Sonya Keith, LCSW, didn’t set out to become an OCD specialist. She came to NOCD because a friend wouldn’t stop talking about the place. Two years later, she’d become one of NOCD’s Life Changer therapists, a recognition reserved for clinicians producing standout outcomes for their members.
In this episode of the Get to Know OCD Podcast, Sonya sits down with Dr. Patrick McGrath, NOCD’s Chief Clinical Officer, to talk about what changed for her at NOCD, from the training, to the culture, to being rewarded for the work she does. Below is the conversation, lightly edited for clarity and length.
Meet Sonya Keith
Dr. McGrath: Can you tell everybody first, just a little bit about you and how you came to NOCD in the first place?
Sonya: So my name is Sonya. I’m a licensed clinical social worker in California. I’m licensed here and in Arizona. I also do a little bit of teaching on the side. I’m a mom of girls, and when I was working in the county office, I was referring people to therapy, and I would see some people really able to change their lives with the support of good mental health therapy, and I thought I wanted to do that. So I got my license and I was doing therapy, and I wasn’t really feeling like I was making as big an impact as I could.
I had a friend who worked at NOCD. She called me one day and said, “I work at this amazing place. You’ve got to come try it. It’s like nothing we’ve ever done before. It’s a startup company. They really have a mission and a drive.” And I was bored that day, so I said sure. It’s been full tilt ahead ever since.
She started at NOCD in September 2023. She wanted to do well because her friend had brought her on, and she wanted to respect her friend’s name. But once she got there, it was more than she expected, and it’s become, in her words, one of the most rewarding career choices she’s made.
Feeling valued as a clinician, not a cog
Dr. McGrath: You said coming here was one of the most rewarding things you’ve done career-wise. What specifically is it about being at NOCD that fulfills that, that makes that experience true for you?
Sonya: There are so many times when you join a company where you just feel like you were replaceable, like a cog in a wheel. NOCD has been very different. They’re really invested in me as a therapist, and the things that I’m interested in, right down to the CEUs I can pick and choose to take, and the relationship that I have with the team, where I can say here’s a special interest I have, who wants to know more about this, who can tell me more information. We have a very vibrant Slack channel going on with a hundred different topics, from what book have you read, to hey, I’m just trying to look for a new exposure for my client. I’ve never worked in a place where who I was as a person really drove the way that I deliver treatment.
Dr. McGrath: What has it been like to have a company that does take your opinions seriously, listen to you, even make changes based on ideas you’ve had?
Sonya: It’s wild. It’s so interesting to sit at a meeting and say, “I really wish the electronic health record platform was capable of doing this,” or “here’s something that would make my life easier as a therapist,” and have somebody say, “Let me send off a text message,” and before the conversation’s over, be told, “That change has been made now.” No one’s ever had that kind of dynamic relationship with me before, where my opinion as a line worker affected the way things happen up the chain.
That responsiveness carries directly into her work with members, and even into her own workload.
Sonya: It translates into the work I do with members. It also translates into my free time, because the hard part about being a therapist is so much of it is paperwork. It’s been able to streamline my writing notes, so I can focus more with the client and having that conversation instead of thinking, well, if I do this extra intervention, that’s so much more work on my end. Because I feel very nurtured by my team, when it comes to working with clients I’m not feeling dried out, like anybody could do this. I feel like me as a person, I’m valuable, so then my relationship with the clients is going to be valuable too.
What NOCD’s training gave her that grad school didn’t
Dr. McGrath: When you go into a session, hopefully you feel very well trained. That’s the goal we have with everyone, and that you have tools available to you to efficiently work with your members. Do you feel that’s a different kind of experience here than maybe at other places you’ve worked?
Sonya: Absolutely. In therapy, your best tool is always yourself. It’s what you know. It’s your confidence. It’s your ability to communicate with the client, and often that’s the only tool that you have. At NOCD, we have a whole variety of psychoeducation and slides and things that we can share with clients, and that has been very helpful. I’m not left alone on an island trying to find the next thing. NOCD has built a universe of opportunities and resources that I can draw from when I’m working with a client, and I think clients have been telling me they like that too, that it feels like a robust, live practice rather than just cut and dry.
Before NOCD, that kind of structure and resource library simply hadn’t existed for her.
Key elements Sonya highlights:
- Structured session planning, so she isn’t left guessing what comes next in a session
- A library of psychoeducation materials and resources she can pull into sessions in real time
- The ability to bring what she’s learned back to her outside teaching work, giving students a deeper, evidence-based understanding of OCD
Dr. McGrath: Did you have OCD knowledge and treatment knowledge before you came to NOCD?
Sonya: Absolutely not. When I learned about OCD in grad school, it was 13 slides. It took three minutes, and that was all there was to it.
Dr. McGrath: Which 13 slides sounds generous from what I hear from a lot of places, actually.
Sonya: Well, now it’s three hours. That was one of the things I was able to do with what I’ve learned at NOCD: take it to my outside teaching job and say, I have so much more information. Let’s talk about the suicide risk, the co-occurring disorders, now that we know it’s its own category in the DSM. Let’s share it with the students so they can feel more confident working with clients.
Becoming a Life Changer therapist
Dr. McGrath: By the end of 2025, you were one of our Life Changer therapists, a program we started to reward therapists who have amazing outcomes with the members they work with. Do you want to tell everybody what that experience was like for you?
Sonya: It was wild. We have metrics available to us, so it’s never a mystery of how you’re doing in your job, where your strengths are, where your weaknesses are. We’re constantly getting that information back. So we don’t have to wait until we meet with our supervisor to find out.
Unlike a once-a-year evaluation where the outcome can feel arbitrary, Sonya said NOCD’s day-to-day metrics gave her a clear, ongoing read on her own performance, and something to work toward.
Sonya: Those metrics show, across the company, where everybody is. I don’t always need to be the best. I just need to be better than average, so it’s a fun game I get to play with myself. But it’s also very rewarding to say this job that I love doing, these members I enjoy talking to, I’m doing it well and it has real impact. Being consistently told, “Hey, I’m so glad you’re here, you’re doing a good job,” is nothing I’ve ever really experienced before, and I’ve worked in some large companies, for the county, and in some small places too.
The recognition culminated in a trip to Cabo San Lucas with a small group of fellow Life Changer therapists.
Sonya: We had meetings about what worked well for us and what we would want to change. We learned the history of the company and where it wants to go, and were really able to have a conversation about that. And then there was a lot of really good food and a spa and the beach, being treated not just as an employee but as a whole person. It was completely refreshing.
Dr. McGrath compared it to something more familiar from other industries.
Dr. McGrath: I hear about that at very large organizations, the President’s Club idea: if you sell so many millions of dollars of product, you get to do this cool thing. That was really the inspiration for us with the Life Changer Club. Over the next year, we want to open that up to a lot more people, to make sure all of our therapists know that when you hit this level of results for your members, you will be rewarded for it.
Community and flexibility as a remote therapist
Some therapists worry that going remote means losing the sense of community that comes with an office. Sonya said that hasn’t been her experience.
Dr. McGrath: People considering coming to NOCD will want to know, am I just doing a virtual job where I’m sitting home alone all day? What is the culture of the company to make sure people are connected?
Sonya: That was a conversation I must have had 52 times in December, when we went as a company to New Orleans and met people we’d only seen as tiny Slack pictures. My supervisor, my COM, or clinical operations manager, is a wonderful person and clinician that I can go to. There’s a phrase you’ll hear a lot at NOCD, egoless questioning, just the ability to be vulnerable and say, “I don’t know this. I want to know this.” There are also consultations going every day, specific ones for specialty areas like autism, depression, or body dysmorphia, and I can go into any one of those and say, I’m having an issue with a client, who can help me out.
She also pointed to the informal side of NOCD’s culture, from trivia nights to a health and wellness group that works out together over Zoom, and to the flexibility built into her schedule.
Sonya: I’m in charge of my schedule. I’ve agreed to do a certain number of therapy hours every week, but if I need to take two hours off to go pick up my child from the bus stop, I get to do that. Again, I am treated so well, and that allows me to treat my clients so well.
Dr. McGrath said that flexibility and investment reflects a broader goal.
Dr. McGrath: We want people to consider this their therapy home, the place they can retire from eventually, when they’re set for that part of their life.
Standards, and staying motivated by them
Dr. McGrath: That being said, we have standards. We expect people to meet standards, and those are upfront and ready for you to take a look at, where you can see where you’re at comparatively across the network. How does that motivate you to continuously do better?
Sonya: Well, that metrics thing. It’s visual, it’s a number, it appeals to me in so many different ways. What I’ve had in the past working places is a mystery of not knowing if I’m doing well or not, an evaluation once a year where nobody ever gets a perfect score. Here, I constantly know every day whether I’m reaching out to my clients at NOCD’s expectation, whether I’m setting my clients up frequently enough.
That transparency, she said, hasn’t come with the fear of punishment.
Sonya: Even when there have been times when I have not been a perfect clinician, or even a good enough clinician, I’ve gone through audits and sat with the audit team and said, what did I do, how would you like me to do it better? I’ve never walked out of an audit meeting and cried. I’ve always gone, wow, I learned something new today. I’ve never had that somewhere else before.
Advice for anyone considering NOCD
Dr. McGrath: What would your advice be to those folks who are thinking about a career change, maybe coming to NOCD?
Sonya: I would tell them, do a little research on what OCD is, and then live dangerously and apply. Take that opportunity to learn about a new evidence-based practice. It’ll make you a better clinician. Like yourself enough to trust your skills and believe you can expand your knowledge base. Like yourself enough to want to work for a company that, while it’s rapidly growing, still feels very small, still feels very personal. And try it out.
Dr. McGrath: Are you happy you did?
Sonya: I’m so happy I did, all the time.
Asked what she hopes for the members she works with, Sonya described something bigger than symptom relief.
Dr. McGrath: When you think about what you have as goals, not only that you define for the members you work with, but that your members want to achieve too, what do you want to help them achieve, to be, to live in their life?
Sonya: I want members to be able to live their lives without constantly being haunted by their own fears. I want them to be able to recognize that they have feelings, but those aren’t always facts, and to be able to separate those things out and live deliberately and consciously. I want them to be able to say, I did so much, even though I was scared.
The two went on to talk about how OCD tries to convince people it’s protecting them, and why learning to separate “is this me, or is it my OCD” is such a core part of the work.
Dr. McGrath: Any final words of inspiration for those listening today?
Sonya: Be brave and try something new. You may just find that you really love it.
NOCD’s mission is to restore hope for 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.
