How OCD Therapy Works

If you or someone you love is dealing with obsessive-compulsive disorder (OCD), you’ve probably heard about therapy as a potential solution. But what does OCD therapy actually involve? Understanding the steps, methods, and benefits of treatment can make the journey toward recovery feel less daunting and more achievable.

OCD is a mental health condition characterized by intrusive thoughts (obsessions, which lead to feelings of anxiety) and repetitive behaviors or mental acts (compulsions, which are performed to decrease anxiety). These patterns can be debilitating and overwhelming, but evidence-based therapy offers a path to relief. Let’s explore the process of OCD therapy and what you can expect along the way.

Step 1: Assessment and Understanding

The first step in OCD therapy is a thorough assessment. A mental health professional will take time to understand your specific symptoms, triggers, and how OCD impacts your daily life. This step is essential because no two cases of OCD are exactly alike. The therapist may use structured interviews, questionnaires, or even self-reported symptom trackers to get a clear picture of your situation.

One key aspect of this phase is education. Understanding what OCD is—and how it functions—is empowering. You’ll learn that OCD isn’t a reflection of your character or choices, but rather a condition rooted in brain function. This foundation sets the stage for effective treatment.

Step 2: Choose an OCD Therapy

The gold standard for OCD treatment is Cognitive Behavioral Therapy (CBT), particularly a specialized form called Exposure and Response Prevention (ERP). Here’s how it works:

Create a Hierarchy: You and your therapist will start out by creating a hierarchy of fears based on your OCD. For example, if you have a fear of germs, you may be asked what a 10/10 thing on this fear scale would be - maybe for you, this would be "touching a public toilet with your bare hands." Next, you would fill in the rest of your hierarchy with decreasing levels of fear (for example, a 5/10 may be "touching the handle of a shopping cart" and a 1/10 might be "touching the doorknob of my bedroom door.").
Exposure: As part of this treatment, you’ll gradually face situations, thoughts, or objects that trigger your obsessions. This is a stepwise process, and we generally avoid jumping in the deep end immediately. For example, your first exposure might be looking at a 4/10 on your hierarchy list and starting there, gradually building up your tolerance levels from there.
Response Prevention: During an exposure, you’ll learn to refrain from performing your usual compulsions - this is known as "response prevention." For example, instead of washing your hands, you’ll sit with the discomfort of your hands feeling "contaminated" and let the anxiety decrease on its own. Studies have found that, given enough time, our brains will decrease our anxiety automatically even if we don't engage in our compulsions. Over time, this process retrains your brain to stop associating specific triggers with overwhelming fear.

ERP can be challenging at first, but it’s incredibly effective. Studies show that most individuals experience significant reductions in OCD symptoms after engaging in ERP.

Step 3: Developing New Skills

OCD therapy isn’t just about reducing symptoms; it’s also about equipping you with skills for long-term success. You’ll learn strategies to:

Challenge Irrational Thoughts: Cognitive restructuring helps you identify and reframe unhelpful beliefs, such as “If I don’t check the stove 10 times, my house will burn down.”
Practice Mindfulness: Techniques like deep breathing and grounding exercises can help you stay present during moments of high anxiety.
Build Resilience: Overcoming OCD often involves setbacks. Therapy provides tools to navigate these challenges with confidence.

Step 4: Tracking Progress and Adapting

OCD therapy is a dynamic process. As you progress, your therapist will regularly assess what’s working and make adjustments as needed. For instance, if certain exposures feel too overwhelming, your therapist might break them into smaller steps to ensure steady progress.

You’ll also track your symptoms over time, noting improvements in areas like reduced compulsions, lower anxiety levels, and greater ability to engage in daily activities. These benchmarks serve as motivation and evidence that change is possible.

We'll also pay attention to what's happening in your life and make changes to the treatment plan as needed. For example, maybe you just got invited to a wedding in two months that you feel incredibly nervous about because of the way it intersects with some of your obsessions or compulsions. A good OCD therapist will modify the treatment plan to incorporate preparing you for that wedding.

Step 5: Maintaining Gains and Preventing Relapse

Once your symptoms are under control, therapy transitions to a maintenance phase. This stage focuses on reinforcing the skills you’ve developed and addressing any lingering challenges. Many therapists recommend periodic check-ins to ensure you stay on track.

Relapse prevention is a key component of this phase. You’ll work on identifying early signs of symptom re-emergence and have a plan in place to address them promptly. With the right support, you’ll be equipped to manage OCD effectively for the long term.

The Role of Medication in OCD Therapy

While therapy is the cornerstone of OCD treatment, medication can be a helpful addition for some individuals. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to reduce the intensity of obsessive thoughts and compulsions. Medication isn’t a standalone solution, but when combined with therapy, it can enhance results. While a psychologist usually can't prescribe medication, they can work with your primary care doctor or another psychiatrist to help you find the medication that works best for you.

Why OCD Therapy Matters

Living with OCD can feel isolating and overwhelming, but therapy offers a lifeline. By addressing the root causes of your obsessions and compulsions, therapy empowers you to regain control over your life.

Remember, you don’t have to face OCD alone. Effective treatment is available, and recovery is within reach. If you’re ready to begin your journey, consider reaching out to a trained OCD therapist today.

We Can Help!

Are you ready to explore how OCD therapy can work for you? Contact North Star Psychology to schedule a telehealth consultation and take the first step toward reclaiming your life. We'll work with you to identify your symptoms, draw up a concrete plan, and get started quickly. We specialize in OCD therapy and offer convenient telehealth appointments that can be done at a time and place that works for you.

Ready to schedule that appointment? Give us a call at (205) 797-1897, or send an email to info@NorthStarPsyc.com - we'll get you placed on our schedule as soon as possible.