Written by: Virginia Kuhn, LPC
If you have been wondering whether your thoughts, fears, or repeated behaviors could be OCD, taking the next step can feel intimidating. You may be unsure whether your concerns “count,” worried about what a therapist might think, or overwhelmed by all the information online. You don’t need to diagnose yourself before asking for help. A therapist who understands OCD can help you make sense of what you’re experiencing and discuss options for support.
Start by finding a therapist who treats OCD
OCD can involve more than visible routines like repeated handwashing or checking. Some people experience compulsions that happen mostly in their minds, such as silently reviewing a conversation, repeating a phrase, praying to neutralize a thought, seeking reassurance, or trying to feel completely certain. Avoiding situations can also become part of the OCD cycle. Because symptoms can look different from person to person, it can help to speak with a clinician who has specific experience assessing and treating OCD.
Start by searching Psychology Today or the IOCDF Directory. When contacting a therapist, consider asking:
What training or experience do you have in treating OCD?
Do you provide Exposure and Response Prevention (ERP)? What does that look like in your practice?
How do you assess obsessions, compulsions, avoidance, and mental rituals?
Do you offer ACT or I-CBT, or integrate these approaches with ERP?
How do you tailor treatment to a person’s needs, identity, and pace?
Do you accept my insurance, and do you offer telehealth?
A good OCD therapist should be willing to explain their approach, answer your questions, and collaborate with you on treatment. ERP should be gradual and planned together; you should not be forced or surprised with an exposure.
What is the Y-BOCS?
Many clinicians who work with OCD use the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) as one part of assessment and to track symptoms over time. It asks about the impact of obsessions and compulsions, including how much time they take, how distressing they are, and how much they interfere with daily life.
The Y-BOCS is a measure of symptom severity, not a stand-alone diagnostic test. A clinician will also ask about your experiences and history, how symptoms affect your life, and whether another concern might better explain them. Not every therapist uses the Y-BOCS, and an evaluation can still be thoughtful and useful without it.
Treatment options for OCD
Exposure and Response Prevention (ERP)
ERP is a form of cognitive behavioral therapy and a first-line psychological treatment for OCD. With your therapist, you identify situations, thoughts, or sensations that trigger OCD and practice approaching them without doing the usual compulsion or avoidance. The goal is not to prove that a feared event is impossible or to eliminate every anxious feeling. It is to learn that you can make room for uncertainty and choose not to follow the OCD ritual.
Example: Someone worries they may have left the front door unlocked and checks it repeatedly. In ERP, the therapist and client might plan to check the lock once, leave, and practice not returning to check. They might begin with a manageable step and work toward more challenging practice over time. For someone whose compulsions are mostly mental, the practice could involve noticing an urge to review or seek reassurance and choosing not to do that ritual.
Exposure exercises are chosen collaboratively and are designed to be safe and appropriate. A therapist helps plan the steps, prepare for distress, and practice response prevention between sessions.
Acceptance and Commitment Therapy (ACT)
ACT helps people notice thoughts and feelings without treating them as facts, commands, or emergencies. It also helps them choose actions guided by personal values, even when anxiety or uncertainty is present. ACT can be used alongside ERP; research on ACT for OCD is growing, while ERP has the more established evidence base.
Example: A person has the thought, “What if I hurt someone by making a mistake?” Instead of trying to get complete certainty or mentally review every detail, they might practice naming it as an OCD thought—“I’m having the fear that I made a dangerous mistake”—and then return attention to the meaningful activity in front of them. The aim is not to convince themselves nothing bad could happen, but to respond more flexibly to the thought.
Inference-based Cognitive Behavioral Therapy (I-CBT)
I-CBT is an OCD-specific approach that focuses on how obsessional doubt is created. It helps people notice when the mind is relying on imagined possibilities or mistrusting what is observable in the present. With a trained therapist, clients learn to examine the reasoning behind OCD doubts and distinguish an imagined possibility from the information they actually have.
Example: Someone sees a small mark on their hand and becomes convinced they may have touched a contaminant, despite having no clear evidence that this happened. I-CBT might help them notice how the mind moved from “there is a mark” to a feared story about contamination, and return to what they can directly observe rather than following the imagined chain of possibilities.
I-CBT is a specialized option with a growing research base. It may be worth discussing with a trained clinician if you are interested in this approach, hesitant about ERP, or have not gotten enough benefit from other treatment.
You can ask for help before you are certain
You don’t need to arrive at a first appointment with a diagnosis or a perfect explanation. You can simply describe what has been happening: the thoughts or urges that distress you, what you do to try to feel better, what you avoid, and how this affects your life. A therapist can help you sort through those experiences and decide together what next steps make sense.
OCD is treatable, and support is available. Reaching out to a clinician with OCD-specific experience is a meaningful first step toward understanding what you’re facing and finding care that fits.
This article is for educational purposes and is not a substitute for an individualized evaluation, diagnosis, or treatment. For a diagnosis or treatment recommendations, consult a qualified mental health professional.