Living with obsessive-compulsive disorder (OCD) can feel overwhelming and exhausting. It can feel like your mind is constantly running at full speed, overanalyzing every detail.
OCD is a mental health condition that involves intrusive thoughts, urges, feelings, sensations and/or images that become obsessions, causing significant distress. This often leads to performing physical and mental compulsions in an attempt to reduce distress and/or prevent what you’re afraid of from coming true. OCD loves to latch onto daily stressors and anxieties, making even simple tasks feel like climbing a steep mountain.
However, it is very much possible to regain control of your life from your OCD with the help of a therapist trained in exposure and response prevention (ERP) therapy. ERP is an evidence-based treatment for OCD that works by gradually exposing you to the thoughts, images, or situations that trigger your obsessions, while helping you resist the urge to perform compulsions. Research shows that ERP and medication are the most effective treatments for OCD, with about 70% of people benefitting from one or both.
An OCD specialist can help you manage obsessions and compulsions, giving you the tools to regain control of your life and make everyday challenges feel more manageable. That being said, sometimes the hardest part of getting help is taking that first step and booking an appointment. By providing you with expert advice and helpful tips, our goal is to make the process of finding a therapist less daunting.
OCD counseling – what does it look like?
Treating OCD requires a specialized approach due to how the disorder operates. OCD thrives on a cycle of obsessions followed by compulsions to relieve the anxiety of intrusive triggers. However, performing compulsions only reinforces the cycle.
In order to break the cycle, treating OCD requires a specific type of therapy that focuses on stopping repetitive actions without overthinking what is causing them. Traditional talk therapy is not recommended because it can often exacerbate symptoms instead of help. This is because it focuses on thinking about the “why” of the intrusive thoughts themselves. For some individuals, this can actually reinforce their compulsions and make them feel like they are performing them for a valid reason.
As Dr. Patrick McGrath explains, “We don’t talk people out of OCD. We behave people out.” That’s why exposure and response prevention therapy is recommended to treat OCD— it teaches you how to tolerate discomfort and resist compulsions without solely focusing on the intrusive thoughts. The goal of ERP is to face your obsessions without giving into the urge to perform corresponding compulsions, breaking the cycle of OCD over time. ERP teaches you that the discomfort will eventually decrease without the need for compulsions, allowing you to regain control.
We don’t talk people out of OCD. We behave people out.
Dr. Patrick McGrath
That’s why working with an OCD specialist trained in ERP is key. 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 for OCD, seeking reassurance is often a compulsion itself. Therapy based around reassurance will only provide temporary relief and not get to the core of the problem. Make sure your therapist is specifically trained in ERP to ensure you’re getting the most effective treatment.
It is also important to note that ERP can be done both in person, or virtually through a telehealth platform. This can be especially helpful for anyone who is more comfortable doing therapy in their own homes, or for those who have tight schedules, or if there are no nearby providers who offer ERP. Whatever the case, it’s good to know that OCD treatment is customizable to what is most beneficial and logical for your lifestyle and needs.
How to find an OCD therapist that’s right for you:
Choosing the right therapist is a deeply personal decision. A lot of the time, starting therapy can feel scary and you might fear your therapist will judge you. This is not the case. A therapist specializing in OCD has heard their clients discuss all kinds of intrusive thoughts and compulsions and will never judge you for yours. They know that these thoughts are not reflective of who you are and or your values—which is exactly why the thoughts are described as intrusive.
Another important part of this process is determining if the therapist is a good fit for your specific needs. As Dr. McGrath explains, “It is okay to interview your therapist and make sure that they’re right for you. You should make sure that you feel that you’re comfortable working with them, that this is a person who will challenge you, who will listen to you, and you feel as if they have your best interest at heart.” Trusting your therapist is crucial, especially since ERP therapy involves facing discomfort.
When searching for a therapist, consider whether they have experience working with clients who share similar identities to yours, whether that’s in terms of race, religion, sexual orientation, or mental health conditions. Additionally, realize that this person is here to help you so you should feel they understand you as much as possible. It is okay to seek out a therapist with a similar background as yourself. Maybe you are part of the LGBTQIA+ community and want a therapist who is, too. Maybe you belong to a certain faith and want your therapist to share those same values. These are all valid things to bring up because they can be vital in helping you feel fully understood and supported in your recovery. Remember, this is for you, and it is not selfish to make sure your therapist understands you as much as possible.
It is okay to interview your therapist and make sure that they’re right for you. You should make sure that you feel that you’re comfortable working with them, that this is a person who will challenge you, who will listen to you, and you feel as if they have your best interest at heart.
Dr. Patrick McGrath
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, as well as psychiatrists. These titles don’t matter as much as making sure the person has specialized training in treating OCD. “While all of these types of mental health professionals have different backgrounds and education levels, it’s important to remember that none are necessarily better or worse at treating OCD,” shares 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. “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,” Dr. Valentine explains.
Dr. McGrath reiterates the importance of finding a therapist who has gone through specific exposure and response prevention training. This can include a clinician who has attended a behavioral therapy training institute, or has experience working in a treatment program or lab/graduate program that specializes in OCD. Either way, hands-on experience is crucial.
Questions you can ask a therapist:
If you’re not sure where to begin, here are a few different questions you can ask a potential therapist to see if they are the right fit for you.
- “Do you use exposure and response prevention (ERP)?” Because of the evidence showing how effective ERP can be at treating OCD, this is the first question you should ask any potential therapist. ERP is the standard treatment for OCD, so if they don’t mention ERP, consider that a red flag.
- “How much experience do you have treating OCD?” It is always good to know someone’s level of familiarity with treating OCD. This is a time to be selfish and look out for yourself. 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 any therapist who is younger or early in their career, but it is something to be aware of when deciding whether or not they’re right for you.
- “What themes of OCD have you treated?” OCD can often fixate around different themes. While all types of OCD share similar symptoms, someone’s subtype is the specific way their OCD affects them. Subtypes are relatively stable over time, though new symptoms can appear and old ones might fade. Some common OCD subtypes are harm OCD, and relationship OCD.
It can be important to make sure your therapist has experience with treating your specific theme or subtype of OCD so you feel confident in their ability to help you. It can also make you feel more comfortable and help lessen any shame you have around your intrusive thoughts. - “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 the therapist and the client. Trust and collaboration are key here because OCD treatment can be hard mental work.
Make sure you are comfortable with the way your therapist handles treatment. Maybe you respond better to someone who shows empathy and connection as opposed to someone who takes the tough love approach. Maybe it’s vice versa. Ask yourself about the qualities you want to see in a therapist that will make you feel the most open and comfortable. Considering these things can help you find a therapist that you truly feel comfortable around.
- “Do you treat conditions that co-occur with OCD?” OCD is an illness with a very high comorbidity rate, meaning that often it can occur at the same time or in relation to another condition, such as anxiety, depression, or addiction. If this is the case for you, make sure your therapist is well-versed in treating the co-occuring conditions you may be experiencing.
- “Do you have experience working with my specific identities?” These identities can include gender, race, socioeconomic status, sexuality, religion, neurodivergence, and more. For a lot of people, working with someone who has previously worked with individuals that share similar identities with you can be very reassuring. Your identity is 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.
It is also completely valid to search for a therapist who shares a similar identity to you, especially if it makes you feel more safe and comfortable sharing your own experiences.
One thing to look out for is someone who gets irritated by this question. A good therapist will understand why you want to know more about them and the people they have worked with.
The Bottom Line
It’s so important to seek out a therapist who specializes in OCD and also respects your values and identity. This way, your treatment feels both effective and supportive, which is key in making it work. If you are signing up for therapy or even taking initial steps like searching for OCD therapists near you— that’s huge! Be proud of yourself for taking this leap. It’s not an easy journey, but it’s a crucial move toward managing OCD in a way that works for you.