Find an OCD Therapist

Understanding obsessive-compulsive disorder

Obsessive-compulsive disorder is a pattern of persistent thoughts, images or urges - called obsessions - that feel intrusive and unwanted, together with repetitive behaviours or mental acts - called compulsions - that are performed in an attempt to reduce distress or prevent a feared outcome. For many people the obsessions and compulsions become time-consuming and interfere with daily routines, work, relationships and wellbeing. Themes often include fears about contamination, worries about causing harm, doubts about safety or order, and a need for things to feel 'just right'. How OCD shows up varies from person to person, and you may experience a mixture of mental rituals, checking behaviours, avoidance or reassurance-seeking.

Living with OCD can feel isolating because the thoughts are often distressing and difficult to share. You might find yourself stuck in cycles of anxiety and compulsion that are hard to break without support. Therapy aims to help you develop ways of responding differently to obsessions so that intrusive thoughts have less control over your day-to-day life.

Signs you might benefit from therapy

You should consider seeking specialist help if intrusive thoughts or repetitive behaviours are taking up significant time each day, causing you marked distress, or interfering with responsibilities at work, home or in relationships. If you find that rituals disrupt your routines, cause you to avoid situations you once managed, or lead to persistent anxiety, a therapist can work with you to identify patterns and set practical goals. You might also seek therapy if attempts to reduce compulsions on your own have been unsuccessful, or if the content of your thoughts leaves you feeling ashamed, overwhelmed or uncertain how to cope. If intrusive thoughts involve concerns about harm to yourself or others, it is important to reach out for professional support promptly so a practitioner can assess risk and agree next steps with you.

What to expect in OCD-focused therapy sessions

At your first sessions you and your therapist will usually spend time understanding the nature of your obsessions and compulsions, how they started, and how they affect your life. This assessment helps to build a shared formulation - a working explanation of what maintains the cycle of obsessions and compulsions - and to set clear, achievable goals. Sessions are collaborative, and your therapist will explain the rationale for proposed interventions and check that you feel comfortable with the plan.

Therapy often involves regular appointments, typically weekly or fortnightly, lasting around 50 minutes. You can expect to complete practical exercises between sessions and to review progress regularly. Homework is an important component because real-world practice helps you build confidence and notice change. Your therapist will support you through challenging moments, help you tolerate distress while resisting compulsions, and work with you to prevent relapse. Where appropriate, family members or close others may be invited to join discussions about how best to support change in a helpful way.

Typical session flow

A typical session might begin with a brief review of the week and any tasks you agreed to attempt, followed by focused work on exposures or cognitive strategies tailored to your priorities. You will plan what to try before the next meeting and reflect on what helped and what felt difficult. Over time the therapist will help you build a hierarchy of situations or thoughts to address and will adapt the pace to your needs so you can steadily expand the range of activities you manage without rituals.

Common therapeutic approaches used for OCD

Cognitive behavioural therapy is the most commonly used psychological approach for OCD and usually includes a technique known as exposure and response prevention. Exposure involves gradually confronting feared situations or thoughts, while response prevention means resisting the rituals that normally follow. This helps you learn that anxiety reduces on its own and that feared outcomes are less likely than they feel in the moment.

Other approaches that practitioners may draw on include acceptance and commitment therapy, which focuses on changing your relationship to thoughts rather than trying to eliminate them, and metacognitive strategies that explore how you interpret and respond to intrusive thinking. Some therapists include mindfulness and stress-management techniques to help with general anxiety and mood. In some cases medication is discussed as part of a broader treatment plan; if this is relevant your therapist can liaise with your GP or a psychiatrist to ensure care is coordinated. Many therapists combine approaches to fit your individual needs and preferences.

How online therapy works for OCD

Online therapy for OCD operates much like in-person work, with the core elements of assessment, formulation, exposure practice and review taking place via video call or telephone. Therapists use digital tools to share materials, set and monitor homework, and support you between sessions by email or messaging according to their practice policies. For exposure work you and your therapist can plan exercises you carry out in your environment while remaining in contact, or you may agree on step-by-step tasks you complete independently and then review together.

Online sessions can offer practical benefits such as easier scheduling, access to therapists outside your local area, and the option to practise exposures in the actual contexts that trigger your obsessions. It is important to check that any clinician you choose follows UK data protection and professional guidance and that you have a suitable private space for sessions to protect your own sense of safety and focus. If you have concerns about how online work would suit your particular situation, discuss these with potential therapists during an initial call.

Tips for choosing the right therapist for OCD

When selecting a therapist you may prefer someone who explicitly states experience with OCD and with evidence-based approaches such as CBT and exposure and response prevention. Look for practitioners who are registered or accredited with recognised UK bodies, for example BACP, HCPC or NCPS, and who are transparent about their qualifications, ongoing training and supervision arrangements. Ask about the therapist's typical session length and frequency, their approach to homework and relapse prevention, and whether they offer any shorter or longer appointments to meet your needs.

Trust and rapport matter. A therapist who listens without judgement and explains interventions clearly will make it easier for you to attempt challenging exercises. It is reasonable to request an initial consultation to get a sense of fit before committing to a programme. Discuss practicalities such as fees, cancellation terms and whether the therapist is comfortable liaising with your GP or other health professionals when that is helpful. If cost is a concern, ask whether the practitioner provides a sliding scale, low-cost options or can signpost NHS or charity services in your area.

Deciding to seek help for OCD is a significant step, and finding the right therapist makes a real difference. By choosing an accredited professional who specialises in OCD, discussing aims openly, and agreeing a clear plan, you can begin to break the cycle that has been limiting you and develop strategies that help you live with less interference from intrusive thoughts and rituals. Use the listings above to compare profiles and reach out to a practitioner who feels like a good match for your goals and circumstances.