Five years ago, it was extremely difficult for people managing obsessive-compulsive disorder (OCD) to find specialized treatment—particularly exposure and response prevention (ERP) therapy, the most effective therapy for OCD. Most providers didn’t accept insurance, ERP sessions cost an average of $350 out-of-pocket, it was difficult to find specialized therapists outside of urban centers, and there simply weren’t enough therapists with the training needed to treat OCD with ERP.
Today, the OCD community can work with over 650 OCD therapists in the NOCD Therapy network who accept major insurance plans, knowing that they’re in truly qualified hands.
Why? It comes down to the high standards we set for all our therapists. Let’s take a look at how we make sure every NOCD Therapist is able to provide the best possible care for the OCD community.
NOCD Therapists receive months of interviews and intensive training
To be hired as a NOCD Therapist, candidates must be master’s- or PhD-level clinicians and have significant experience providing one-on-one therapy. During our rigorous interview process, our clinical leaders make sure every candidate is empathic, culturally aware, and able to build trusting relationships with people of all backgrounds. They’re also evaluated on how they respond to the taboo intrusive thoughts, images, and urges that many people with OCD experience—if they show any signs of bias or stigma, they’re disqualified.
Once therapists pass this hiring process and join NOCD, they enter an in-depth training program that prepares them to treat all subtypes of OCD with ERP therapy, covering every aspect of the treatment process. “Our training for every therapist begins with lecture-style instruction,” says Chris Novak, MS, LCPC, FACHE, Chief Network Operating Officer at NOCD. “Most therapists will tell you that this is almost like a grad-school level class and that they’ve never had such intensive training.”
Most therapists will tell you that this is almost like a grad-school level class and that they’ve never had such intensive training.
Maintaining the highest standard: The CAMs process
Starting in the third week, new NOCD therapists begin to be evaluated on their mastery over their training, and gain expert insight while applying their skills in a therapy setting. This is done in a series of weekly exams called Clinical Advising Meetings (CAMs) that are led by NOCD’s Clinical Leadership team—a group of OCD experts who share decades of experience treating the condition.
In these meetings, NOCD’s Clinical Leaders play the role of NOCD Therapy Members to provide valuable mentorship and evaluate new therapists’ ability to apply what they’ve learned in training to real therapy sessions. CAMs cover every topic that our Clinical Leadership team believe therapists must master in order to treat the diverse needs of the OCD community.
There are nine CAMs that every new therapist must pass over a four-month period—if they don’t pass every one, they aren’t able to continue working at NOCD. Here’s a look at what each CAM entails:
Week 1: Build rapport and trust with a new Member
Opening up to a new therapist can be extremely daunting, especially if you’re living with a condition as stigmatized and misunderstood as OCD. That’s why in their first CAM, new NOCD therapists must go through the process of conducting the first very therapy session with a new Member. “On day one, our Members need to feel safe and understood. We want to make sure our therapists are comfortable building rapport right out of the gate,” says Taylor Newendorp, LCPC, Chief Network Clinical Director at NOCD.”
Week 2: Accurately diagnose OCD and related conditions
On average, it takes people with OCD 14-17 years to receive the right diagnosis and start evidence-based treatment—that’s why the second CAM that all NOCD Therapists must complete focuses on conducting an accurate diagnostic assessment. “This step is absolutely crucial to make sure the Member gets the proper treatment,” explains Newendorp. “They have to understand what the Member’s symptoms are, how their life is impacted, and what other conditions they might be dealing with at the same time.”
Weeks 3-4: Create custom treatment plans
Everyone’s experience with OCD is completely unique—one reason ERP therapy is so effective is because it can be tailored specifically to a person’s individual symptoms. “A one-size-fits-all approach to ERP just isn’t effective,” Newendorp explains. “Creating a custom treatment plan for Members’ specific symptoms is so important that we dedicate two CAMs to this process alone.”
A one-size-fits-all approach to ERP just isn’t effective.
To build a personalized treatment plan, the therapist and Member collaboratively build what’s called an exposure hierarchy. Members practice custom exposure exercises to progress through ERP, facing their triggers and learning to resist engaging in compulsions. These are structured in a hierarchy so Members start with the least distressing triggers before moving up to more difficult ones.
While exposures are important, the other half of ERP—response prevention—is truly the key to managing OCD. “By resisting compulsions, you break the vicious cycle of OCD and learn that you are able to tolerate distress and accept uncertainty,” explains Dr. Patrick McGrath, PhD, NOCD’s Chief Clinical Officer. In these CAMs, therapists are tested on their ability to teach Members specific response prevention techniques such as non-engagement responses, simple phrases used to lean into uncertainty and resist compulsions.
Weeks 5-6: Treat children and adolescents with OCD
Around 50% of people with OCD first experience symptoms during childhood and adolescence. That’s why it’s so important for us to ensure that every new therapist can serve the specific needs of younger people with OCD—and work closely with their parents or guardians.
CAMs five and six both focus on therapists’ mastery of these complex skills. “These CAMs allow therapists to practice how they would talk about clinical concepts with younger Members and their families. It’s very important for them to adapt their language so children can understand,” says Newendorp.
Week 7: Work with co-occurring conditions
OCD symptoms can impact all areas of life, and it’s common for people with OCD to develop anxiety and depression as a result. Often, treating OCD leads to significant reductions in anxiety and depression—but sometimes, treating these conditions along with OCD helps Members achieve the best results.
Research shows that ERP is effective for both OCD and anxiety, but treating depression requires a different approach. CAM seven tests therapists on their ability to treat depression along with OCD: “Therapists get the opportunity to show how they would teach Members about depression, explain how treatment works, and create a treatment plan for OCD and depression together,” says Newendorp.
Week 8: Treat conditions closely related to OCD
People in the OCD community often live with other conditions that share similarities with OCD, but require different specialized treatment. CAM eight ensures that new therapists can apply their specialized training to help Members manage these conditions: “As they go through their earlier CAMs, therapists receive in-depth training on treating body-focused repetitive behaviors (BFRBs) like nail biting and skin picking, as well as tic disorders,” explains Newendorp.
Week 9: In-depth personal reviews
Every therapist brings unique strengths to the NOCD Therapy network, so it’s important for their training and evaluation to be personalized as well. At the end of their four-month training program, new NOCD therapists complete CAM nine, which is an opportunity for Clinical Leaders to dive deep into the areas where they want to focus individually with the therapist. “At this final stage, Clinical Leaders can go more in-depth on particular areas and evaluate therapists on specific, personalized topics,” says Newendorp.
This final check-in also gives Clinical Leaders an opportunity to reinforce therapists’ mastery of response prevention skills—the greater a therapist’s ability to educate Members on this key aspect of managing OCD, the more lives they’ll be able to change.
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.
Our intensive evaluation process leads to life-changing treatment
Because of the many complexities of OCD, it’s crucial for anyone in the OCD community to work with a therapist who’s truly qualified to treat the condition, equipped with the well-rounded expertise they need to work with NOCD Therapy Members.
“OCD is unique in the way it presents, and if a therapist doesn’t understand it deeply, then Members won’t get the results they deserve,” says Newendorp. “That’s why our therapists are constantly guided by our Clinical Leadership team, which is composed of well-established clinicians who have been treating OCD with ERP for many years.”
OCD is unique in the way it presents, and if a therapist doesn’t understand it deeply, then Members won’t get the results they deserve.
Because of the efforts we’ve put into extensive therapist training and evaluation, we’ve been able to consistently deliver life-changing results for people with OCD. Peer-reviewed research has shown that NOCD Therapy leads to significant results twice as fast as typical ERP therapy.
If you’re ready to overcome OCD with evidence-based therapy, book a free 15-minute call with our team to start your treatment journey.