How to find an OCD therapist who actually does ERP
Supportive isn't the same as effective, especially with OCD.
You've told a therapist about the thoughts. Maybe the intrusive images, maybe the checking, maybe the way you replay conversations for hours looking for something you said wrong. They listened kindly, taught you some breathing exercises, and helped you weigh the evidence for and against your fears. It felt supportive. Months later, the OCD is right where it was.
This happens a lot. OCD is often missed or treated like general anxiety, and the approaches that help general anxiety don't reliably reach what keeps OCD going. Finding someone who treats OCD specifically still takes some searching, even in places with plenty of therapists.
Why general therapy often doesn't help OCD
OCD runs on a loop. An intrusive thought creates anxiety or a sense that something is wrong. You do something to neutralize it: check, ask, review, avoid, confess, mentally argue it out. You feel briefly better. And your brain learns that the thought was dangerous and the ritual was necessary.
A lot of well-meaning therapy accidentally joins the loop. Examining the evidence for a fear, reassuring you that you'd never act on a thought, helping you figure out whether a doubt is true: these feel helpful in the moment and often work as one more compulsion. That's not a failure of effort on anyone's part. It's a mismatch between the tool and the problem.
What to look for in an OCD therapist
Exposure and response prevention (ERP) is the best-supported therapy for OCD. In ERP, you gradually and deliberately approach the thoughts and situations that set off your OCD, and practice not doing the compulsion. Over time your brain learns it can handle the uncertainty without the ritual.
A few questions worth asking a potential therapist:
Do you use ERP, and what does it typically look like with you?
How do you work with mental compulsions, like reviewing or self-reassurance?
What do you do when a client asks you for reassurance in session?
Have you worked with my kind of OCD?
The reassurance question is a pretty good test. An OCD-trained therapist will have thought about it, and will be able to explain, kindly, why they won't keep answering the same question for you.
OCD comes in more forms than people expect
Plenty of people don't realize what they're dealing with is OCD, because it doesn't look like hand-washing or checking locks. I work with adults experiencing:
Intrusive thoughts, checking, reassurance seeking, and mental rituals
Mostly mental OCD, sometimes called "Pure O"
Relationship OCD (ROCD), with persistent doubts about a partner or your feelings
Harm OCD, with unwanted thoughts about causing harm
Health-related OCD, with fears about illness and your body
Scrupulosity, centered on morality, ethics, or religion
OCD alongside ADHD, anxiety, or eating and body image concerns
If you're not sure whether it's OCD, that's a fine place to start. Sorting that out is part of the work.
Why virtual ERP works well
People sometimes assume OCD treatment has to happen in an office. For many, video is actually an advantage. OCD doesn't show up in a therapist's office. It shows up in your kitchen, at your desk, in your car, at your front door. Doing exposures where the OCD actually lives can make them more relevant, and the practice tends to carry over into daily life more easily.
Video also removes some practical barriers: no commute, fewer missed sessions, and access to someone who specializes in OCD even if nobody nearby does.
Getting started
I treat OCD with ERP by video for adults in Arizona and Colorado. You don't need to be sure it's OCD before you reach out. Read more about OCD therapy and ERP, or book a free 15-minute consultation.
