD in several ways. For instance, NOCD Therapy Members who need the most support are able to meet with their therapist for 60-minute sessions up to five times per week, ensuring that they receive as much guidance as possible as they get started. As they progress through therapy, they continue to collaborate with their therapist to determine how frequently they should meet, and can adjust their treatment plan as needed.
Recommendations about session frequency are just one of the many decisions made on a case-by-case basis during NOCD’s thorough assessment process, which takes place over the first two sessions of therapy. Particularly for Members with more severe symptoms, NOCD Therapists are encouraged to consult with clinical leaders who have extensive experience in OCD treatment in order to make the most informed decisions possible about their Members’ care—including whether they might need concurrent treatment for a co-occurring condition.
The close guidance and collaboration between NOCD Therapists and clinical leaders also allows Members with the most severe symptoms to be matched with the NOCD Therapist who’s the very best fit. While every therapist in the NOCD Therapy network has specialized training to treat all types of OCD, some Members have other mental health conditions, distinctive treatment histories, or other factors that can make a significant impact on their treatment plan. In these cases, we can quickly and easily match them with a therapist who closely suits their needs among the hundreds of clinicians in our network, all of whom have received extensive, graduate-level training from top OCD experts on NOCD’s Clinical Leadership team.
Additionally, the innovative structure of NOCD Therapy allows us to help people who need the most support in ways other outpatient therapy services simply can’t. We provide all Members with several forms of support between sessions: direct messaging with their therapist, real-time support when OCD symptoms strike, tools to practice therapy exercises and track their progress, dozens of live support groups, dozens of live support groups, expert-reviewed educational articles, and a vibrant social community of others with OCD, all at no extra cost. These resources can be most powerful for Members who need the most support due to the severity of their symptoms.
Does NOCD ever refer people for more intensive treatment?
The type of care recommended by experts for severe OCD varies quite a bit: intensive outpatient programs (IOPs), partial hospitalization programs (PHPs), and residential treatment centers may provide some people with the best opportunity to beat OCD. NOCD and all other providers of outpatient care—like in-person OCD specialists, general therapists, or psychiatrists—are able to refer people to these programs when Members would benefit from more intensive treatment, for a variety of reasons.
Every treatment plan at NOCD is developed on a case-by-case basis, regardless of symptom severity. Sometimes the specialization, accessibility, and additional support provided by NOCD Therapy allows people to achieve life-changing results without needing expensive in-person treatment. But in some cases, we make collaborative decisions about referring Members to other trusted providers for in-person care—often due to the severity and nature of their symptoms.
For example, if a NOCD Therapist believes that a Member’s co-occurring substance use disorder (SUD) is likely to hold them back from progress in therapy, they would be encouraged to consult with a member of NOCD’s clinical leadership team about potentially referring the Member to a trusted provider for more intensive substance use treatment.
NOCD Therapists can also work in conjunction with a Member’s outside provider for their SUD, ensuring that their care for OCD will be productive and challenging, without triggering the Member to lose progress in their SUD treatment. For these cases, we’ve built an in-house coordinated care system to ensure that Members working with several providers get the best possible treatment.
The bottom line
OCD is a complex and often debilitating condition, and we cannot effectively serve the OCD community by offering “one size fits all” care. At NOCD, we carefully tailor treatment plans to each Members’ individual needs—including the severity of their symptoms—and work with insurance providers to make effective treatment affordable for Members who are struggling the most.
All of our processes and protocols—from the thorough assessment every Member goes through when they begin treatment, to the NOCD Therapist they’re paired with and the support they receive between sessions—have been built to serve the diverse OCD community. Starting with the very first time they speak with us during their intake call, NOCD Therapy Members living with severe OCD receive the elevated level of care they need—and they achieve remarkable results.