OCD therapy

Obsessive‑compulsive disorder (OCD) is a treatable condition. Effective therapy can reduce distressing obsessions (intrusive, unwanted thoughts, images or urges) and the compulsions (repetitive behaviours or mental rituals) people use to try to neutralize them. Common goals in therapy are to decrease avoidance and compulsive responses, improve daily functioning, and increase quality of life.

Evidence-based approaches

  • Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP)

    • ERP is the frontline treatment for OCD. It involves gradually and systematically facing feared situations, thoughts, or images (exposure) while refraining from performing compulsive behaviours or mental rituals (response prevention).

    • Sessions typically begin with a thorough assessment and collaborative development of a hierarchy of feared situations. Exposures move from easier to harder items on the hierarchy.

    • Homework practice between sessions is essential for progress.

  • Cognitive therapy

    • Focuses on identifying and challenging unhelpful beliefs that maintain obsessions and compulsions (for example overestimation of threat, intolerance of uncertainty, inflated responsibility).

    • Often integrated with ERP to target the thinking patterns that fuel compulsive responding.

  • Acceptance and Commitment Therapy (ACT)

    • Emphasises acceptance of unwanted internal experiences, greater psychological flexibility, and committed action aligned with personal values.

    • Can be helpful for people who struggle with trying to control or eliminate intrusive thoughts.

What to expect in therapy

  • Assessment: Detailed history of symptoms, functioning, and any co‑occurring conditions (depression, anxiety, ADHD, tic disorders).

  • Collaborative goal setting: Prioritising meaningful changes (e.g., reducing time spent performing rituals, returning to work or relationships).

  • Regular practice: Consistent exposure exercises and response prevention are central.

  • Skill building: Learning relapse prevention strategies, cognitive restructuring, distress‑tolerance skills and emotion regulation.

  • Family involvement: When appropriate, family members can be educated about OCD and coached to avoid accommodating behaviours that reinforce compulsions.