Psychotherapy for
Obsessive Compulsive Disorder (OCD)
by Paul Lohkamp, MSW, LCSW
Obsessive Compulsive Disorder (OCD)
by Paul Lohkamp, MSW, LCSW
Psychotherapy for Obsessive Compulsive Disorder
OCD is best treated by a therapist with advanced training and experience in behavior therapy, specifically,
“exposure and response prevention therapy” (E/RP). A comprehensive OCD assessment is essential and needs
to include a level of care evaluation.
Some OCD patients may not benefit from once a week, fifty-minute sessions. The therapist needs to be willing to
go to the client, if necessary, and to offer a variety of ways to do behavior therapy. Family involvement is also
very important.
Optimal treatment for most people with OCD involves the combination of medication plus the behavior therapy
techniques of exposure and response prevention (E/RP). A person’s primary physician will often perscribe the
important medication, an “SSRI” antidepressant. Sometimes a referral to a psychiatrist is needed. Finding a
therapist or counselor skilled in E/RP is another issue.
Selecting a Behavior Therapist for OCD
The “exposure” part of the therapy involves actually confronting the source of the anxiety and/or discomfort. For
example, a person afraid of contamination from public bathrooms might be asked to go with the therapist or
helper to a bathroom and touch some "contaminated" item there.
The “response prevention” part of the therapy occurs when the client does not wash her hands while feeling
contaminated. With repeated sessions, the discomfort diminishes until the contaminated item no longer produces
excessive anxiety or discomfort. The behavior therapist then has the client tackle an even more stressful situation
until all of the fears have been confronted.
In summary, this gradual process of exposing oneself to a fearful situation (exposure) and not giving in to the
ritualistic response (response prevention) is behavior therapy for OCD.
If you have any questions about OCD or about finding a behavior therapist, don’t hesitate to call or email
Paul Lohkamp
OCD is best treated by a therapist with advanced training and experience in behavior therapy, specifically,
“exposure and response prevention therapy” (E/RP). A comprehensive OCD assessment is essential and needs
to include a level of care evaluation.
Some OCD patients may not benefit from once a week, fifty-minute sessions. The therapist needs to be willing to
go to the client, if necessary, and to offer a variety of ways to do behavior therapy. Family involvement is also
very important.
Optimal treatment for most people with OCD involves the combination of medication plus the behavior therapy
techniques of exposure and response prevention (E/RP). A person’s primary physician will often perscribe the
important medication, an “SSRI” antidepressant. Sometimes a referral to a psychiatrist is needed. Finding a
therapist or counselor skilled in E/RP is another issue.
Selecting a Behavior Therapist for OCD
- o Does the therapist present as knowledgeable and likeable? The client’s relationship with the
therapist is most important, especially since behavior therapy involves asking the client to do things that
are usually uncomfortable.
o What technique(s) does the therapist uses to treat OCD? If the therapist does not say “exposure
and response prevention (E/RP)” therapy, has never heard of E/RP or is vague about discussing these
treatments; it may be best to look elsewhere. The therapist should be able to explain exposure and
response prevention (E/RP) in clear terms
o Does the therapist have special training in E/RP? How many patients have they treated with
behavior therapy, and what is their success rate? How much of their practice currently involves anxiety
disorders and especially OCD.
o Is the therapist flexible and available to see clients in various settings? It is sometimes
necessary to go out in the real world to do behavior therapy; for example, to visit public bathrooms or to
ride in a car with the patient. A comprehensive assessment at home may be needed. Also, the therapist
needs to be skillful in negotiating with insurance companies to get in-home or community based treatment
covered.
The “exposure” part of the therapy involves actually confronting the source of the anxiety and/or discomfort. For
example, a person afraid of contamination from public bathrooms might be asked to go with the therapist or
helper to a bathroom and touch some "contaminated" item there.
The “response prevention” part of the therapy occurs when the client does not wash her hands while feeling
contaminated. With repeated sessions, the discomfort diminishes until the contaminated item no longer produces
excessive anxiety or discomfort. The behavior therapist then has the client tackle an even more stressful situation
until all of the fears have been confronted.
In summary, this gradual process of exposing oneself to a fearful situation (exposure) and not giving in to the
ritualistic response (response prevention) is behavior therapy for OCD.
If you have any questions about OCD or about finding a behavior therapist, don’t hesitate to call or email
Paul Lohkamp
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