OCD Treatment · Telehealth · Adults
OCD Therapy for Intrusive Thoughts
Online OCD therapy for adults in Arizona, Colorado, Idaho, and South Carolina.
OCD doesn't always look like what people expect. Sometimes it's obvious rituals or checking. Sometimes nobody around you would know anything is happening. You might spend hours reviewing conversations, researching symptoms, asking someone you trust for reassurance, checking how you feel, or trying to figure out whether a thought means something about who you are. You may know the thought doesn't make sense and still feel like you need to resolve it before you can move on. And sometimes the hardest part is the thought itself. Intrusive thoughts can be disturbing, unwanted, and completely inconsistent with your values. The more important it feels to figure out why you had it or what it means, the more attention the thought demands.
When thoughts become a problem
Everyone has strange, unwanted thoughts. OCD becomes different when the thought gets treated like a problem that needs to be solved.
That can look like:
Mentally reviewing something you said or did
Checking your feelings or reactions
Replaying memories to make sure you remember correctly
Searching online for certainty
Asking other people whether something is okay
Avoiding situations that trigger a thought
Trying to suppress or replace unwanted thoughts
Analyzing whether a thought means you secretly want something
Repeatedly testing yourself to see how you feel
Some of these are obvious compulsions. Others happen entirely in your head.
Mental compulsions are still compulsions
You don't have to wash your hands, check a lock, or repeat a behavior for OCD to be running the show. Mental reviewing, analyzing, comparing, monitoring, and trying to reach certainty can all become part of the OCD cycle. The difficulty is that these behaviors can look like thinking. And because thinking is something we normally consider useful, it can be difficult to recognize when you're actually performing a compulsion.
Reassurance can become part of the cycle
You might ask your partner, a friend, a therapist, or Google the same question over and over. Sometimes the reassurance works. For a little while. Then the doubt comes back, and you need to ask again. This isn't because you're incapable of being reassured. It's because reassurance can become another way of trying to get the certainty OCD keeps demanding.
OCD doesn't always announce itself as OCD
I work with OCD presentations including intrusive-thought OCD, Health OCD, ROCD, harm-related obsessions, and presentations that have been misunderstood as generalized anxiety, perfectionism, or something else entirely.
You don't need to walk in knowing exactly what subtype you have. Part of the work is understanding what is actually maintaining the cycle.
How I work with OCD
I use Exposure and Response Prevention (ERP), an evidence-based treatment specifically developed for OCD. That doesn't mean forcing yourself to confront your worst fear on the first session. We start by understanding your particular OCD cycle: what triggers it, what you do to feel better, what those strategies are costing you, and where the cycle can be interrupted. The work is collaborative and structured. I'll explain what we're doing and why, and we'll move at a pace that is challenging without being arbitrary. The goal isn't to make sure you never have an intrusive thought again. It's to stop having to organize your life around what the thought might mean.
You don't have to be certain that it's OCD before reaching out.
If you're spending more time than you'd like trying to figure out whether your thoughts, feelings, memories, or reactions mean something, we can start there.
Common questions about ERP.
-
A: Most people see meaningful progress within 12 to 20 sessions of structured ERP, though this varies depending on the complexity and duration of the OCD presentation. Some people move faster. Some need more time. A Good Faith Estimate — which outlines expected session frequency and anticipated cost — is provided before the first session so you have a realistic picture before committing.
-
A: ERP is a specific form of CBT — Cognitive Behavioral Therapy — but the two terms are not interchangeable. General CBT for anxiety typically involves thought challenging, relaxation, and coping skill development. ERP specifically targets the compulsion cycle through structured exposure and response prevention. A therapist who practices general CBT is not necessarily trained in ERP. For OCD, the distinction matters.
-
A: ERP is uncomfortable. It involves deliberately confronting the thoughts and situations that trigger OCD without performing the compulsion that would relieve the anxiety. That's genuinely difficult, and it's appropriate to acknowledge that. It is also time-limited discomfort in service of a lasting outcome, and it's done collaboratively — nothing on the hierarchy is approached without your understanding and agreement. Most people who complete ERP describe it as hard and worth it.
-
A: ERP delivered poorly or incompletely often doesn't produce the expected results. Common problems include exposures that aren't specific enough to the actual OCD presentation, hierarchies that move too slowly to produce habituation, or an approach that inadvertently incorporates reassurance. If previous ERP felt incomplete or didn't address your specific OCD subtype directly, it may be worth trying again with a clearer framework.
-
A: No. Many clients arrive with a generalized anxiety diagnosis and a pattern that looks like OCD on assessment. We'll do a thorough intake to understand your specific presentation. If OCD is what we're treating, we use ERP. The formal diagnosis label matters less than getting the right treatment approach.
OCD is treatable.
OCD therapy is currently available by telehealth to clients physically located in Arizona, Colorado, Idaho, and South Carolina. If you've been managing OCD without the right treatment or if you've never been sure whether what you're experiencing is OCD a consultation is the right starting point. It's free, it's brief, and it's how we figure out whether this is a fit.
Virtual · Licensed in CO · ID · SC · Currently accepting new clients