CBT for OCD

8-20 Sessions

Obsessive-Compulsive Disorder (OCD) develops when normal vigilance transforms into intrusive thoughts you can’t shake and ritualistic behaviors that are difficult to control. What may begin as an effort to feel more certain or safe can quickly spiral into a cycle: disturbing thoughts trigger anxiety, performing rituals temporarily calms that anxiety, and that brief relief actually reinforces both the fear and the behavior. Over time, this cycle can become increasingly rigid and time-consuming, draining your energy and interfering with work, relationships, and the activities you once enjoyed.

Our CBT for OCD plan combines two highly effective, evidence-based approaches: cognitive therapy, which helps address unhelpful thought patterns, and exposure and response prevention (ERP), which supports you in confronting fears while gradually reducing compulsive behaviors. This structured 10-session protocol is tailored to your specific symptoms and goals. For children, we incorporate kid-friendly metaphors and parent involvement, while teen-focused interventions are designed to balance autonomy with guidance and support.

Sessions are delivered virtually, with limited in-person availability.

Treatment at Therapy Lab starts with an assessment to help you understand your unique OCD profile. Then, we move into cognitive work to challenge the beliefs fueling your OCD before guiding you through a series of carefully sequenced exposure exercises. These help you build your ability to tolerate uncertainty and discomfort while reducing your reliance on compulsions.

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The only way out is through. - Robert Frost

OCD affects approximately 2-3% of the population and can begin at any stage of life. While most people experience occasional intrusive thoughts, a person with OCD will spend a significant amount of time on obsessions or compulsions—typically more than an hour a day—causing distress or disruption in daily life.

You might find yourself repeatedly checking locks or appliances, mentally replaying conversations to make sure you didn’t say something wrong, or avoiding people or places that trigger obsessive fears. Maybe you feel compelled to arrange things “just right,” count to certain numbers, or seek constant reassurance from loved ones. Even when you know these behaviors aren’t rational, it can feel impossible to stop.

Common indicators for this plan include:

Recurring thoughts, images, or urges that cause anxiety (obsessions)
Repetitive behaviors or mental acts that reduce distress (compulsions)
Excessive checking, counting, cleaning, or ordering behaviors
Rigid routines that must be followed in specific ways
Seeking frequent reassurance about feared outcomes
Time-consuming mental rituals like reviewing events or counting
Significant distress when unable to complete compulsions
Avoiding situations that trigger obsessions or necessitate rituals
Relationship strain stemming from accommodation of symptoms

Why you might choose this plan

What to expect

OCD shows up differently as children grow and develop. Younger kids might experience unexplained fears, constantly ask parents "Are you sure?" questions, or insist on routines that end up disrupting family life. Children often struggle to put their obsessive thoughts into words, which means their compulsions might be misinterpreted as behavioral issues or defiance.

As young people enter adolescence, OCD symptoms frequently become more intense. Teenagers typically recognize that their thoughts and behaviors don't make logical sense, which unfortunately adds another layer of distress. Many teens work hard to hide their symptoms because they feel embarrassed or "different." When a teenager starts avoiding school, their grades unexpectedly drop, or they pull back from friends and activities they used to enjoy, these changes sometimes point to underlying OCD that needs attention.

In-person, telehealth or both

How long does therapy take?

OCD responds remarkably well to evidence-based treatment. About 70% of people see significant improvement through proper CBT with ERP—a much better outcome than with general talk therapy alone. This specialized approach directly addresses the patterns that keep OCD cycles going rather than just discussing symptoms.

We begin treatment with a thorough assessment of your particular OCD symptoms. Then we help you understand how OCD essentially functions as an "uncertainty phobia" where your brain demands certainty in situations where it's not possible.You'll learn to identify thought patterns that make threats seem bigger than they are while developing a healthier relationship with uncertainty. Perhaps the most important part of treatment involves exposures—carefully designed situations that bring on obsessive thoughts while you practice sitting with discomfort instead of performing compulsions.

For children, parents become essential partners in the treatment process. We teach parents how to reduce accommodation (helping with rituals) while supporting their child’s efforts to reduce compulsions. With teenagers, our approach balances respect for their growing independence with the structure they need to succeed. Adult treatment often includes recognizing how OCD has influenced self-identity and relationships over time.

Our virtual delivery format provides convenience without compromising effectiveness. Working from your own environment can actually enhance treatment, as it allows us to design exposures that directly relate to the real-world situations where your OCD typically appears.

Therapy Lab clinicians hold advanced degrees in clinical psychology, clinical child/adolescent psychology, and related science-based clinical practices, and they receive specialized training in evidence-based OCD protocols for all age groups. To learn more about CBT for OCD, please see the resources below.

About Therapy Lab therapists

McGuire, J. F., Piacentini, J., Lewin, A. B., Brennan, E. A., Murphy, T. K., & Storch, E. A. (2015). A meta-analysis of cognitive behavior therapy and medication for child obsessive-compulsive disorder: Moderators of treatment efficacy, response, and remission. Depression and Anxiety, 32(8), 580-593.
Reid, J. E., Laws, K. R., Drummond, L., Vismara, M., Grancini, B., Mpavaenda, D., & Fineberg, N. A. (2021). Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive psychiatry, 106, 152223.