If you’ve spent years in therapy for OCD and you’re still struggling, it doesn’t necessarily mean OCD can’t be treated. Sometimes the issue is that the treatment wasn’t specifically designed for OCD. We see this pattern often: patients arrive after years of talk therapy, general anxiety treatment, or CBT that wasn’t structured around the specific approach OCD requires.
Here’s what to actually look for in a therapist.
1. Specific training in ERP
CBT is a broad umbrella. A therapist can be well-trained in CBT generally and still not have specific training in Exposure and Response Prevention (ERP), which is the structured, evidence-based treatment approach OCD requires. ERP involves gradually and deliberately facing the thoughts and situations that trigger obsessions, without performing the compulsion that usually follows. Ask directly: are you specifically trained in ERP for OCD, not just CBT in general. Training, education, and professional involvement through the International OCD Foundation (IOCDF) can be a useful signal that a therapist has invested in developing expertise in this specific area.
2. Experience with your specific type of OCD
OCD doesn’t look the same from person to person. Contamination fears, harm-related intrusive thoughts, moral or religious scrupulosity, relationship-focused obsessions, these presentations can look quite different in the room, and a therapist should have real experience across a range of them, not just general familiarity with the diagnosis.
3. A clear understanding of OCD beyond “anxiety”
“I’m so OCD about my desk” isn’t what clinical OCD looks like. Clinical OCD affects roughly 2 percent of people at some point in their life, and it can involve intrusive thoughts, urges, images, and compulsions that significantly disrupt daily life, not a preference for tidiness. A therapist who understands this distinction well should be able to explain, clearly, how OCD is different from general anxiety and why that difference shapes treatment.
4. A therapist who can explain their approach, and who is honest about fit
You should be able to ask a potential therapist to walk you through how they’d think about your specific situation and get a clear, specific answer, not a vague reassurance. A good OCD therapist will also tell you honestly if your presentation needs something outside their scope, and will refer you to someone who has it rather than stretching to cover it themselves.
5. Additional tools, used when clinically appropriate
ERP is the foundation, but not the whole toolkit. Inference-Based CBT (I-CBT) and Acceptance and Commitment Therapy (ACT) can be useful depending on how someone’s OCD shows up, and Motivational Interviewing can help support engagement when the work itself is hard to stay consistent with. These aren’t necessary for everyone, but a therapist who has them available, and knows when to use them, has more to offer than ERP alone.
6. Family accommodation support, when relevant
If you’re seeking treatment for a child or adolescent, it’s worth asking whether the therapist addresses family accommodation, meaning the ways family members may have adjusted their own behavior around a child’s OCD, such as offering reassurance or helping avoid triggering situations. Therapists trained in SPACE (Supportive Parenting for Anxious Childhood Emotions) work with parents directly to shift these patterns.
Why this is important
OCD can become deeply woven into a person’s routines, relationships, and daily life when it goes untreated, which is one reason early, evidence-based treatment matters. Finding a therapist with genuine, specific training in OCD treatment, rather than general familiarity with anxiety, can make an important difference in getting treatment that is well matched to OCD.
How we approach OCD treatment at The CBT Center
Most of our team treats OCD, with training specific to it. We use ERP as the foundation and draw on I-CBT and ACT depending on what someone needs, with Motivational Interviewing available to support engagement in treatment that can be genuinely difficult to stick with. Dr. Teri Preddy also offers SPACE for families of children and adolescents where accommodation has become part of the pattern.
Dr. Andrew Keenan and I are both board-certified in CBT (ABPP) and listed with the International OCD Foundation. We also teach and present on evidence-based OCD treatment for clinicians nationally and internationally. Dr. Keenan runs a free monthly OCD support group for ongoing peer support alongside individual treatment.
And if we’re not the right fit for what you need, we’ll tell you and help point you toward someone who is.
We see clients throughout New Jersey and in our Highland Park office, and virtually across New York and 40+ states through PsyPact.
Ready to talk to someone who actually gets it?
Whether you’re in New Jersey, New York, or anywhere online through PsyPact, we’re here. Schedule a free consultation and find out if we’re the right fit.
About Dr. Michelle Drapkin
Dr. Michelle Drapkin is a licensed psychologist, board-certified in cognitive behavioral therapy (ABPP, A-CBT), and the founder and director of The CBT Center in New Jersey. She earned her doctorate from Rutgers University and has been practicing for more than 20 years. She keynotes at national conferences and trains therapists in CBT and Motivational Interviewing at the state, national, and international level.
The CBT Center serves clients throughout New Jersey, New York, and 40+ states via PsyPact, offering individual therapy, couples therapy, family therapy, and specialized treatment for anxiety, depression, OCD, insomnia, and more. Their mission: Better Access to Better Care.
Ready to get started? Contact The CBT Center today.
