Faith Hilmer joined NOCD in December 2023, and she’s the first to admit that graduate school hadn’t prepared her for the work she does now. Like a lot of therapists, she learned about general anxiety disorders and various talk therapy modalities, but obsessive-compulsive disorder (OCD), and specialized treatments like exposure and response prevention therapy (ERP), barely came up during her program.
In this episode of the Get to Know NOCD Therapists Podcast, Faith sits down with Dr. Patrick McGrath, NOCD’s Chief Clinical Officer, to talk about what NOCD’s training program is like and what she’d tell anyone thinking about joining NOCD. Below is the conversation, lightly edited for clarity and length.
Meet Faith Hilmer
Dr. McGrath: We’re going to talk about a topic I’m very passionate about: the really specialized training that all of our therapists get when they join us at NOCD. We interview people pretty thoroughly, and those interviews even get reviewed, just to make sure that somebody coming into NOCD has the best qualities we feel will translate into excellent ERP provision.
I’m passionate about this because OCD is a really treatable condition, but very often it’s just been mistreated due to a lack of specialized training. It’s not really a fault of therapists — it’s more of a lack of knowledge that there is even specialized training for OCD. Graduate schools maybe spend 20 minutes on OCD, and probably say it’s washing your hands or straightening things. And, if you get into a Zoom with someone and their house is messy, well, they can’t have OCD, because everybody with OCD would have a clean home. When those stereotypes and tropes continue, it’s unfortunate, because people get misdiagnosed, they get mistreated, and they suffer more.
So when I joined NOCD, my colleagues and I sought to really develop an amazing training experience for those coming into NOCD to be therapists, because we know that learning the correct protocol to help those with OCD would be life-changing.
With that, Dr. McGrath introduced Faith Hilmer and asked her to share a bit about herself, including when she joined NOCD and what the experience had been like so far.
Faith: I joined NOCD in December of 2023, so I just hit my two-year anniversary about a month ago, and it has been a wonderful experience. The training that I’ve been provided has been life-changing. Early on I was drawn to OCD work, and it’s such a joy to be a part of it now.
The training gap most therapists face
Dr. McGrath: When we’re interviewing people, we tell them training is intense. It’s going to feel like a graduate course experience, because you have no idea what you don’t know about OCD until you join NOCD and start going through the training we give.
Dr. McGrath then asked Faith directly how her graduate school training compared — a question she’d later answer, in part, by describing NOCD’s own program as intensely structured and evidence-based.
Dr. McGrath: I’m going to bet, tell me what you think, that that was different than what you learned about OCD in your graduate school experience. How much did you learn about OCD in graduate school?
Faith: In my graduate program, we did not talk about OCD, not one time. We learned about general anxiety disorders and talk therapy and other modalities that could be treated. I think OCD was kind of just lumped in as one of those anxiety disorders. Something as specialized as exposure and response prevention therapy (ERP) was certainly never mentioned in my specific program.
Dr. McGrath: This is not a knock on your program. This is a knock on graduate school training, honestly, that there’s not enough focus on evidence-based treatments. There’s a lot of courses that people are given that, in the end, for those who really do want to practice, just do not help prepare them to be good practitioners. Instead they give a very general overview of what therapy could be like, with the idea that you can apply that to all mental health conditions and it should be sufficient for anybody who comes into your office. I think you would probably disagree that it was sufficient enough.
Faith: I certainly did not feel prepared to confidently treat someone with OCD when I was able to finally grasp an understanding of how severe, how debilitating, the condition could be.
What NOCD’s training program involves
Dr. McGrath then turned the conversation toward what people can expect from NOCD’s training and how quickly their understanding of OCD and ERP tends to shift once they’re here.
Faith: The training that NOCD provides is intense, as we both mentioned earlier, and I mean that in all the best ways. It was structured. It was extremely evidence-based. There was so much information to back up every piece of clinical advice that was provided to us, as well as education.
I would [also] describe NOCD’s training as comprehensive. There were clinical advising meetings where we actually role-played sessions and were given feedback in action, to really guide us through what a first session would look like. It felt like every piece of [the] training was really intentional.
She pointed to the emphasis on education, not just technique, as a standout part of the program.
Faith: They make sure that every part of OCD is something reinforced in therapists’ understanding — such as mental compulsions, reassurance seeking, things that aren’t generally covered in other training programs that we see out there.
Key elements Faith highlights:
- Clinical advising meetings (CAMs), where trainees role-play sessions and receive feedback in real time
- Group discussion and learning alongside a cohort of fellow onboarding therapists
- Individualized practice to reinforce new skills as they’re acquired
- In-depth education on OCD-specific concepts, like mental compulsions and reassurance seeking, before moving into treatment protocol
Practicing before seeing Members
Dr. McGrath: That cohort is important too, because you have a group of people to practice with before our clinical advising meetings, where we play members and basically test you to make sure you’ve taken the information you’ve learned and can apply it. We want that to happen prior to you actually seeing members, because we want you to go into that first member session with confidence that you’ve got this under your belt already, and that one of our members isn’t the first person you’re trying this out with, fumbling around the medical record. So, was that experience helpful to get you ready to see members and start applying what you learned?
Faith: Without a doubt. I am someone who learns by doing. To not be given a manual to sit back and read, and instead actually feel prepared and equipped, and have this cohort of wonderful and excited therapists who are open to practicing even after training, on our own personal time — it was certainly a helpful experience.
Ongoing support after onboarding
Training doesn’t stop after onboarding. NOCD therapists attend case consultation groups for as long as they’re with the company.
Dr. McGrath: Has that continuous case consultation, being able to bounce ideas off each other, present cases, and get feedback from clinical experts, helped your growth?
Faith: Yes. It is such a privilege to feel so supported, and to know that every week, regardless of what my members are experiencing, I have a group of people with so many different experiences and so much knowledge that I can consult on cases with, as well as seek supervision from. There’s things that I continue to learn every week when it comes to OCD and how it can show up for different people.
What it’s like working remotely
Some therapists worry that leaving an office or private practice for remote work will mean losing that sense of community.
Dr. McGrath: People coming from an agency or their own private practice sometimes worry that going remote means losing the people around them and feeling isolated. So I’ll ask you directly: do you feel alone, or do you feel in touch with people whenever you need to be?
Faith: I feel more in touch with people here at NOCD than I have working in person in my entire experience. I have yet to have an experience where I’m presented with a new challenge and there’s not support literally at my fingertips, whether it’s from a representative of leadership or someone who’s been at NOCD longer than I have. Every day we have team Slack channels where people are constantly communicating, jumping in to support other people, and I think NOCD does such an impressive job at keeping that community in a remote telehealth company.
Considering a career at NOCD?
Dr. McGrath: If you had to describe our training experience in a word or phrase, what would you say?
Faith: The first word that comes to mind is transformational — not only because these clinicians come in thinking things go one way, and learn that with OCD it’s a little different. There are things that are unlearned as a therapist, like giving reassurance or checking facts. There’s so many different ways that OCD therapy is different, and for that purpose, transformational is one of the big words that comes to mind.
Dr. McGrath: What would you say to people out there thinking about joining NOCD?
Faith: You actually don’t have to come in as an OCD expert. The training is there to equip you and make you that expert. Coming in and joining a specialized therapy group feels intimidating, but you are so well equipped to be that expert, even if you never thought you could be.
Dr. McGrath: Faith, thanks for spending some time today. I really appreciate what you’ve shared and your openness, and I hope it’s very encouraging to anybody who might be thinking about NOCD as a career.
Faith: Yeah, it’s my pleasure. Thanks for having me.
NOCD’s mission is to restore hope to people with OCD through better awareness and treatment, and we know the key to that mission is investing in our therapists, to ensure they’re equipped to deliver this life-changing care. If you’re a licensed therapist looking to deliver specialized, evidence-based care and want to see if NOCD might be the right fit, visit our careers page to learn more.
