OCD treatment may take approximately 10-20 sessions. Within 15 sessions, you’ll likely have a sense for whether treatment is working for you.
I can’t promise you that your obsessions will go away completely. What is more likely is that you will reduce, if not eliminate, compulsions and take steps towards leading a fuller life.
Improvements from cognitive behavior approaches to OCD tend to be pretty long lasting. However, you may find it beneficial to come back for maintenance or “booster” sessions if you find you’re struggling with obsessions and/or compulsions again.
A high dose of an antidepressant can be effective in alleviating OCD symptoms. It is rarely a total cure. OCD is one condition where research suggests there is a clear advantage of cognitive behavioral therapy over medication. However, some clients report that medication can help reduce the intensity of OCD symptoms so that they can more effectively commit to treatment.
I’ve written a blog post offering some information about medication for OCD.
We don’t have anyone at our clinic who prescribes medication, but I am able to provide referrals or work with your prescriber.
When people use the term “Pure O,” they’re usually referring to a form of OCD in which compulsions are primarily mental, and there are few overt behavioral compulsions. Although Pure O can be a little trickier, the basic principles of ERP still apply. Exposure may involve recording scripts of obsessive thoughts or feared scenarios, or it may involve doing things that deliberately bring up the obsession.
Many manualized protocols for treating OCD recommend that the therapist meet with the client outside the office for out-of-office exposures. Although I support this approach, the reality is that insurance doesn’t reimburse for out-of-office visits. When possible, a client and I may leave my office to do some real world exposure in the neighborhood nearby.
If someone is willing to pay out of pocket, then I will meet someone for an out-of-office exposure. In my experience, though, this isn’t usually necessary. Many clients are able to learn to implement exposure on their own, and I’ve found that family and loved ones can learn to be great coaches!
I work with adults only. Occasionally, I’ll work with an adolescent close to 18; however, I don’t have experience working with parents and schools, something a good child and adolescent therapist does. If you have trouble finding an OCD therapist for your child or adolescent, please let me know, and I can offer referrals.
I am experienced in working with problematic hair pulling (i.e., trichotillomania) and skin picking (i.e., excoriation). You can read more about my writings on these problems on this website. You can also read more about my approach here. I don’t tend to work with hoarding, and I do not work with body dysmorphia.