Evidence-Based OCD Treatment

Serving NV, CA, OR, AZ & PsyPACT States

Overcoming Obsessive-Compulsive Patterns

Obsessive-Compulsive Disorder (OCD) is often misunderstood as simply being overly neat, organized, or particular. In reality, OCD involves unwanted, intrusive thoughts, images, or urges (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce distress, gain certainty, or prevent a feared outcome.

Compulsions may provide temporary relief, but over time they can reinforce the cycle of obsessions, uncertainty, and compulsive responding. Common OCD Themes Treated in Telehealth Practice:

  • Harm & Intrusive Thoughts: Unwanted fears or images involving accidentally or intentionally causing harm to yourself or others.

  • Relationship-Focused OCD (ROCD): Persistent doubts about a relationship, attraction, compatibility, or feelings, often accompanied by checking, analyzing, or reassurance-seeking.

  • Somatic & Sensorimotor Obsessions: Becoming intensely focused on normally automatic bodily sensations or processes, such as breathing, blinking, swallowing, or heartbeat.

  • Scrupulosity & Moral OCD: Intrusive fears about violating religious beliefs, personal ethics, or moral standards.

  • Contamination & Health-Related Obsessions: Persistent fears involving contamination, illness, toxins, or other threats to physical health.

The particular content of OCD can vary considerably. Treatment focuses less on what OCD happens to be about and more on the patterns of avoidance, compulsive responding, and attempts to obtain certainty that keep the problem going.

My Clinical Approach: ACT-Informed OCD Treatment

Exposure and Response Prevention (ERP) is a form of cognitive behavioral therapy and one of the best-supported psychological treatments for OCD (Steele et al., 2025). ERP involves intentionally approaching feared thoughts, sensations, situations, or uncertainty while reducing the compulsions and avoidance that ordinarily follow. It is an active, experiential treatment: we develop structured exercises that give you repeated opportunities to practice approaching discomfort and uncertainty without responding in the ways OCD demands. In some ways, ERP is a bit like deliberately watching a scary movie over and over again: the goal isn't to convince yourself that nothing feels scary, but to practice experiencing fear and uncertainty without escaping, checking, or doing something to make the feeling go away.

ERP is the foundation of my approach. I also draw heavily from Acceptance and Commitment Therapy (ACT) to help clients change how they respond to intrusive thoughts and uncomfortable internal experiences.

Rather than spending therapy trying to prove that an intrusive thought is false, eliminate uncertainty, or make anxiety disappear, ACT emphasizes learning to make room for unwanted thoughts and feelings while choosing behavior based on what matters to you.

Importantly, I don't view ACT as a replacement for ERP or assume that adding ACT somehow makes ERP more effective. Research comparing ERP with ACT-integrated ERP has found substantial improvement with both approaches (Twohig et al., 2018). I use ACT because it provides a useful framework for practicing willingness, stepping back from thoughts, and moving toward meaningful activities even when OCD is demanding certainty.

In ACT-Informed ERP, We May Also Work On:

  • Stepping Back from Intrusive Thoughts: Learning to notice thoughts as mental events rather than automatically treating them as facts, threats, or instructions that require a response.

  • Making Room for Uncertainty: Practicing willingness to experience anxiety, doubt, or discomfort without relying on compulsions to make those experiences go away.

  • Moving Toward What Matters: Redirecting time and energy toward relationships, work, school, interests, and other personally meaningful activities rather than organizing life around OCD.

Frequently Asked Questions

  • Yes. Research supports delivering ERP through videoconferencing, although the evidence base for telehealth ERP is smaller than the broader literature supporting ERP itself (Vogel, 2014). Telehealth can also have a practical advantage for ERP: we can work with triggers, compulsions, and avoidance in the environments where they actually occur rather than limiting exposure practice to a therapist's office.

  • ERP is itself a form of cognitive behavioral therapy and remains central to my treatment of OCD. ACT differs primarily in emphasis. Rather than trying to determine whether an intrusive thought is true, rational, or likely, ACT focuses on noticing thoughts without automatically responding to them, allowing room for uncertainty and discomfort, and choosing behavior based on your values.

    In my approach, ACT complements ERP rather than replacing it.

Trying To Find a Las Vegas Therapist or Online Therapy?

You can learn more about my background and credentials on my About Me page. I serve Las Vegas, NV, and Nevada statewide as well as Portland, OR, and all of Oregon statewide (California and 39+ PsyPACT states) via teletherapy. You may call me at (702) 530-6134, schedule an initial consultation, or use the contact form to take the first step.