You may have heard that exposure and response prevention (ERP) therapy is recommended as the first-line treatment for obsessive-compulsive disorder, but you might not be aware of its efficacy across all subtypes of OCD. Regardless of whether OCD centers on contamination, perfectionism, relationships, or themes that feel rare or taboo, ERP has consistently helped people break the cycle of obsessions and compulsions to find relief.
Many people who have lesser-known or stigmatized themes, such as harm or pedophilia OCD, have questioned whether ERP would work for them. But a recent peer-reviewed study, led by NOCD, the world’s leading provider of OCD treatment, has demonstrated that ERP is effective across the full spectrum of OCD subtypes.
Even if your OCD feels complex or taboo, you’re not alone, and you’re not beyond help. There’s effective, evidence-based treatment that can help you get on the path to recovery.
Why OCD is so difficult to diagnose
Every person with OCD has a unique story. Some begin experiencing symptoms in childhood, while others develop OCD in college or later in adulthood. The journey to receiving a proper diagnosis also varies, but for many, it involves misdiagnosis, confusion, and significant distress.
One major reason OCD is so often overlooked or misunderstood is that it can manifest in an infinite number of subtypes or themes. These themes may appear unique, but they are all driven by the same cycle of obsessions and compulsions.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
What is ERP therapy?
Developed in the 1960s, ERP therapy has transformed the way OCD is treated. ERP is a form of cognitive behavioral therapy (CBT) that teaches people how to confront their fears directly by accepting uncertainty rather than resorting to compulsions, such as checking, seeking reassurance, or mental rumination.
With the help of a trained ERP therapist, you intentionally trigger your OCD-related fears through carefully planned exposures. Then you learn healthier ways to respond to intrusive thoughts without engaging in compulsive behaviors.
How NOCD Therapists are trained in ERP
At NOCD, all therapists must complete an intensive, graduate-level training program on OCD and ERP before working with our Members. “Our training program is unlike any others of its kind,” says Nicholas Farrell, PhD, LP, NOCD’s Director of Clinical Development & Programming. “We don’t just do traditional classroom-style training, we supplement it with experiential [real-life] training and learning opportunities.”
NOCD Therapists participate in eight Clinical Advising Meetings (CAMS), which are structured practice sessions that ensure they are well-prepared to deliver life-changing OCD treatment to Members. CAMS are opportunities for therapists to apply the skills and knowledge they’ve gained in real sessions—and if the therapists don’t pass them, they aren’t able to work with Members. “It’s like test-driving the car before you actually get out on the road,” says Dr. Farrell.
What are OCD subtypes?
Subtypes are different themes that a person’s obsessions and compulsions can center on. Common examples include harm, contamination, sexuality, religion, and relationships—but those are just a few of the many ways OCD can show up. Certain subtypes, especially lesser-known themes like pure OCD, or taboo obsessions of a sexual nature, can often hide in plain sight.
While subtypes are not part of an official OCD diagnosis, they can help you understand your experiences. Recognizing a subtype can provide clarity—and possibly a sense of relief—by seeing that others have faced similar struggles and found effective treatment.
NOCD Therapists receive comprehensive training to recognize and treat all OCD subtypes, including those that other providers may overlook. No matter how rare, complex, or culturally sensitive a subtype may be, NOCD Therapy is proven to be effective for around 90% of our Members, including children and adolescents.
Our specialty-trained, non-judgmental OCD specialists deeply understand all themes of OCD, including those that are more taboo, aggressive, sexual, or violent in nature.
How ERP works for all subtypes
The peer-reviewed study published in JMIR examined the treatment outcomes of over 3,000 adults with OCD who received virtual ERP at NOCD. Participants met with NOCD Therapists twice weekly for face-to-face virtual ERP for three weeks. This was followed by six weekly 30-minute check-ins.
“By using a very large sample of individuals, we wanted to demonstrate that regardless of the type or nature of the OCD symptoms, the relief that a person gets from their symptoms with ERP is the same,” explains Dr. Farrell.
At the study’s conclusion, researchers found that virtual ERP led to significant improvements, with an average 43.4% reduction in OCD symptoms and a 62.9% treatment response rate. The study also showed that the ERP helped reduce symptoms of commonly co-occurring conditions like anxiety and depression.
“This research attests to the growing body of literature showing that doing ERP virtually is equally effective compared to more traditional, in-person settings,” explains Dr. Farrell. “That’s an incredibly important contribution to the literature because of the barriers people can face when trying to access ERP.”
This research reveals that not only is ERP effective across taboo as well as less stigmatized subtypes, it’s especially powerful when delivered by therapists who’ve received specialized training in OCD-specific care.
How ERP can help you
If you’ve ever wondered if your OCD is “too strange” or “too complicated” to treat, it’s not. At NOCD, our therapists receive advanced training not only in ERP but also in cultural competence, ensuring care that’s both effective and respectful.
“We always want to be sensitive and respectful to what a Member brings to the table—not just by the way of their symptoms, but the way that those symptoms interact with background and identity,” says Dr. Farrell.
Everyone deserves access to compassionate, evidence-based care for OCD. NOCD is committed to making treatment accessible by accepting most insurance plans and currently providing coverage for 155 million Americans.
No matter what your OCD looks like, know that there’s a path forward, and you don’t have to walk it alone.
