ERP therapy is highly effective for OCD, but its cost can sometimes feel overwhelming. Specialized therapists ensure tailored, effective care, reducing the risk of ineffective treatment. For those unable to afford therapy, support groups, online communities, and educational tools offer valuable interim support.
If you’ve been diagnosed with obsessive-compulsive disorder (OCD) or started researching it, one thing becomes clear very quickly: exposure and response prevention (ERP) therapy is consistently recommended as the most effective treatment for the condition.
Backed by decades of research, ERP is a specialized form of cognitive behavioral therapy (CBT) that helps people with OCD face their obsessions and resist performing compulsions. ERP works by gradually exposing you to situations that trigger your obsessions and intrusive thoughts while helping you resist the urge to engage in compulsive behaviors, which breaks the OCD cycle over time.
While ERP can be life-changing, its cost can sometimes catch you off guard—especially if your insurance doesn’t fully cover it.
It’s completely normal to feel conflicted or overwhelmed when looking into the price of ERP therapy. The truth is, ERP’s cost reflects the unique factors that make it so effective, such as working with highly trained specialists and tailoring treatment to your individual needs. But is it worth it? And what makes ERP therapy so valuable?
In this article, we’ll break down how much ERP typically costs, why the pricing exists as it does, and how the long-term value of this therapy can make it one of the most important investments in your recovery.
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All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
What is the price of OCD therapy?
The cost of working with an ERP-trained therapist without insurance coverage is around $350 per session on average, but it can sometimes be much higher—even up to $500 per session. These costs are sometimes paid fully out-of-pocket, as insurance companies often view OCD as a specialty condition whose treatment they do not cover. This price can feel overwhelming, especially when compared to traditional talk therapy sessions, which typically range between $100 and $200.
What factors affect the cost of ERP therapy?
The cost of ERP therapy depends on a variety of factors, including your personal situation, where you live, the severity of your OCD, and whether or not you have health insurance. Without insurance, sessions can be significantly more expensive, often ranging from hundreds of dollars per session. However, if ERP therapy is covered by a major health insurance provider, the cost can be significantly reduced, sometimes bringing session fees closer to standard copay amounts ($20-$50) for mental health services.
In general, ERP therapy is considered more expensive than other types of therapy due to its specialized nature and the broader challenges within mental healthcare. These include the limited number of trained ERP therapists and the time-intensive, tailored nature of the treatment. For those with health insurance, coverage can make this highly effective treatment far more accessible and affordable.
Misdiagnosis and insurance coverage
One of the reasons ERP therapy can be expensive lies in the history of OCD being frequently misdiagnosed. OCD is often underdiagnosed because its symptoms can overlap with other mental health conditions like generalized anxiety disorder (GAD) or depression. Additionally, the wide range of OCD subtypes—such as harm OCD, religious OCD, or relationship OCD—can make it harder for clinicians unfamiliar with the disorder to recognize its patterns.
This lack of accurate diagnosis trickles down to insurance coverage. Most health insurance companies misattribute costs caused by untreated OCD to other conditions, since many providers misdiagnose OCD. In fact, a staggering 96% of people with OCD don’t surface in claims data due to misdiagnosis and mistreatment.
As Dr. Patrick McGrath, Chief Clinical Officer at NOCD, explains,“Insurance companies will look at their networks and see that not many people have OCD, and then they’ll say, ‘Well, it’s not really an issue.’ So, they don’t prioritize bringing in a specialty network or paying a premium rate for evidence-based treatment for it.” As a result, insurance companies often fail to prioritize covering specialized treatments like ERP therapy, leaving many patients to cover the cost out of pocket.
This is why it’s so important to seek out a specialized therapist if you think you might have OCD—even just for an accurate diagnosis. A specialist can ensure your condition is properly identified, helping you avoid the frustration and setbacks of misdiagnosis. Misdiagnosis not only delays appropriate care, but also contributes to the perception that ERP isn’t widely needed, which in turn drives up its cost by limiting access to covered treatment options.
Limited availability of ERP therapists
Another significant factor driving the cost of ERP therapy is the limited number of therapists who specialize in it. As Dr. McGrath points out, “There’s not a lot of therapists who have traditionally done ERP, and most of them are located in big cities, which are more expensive, causing them to charge a premium.”
This scarcity means that patients in smaller towns or rural areas often have to pay higher rates or travel long distances to access therapy. Additionally, therapists in urban areas may charge more due to the higher cost of living and demand for specialized care.
Virtual ERP therapy
However, the rise of virtual therapy has significantly improved access to ERP, offering effective and often more affordable options compared to in-person sessions. One study analyzed over 3,500 individuals undergoing online ERP therapy and found that virtual ERP was just as effective as in-person treatment, leading to a decrease in OCD symptoms and improvements in depression, anxiety, stress, and overall quality of life. Platforms with virtual ERP provide accessible, evidence-based care at lower costs, particularly helpful for those in underserved areas where in-person therapy might not be an option.
Additionally, the number of therapists specializing in ERP is gradually increasing, thanks to organizations focused on expanding access to this critical treatment. As Dr. McGrath explains,
“You could get a lot of great training for OCD for not very much money, but traditionally there haven’t been enough therapists trained in ERP. That’s why some organizations offer free training and continuing education to increase access to evidence-based care.”
With this expansion in training and the growing adoption of virtual therapy, there is hope that the scarcity of ERP therapists—and the high costs associated with it—will improve in the future.
Why specialized therapists matter for OCD treatment
When it comes to treating OCD, finding a specialized therapist is crucial. Traditional talk therapy can be effective for other mental health conditions, but they often fall short in addressing the unique challenges of OCD. In fact, research shows that using non-specialized forms of talk therapy and CBT for OCD can actually make your condition worse. Specialized training in exposure and response prevention (ERP) therapy is essential for breaking the cycle of obsessions and compulsions that defines the disorder.
Traditional therapy often focuses on alleviating symptoms through general coping mechanisms, but without ERP, it can unintentionally reinforce compulsions or fail to target OCD-specific behaviors. Research consistently shows that ERP is the most effective OCD treatment, making it essential to work with someone trained in this approach.
ERP therapists are trained to address OCD subtypes—like contamination fears, harm OCD, or relationship OCD—that general therapists may not fully understand. This specialization ensures the right treatment approach and increases the likelihood of recovery. Dr. McGrath emphasizes, “If you were going to have surgery on your heart, you wouldn’t go to your GP for that. You’d go to a cardiac specialist. Why wouldn’t you go to someone who specializes in the condition you have?”
If you were going to have surgery on your heart, you wouldn’t go to your GP for that. You’d go to a cardiac specialist. Why wouldn’t you go to someone who specializes in the condition you have?
Dr. Patrick McGrath
Choosing a specialized therapist is an investment in your recovery, and while it might be more costly than traditional therapy, working with an ERP specialist gives you the tools and support you need to manage OCD effectively and reclaim your life.
Why ERP therapy is worth the investment
Untreated OCD often worsens over time, making symptoms more entrenched and harder to manage. Ineffective therapies, like traditional talk therapy or general CBT, can also lead to years of unnecessary costs and frustration, as they often fail to address the root cause of OCD.
Dr. Patrick McGrath explains, “The longer you let OCD grow, the bigger it gets. If you wait, it just makes the therapy more in-depth and more difficult later on. Maybe it is an expense now, but it’s probably going to be probably even more of an expense later.”
The longer you let OCD grow, the bigger it gets. If you wait, it just makes the therapy more in-depth and more difficult later on. Maybe it is an expense now, but it’s probably going to be probably even more of an expense later.
Dr. Patrick McGrath
While ERP therapy may cost more upfront, it’s an investment in effective, evidence-based treatment that directly targets OCD. Starting sooner can help prevent years of emotional and financial strain, giving you the tools to reclaim your life.
Community discussions
What if ERP costs too much for me right now?
For some, the cost can feel out of reach. If you’re at a point where affording ERP therapy isn’t possible right now, it’s important to know that there are still resources and steps you can take to start making progress instead of feeling stuck without help.
Dr. Patrick McGrath highlights some helpful resources. “GOALS groups are typically free and are run by people who have OCD or by clinics. They provide access to community support while you work toward receiving treatment,” he shares. You can find these through the International OCD Foundation, which also has a ‘Find Help’ section for locating additional resources.
Support groups, whether in-person or online, can provide a space to connect with others who understand your experiences and share strategies for managing OCD. Online communities, like forums or social media groups, can also serve as informal support systems while you work toward professional help.
In addition to support groups, educating yourself about OCD can help you better understand your condition and how to manage it. The IOCDF website offers a wealth of free resources, and reading evidence-based books on OCD or ERP can give you tools to start challenging your symptoms on your own. Taking even small steps now can help you feel less alone and more prepared to pursue treatment when it becomes possible.
Bottom line
ERP therapy is the most effective treatment for OCD, offering the tools to break free from obsessions and compulsions. While the cost can be challenging, investing in specialized care early can prevent years of unnecessary struggle. If therapy isn’t affordable right now, resources like support groups, educational materials, and online communities can provide valuable help as you work toward professional treatment.
No matter your situation, you’re not alone. With the right steps and support, managing OCD and reclaiming your life is possible.
Key takeaways
- ERP is the most effective treatment for OCD. It directly addresses the cycle of obsessions and compulsions, making it essential for lasting recovery.
- Working with someone trained in ERP ensures your treatment is tailored to OCD, avoiding ineffective or potentially harmful approaches.
- The cost of ERP can feel high, but it’s worth it. Early intervention can prevent symptoms from worsening and save you years of financial and emotional strain.
- Resources exist if ERP isn’t affordable right now. Support groups, online communities, and educational tools can help you start managing symptoms as you work toward accessing professional care.