Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Why Your Therapy Isn’t Helping Your OCD

5 min read
Dr. Keara Valentine

When it comes to treatment for OCD, many people turn to therapy for help. However, if you’ve been trying therapy and you aren’t seeing the improvement you hoped for in your OCD symptoms, it might be a sign that you’re in the wrong kind of therapy.

While therapy can take some time to help OCD symptoms improve, and sometimes it’s important that you find the right therapist to work with you, it’s far more important to make sure you’re in the right kind of therapy if you want to see results. So how do you know if you’re in the right kind of therapy? And what type of therapy should you try instead? Here’s what you need to know. 

Types of Therapy You Might Find For OCD

Talk Therapy 

Talk therapy relies on a patient communicating past experiences, traumas and underlying thoughts that may be causing or affecting various mental health conditions with their therapist. Talk therapy has been shown to be very effective for some conditions, such as anxiety and depression, but it’s typically not effective for treating OCD. In fact, talk therapy can often exacerbate OCD — making symptoms worse — by having those with OCD repeatedly analyze their thoughts and attempt to solve them.

Cognitive Behavioral Therapy (CBT) 

Cognitive behavioral therapy is a type of talk therapy that works toward changing thinking and behavioral patterns. CBT-trained therapists may ask clients to address fears head-on, learn particular methods for soothing anxiety, use problem-solving to better understand and cope with difficult situations, and other techniques focused on retraining their thinking and behavior patterns.

In many ways, CBT essentially teaches the patient to become their own therapist, allowing them to observe and restructure their thoughts in the moment and gain more control over their responses. For some, CBT can help improve the symptoms of OCD, but there are many different types of CBT performed in many different ways — meaning it can be hard to determine if you’re receiving the right kind of CBT for your OCD. 

Exposure and Response Prevention (ERP) 

Exposure therapy was created to treat  OCD, PTSD and various phobias. Exposure and response prevention therapy is a form of cognitive behavioral therapy that was developed to treat people with OCD. Studies show that ERP is the most effective form of treatment for OCD. In fact, some studies credit it with single-handedly changing the outlook for individuals with OCD from “poor” to “very good.” 

This form of therapy helps people with OCD understand how to identify and cope with their triggers and compulsions, and — in ERP therapy — patients are exposed to different situations in order to provoke their obsessions in a controlled and safe environment, creating the opportunity to practice the prevention of compulsion responses. The goal of ERP is ultimately to free individuals from compulsions by accepting uncertainty so they can live more comfortably.

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How do you know if you’re in the right kind of therapy? 

If you have OCD and aren’t working with a therapist that specializes in ERP, it may be time to re-examine your therapy options. You should always make sure your therapist has experience in treating OCD, but — most importantly — your therapist should have some sort of training or certifications in ERP. While cognitive behavioral therapy may be helpful for some with OCD, ERP is a specialized form of CBT that has a demonstrated track record of working to treat and drastically improve OCD symptoms, making it the best option for treating OCD.

People with OCD who receive ERP often need somewhere between 12 to 25 sessions of ERP to begin seeing improvement in their symptoms. The length of time it takes for someone to see improvement can vary from person to person and depends  on the severity of your symptoms, as well as on the subtype of OCD that you might be experiencing. 

If you’ve been in over 20 therapy sessions and you’re still not seeing any improvements, look at the type of therapy you’re receiving for your OCD — if you’re in talk therapy or CBT and things aren’t starting to get better, you may need ERP.

If you’re in ERP and it’s taking longer than expected, don’t be afraid to talk with your therapist directly about your feelings to see if there is something that could be slowing or affecting your progress. There can be a number of contributing factors that may mean your therapy is taking a little longer. There are times where patients are not forthcoming about all their thoughts and compulsions and therefore there are essential items that are not addressed. And sometimes it just takes time for improvement, but it’s important to ensure that you’re in a form of therapy that’s proven to help those with OCD. It’s worth making sure that you feel comfortable with your therapist and that they know how to use ERP for you.

How can you find a therapist who specializes in ERP? 

The most important thing to look at when you’re seeking a therapist who specializes in ERP is whether or not they have specific training or experience with this therapy type. Search for providers that went through clinical internships, fellowships, or residencies that focused on ERP. People can also search for providers through the International OCD Foundation (IOCDF) or the Association for Behavioral and Cognitive Therapies (ABCT). Both networks allow you to search for therapists in your area who specialize in ERP.

You can also find virtual therapists who specialize in ERP. NOCD’s network of ERP trained therapists is available to people nationwide and is also one of the most cost-effective solutions available today. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.

Remember, it might seem like a long process, but with the right therapist and resources, ERP can be extremely effective for improving the lives of those with OCD. And, over time, you’ll be on the road to freedom and more control over your life.

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NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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