ONLINE AND IN PERSON COUNSELING
IN PEORIA AND THROUGHOUT ILLINOIS

Science-based treatments for OCD

Using approaches that work and making sure they work for you.

You’re here because you want help.

Counseling is an investment of your time, money, energy, and emotion. You may feel so vulnerable sharing your story (maybe yet again), and you want to know you’ll get the help you are seeking.

You may have heard it is important to have a good fit with a counselor, but you’re not sure what that means or how that happens.

You’ve read studies or advertisements claiming one approach is better than another for OCD, and you wonder what approach you should search for and what will work for you.

Therapy should be tailored to YOU. When it is,
it’s not only a better experience,
but it is more likely to be effective.

As a counselor who is passionate about doing good work and helping people, I am incredibly interested in what factors lead to good outcomes. I want to know what works for each client and how I can make sure I am helping people get better.

There are many factors that contribute to outcomes:

Things about you, the client,
Things about me, the counselor,
Things about our relationship working together, the therapeutic alliance,
Things about the method or approach.

We’ll take all of this into account in order to help you recover.

MY METHODS

There are multiple ways to treat OCD. We’ll find the one that’s right for you.

I believe, and research supports, there are two stand-alone psychotherapy treatments with good efficacy in treating OCD. These are Exposure and Response Prevention (ERP) and Inference Based CBT (I-CBT).
For many people, medication is also a big component, either on its own or in combination with psychotherapy.
There are also some promising adjunct therapies that can be integrated to supplement ERP and/or I-CBT. Ones I often use are Rumination Focused ERP (RF-ERP) and Acceptance and Commitment Therapy. I am also learning Metacognitive Therapy, as it is showing promising research as well.
It is rare that someone comes with JUST OCD and no other overlapping conditions. I see you as a whole and work with you are bringing that is within my scope of practice and that you identify you want help with.

How I can help:

ERP for OCD

Intentionally facing your fears while preventing compulsions to break the cycle that maintains OCD.

I-CBT for OCD

Learn how obsessive doubts are created to learn there was nothing to fear to begin with.

Adjunct Therapies

Acceptance and Commitment Therapy, Rumination Focused ERP, and Metacognitive Therapy for additional support with OCD when needed.

OCD Overlaps

When OCD overlaps with Autism, ADHD, sensory sensitivities, generalized anxiety, and/or trauma, we use a very individualized and nuanced approach.

The Two Stand-Alone Treatments I Use: ERP and I-CBT

Exposure & Response Prevention (ERP)

ERP is based on the idea that in OCD, people respond to fear and anxiety of intrusive thoughts by doing compulsions (which can be overt behaviors or mental rituals, reassurances, or rumination).

The compulsions give temporary relief of the fear and anxiety, but ultimately send the message to the brain that the threat is real. The brain then sends more intrusive thoughts in a misguided attempt to protect you from the perceived threat, creating a cycle that is difficult to break. The key to stopping the cycle is stopping the compulsions.

In ERP, we’ll do exposures to the thoughts or things that trigger you, while tolerating the fear and anxiety, and NOT doing compulsions.

One (or both) of 2 things usually occurs:

Habituation: the body cannot maintain fear and anxiety for very long. So after awhile, those feelings go down. With repeated exposure, they don’t start out as high. With each new exposure, they get less and less intense. Eventually the scary things don't scare you or lead to anxiety any more.

Inhibitory learning: you learn that the things you were afraid would happen are less likely to happen than you thought, or, even if they happen, you learn you can handle them better than you thought.

Through habituation and/or inhibitory learning, you learn you don’t need to do compulsions and you can engage in things that are much more enjoyable and important instead.

Inference-Based CBT (I-CBT)

Inference Based CBT helps people understand that their OCD is a result of a reasoning process (there are good reasons they believe what they do) and of being absorbed in a story that is not based in reality (what they can perceive through their senses and common sense).

OCD is based on obsessive doubts (such as what if I left the door unlocked…I could hurt a child…I never stop noticing my breathing…my hands have germs…etc.) which are inferences, mistaking an imagined possibility for a real probability. (It’s POSSIBLE I could hit someone and not know it, so I need to make sure I don’t do that.)

I-CBT teaches you to trust yourself, use your senses, understand how obsessive doubts are created, recognize when you are getting sucked into a story, and learn to stay in reality. In essence, it allows you to regain the certainty you once had before the doubt crept in. To quote my colleague, Theresa Chiu, “Living with OCD is sort of like trusting our doubt and doubting our reality. I-CBT helps us trust our reality and doubt our doubt.”

This approach is not like traditional CBT, which might lead us to disputing the content of the doubts (which could maintain the OCD). Rather, it is an approach that sheds light on the reasoning process and uncovers the way OCD has tricked you so you can stopped being tricked.

How ERP and I-CBT work. Image depicts two paths: ERP through facing your fears, and I-CBT through realizing there is nothing to fear

Other therapy approaches we may also use for support:

Acceptance and Commitment Therapy (ACT)

Teaches skills to develop the ability to be in the present moment, with awareness and openness, and take action, guided by your values.

Rumination Focused ERP

Teaches rumination is a behavior you can control, how to stop ruminating, and then uses exposure simply as an opportunity to practice not ruminating.

Metacognitive Therapy

Focuses on beliefs about your obsessions (thinking this means there’s truth to it) and beliefs about your rumination (this will help me finally figure it out). (Disclosure- I am still in the early stages of learning this modality.)

Cognitive Behavioral Therapy (CBT) and Unified Protocol (UP)

Using the connections between our thoughts, emotions, behaviors, and situations. We learn that making changes in one influences the others. In UP we focus more on relating to emotions.

Motivational Interviewing (MI)

I help you find within yourself your own motivations, based on your own strengths, to make the changes you want, in a way and pace that feels right for you.

Feedback Informed Treatment (FIT)

Spending a brief amount of time in each session to assess your well being and see if what we are doing is helping you get better. We also discuss the quality of your experience in sessions.

Considering When OCD Overlaps:

Your whole life

Although we use a structured approach, we also can take time to address your life stressors and the impact from them (stress). You are a whole person, and we want to treat OCD in the whole context of the bigger picture of YOU. I am not just an OCD mechanic, I am a human therapist working with whole complex human clients.

Autism

We fully explore what facets of someone’s experience are truly distressing and impairing to them and part of OCD vs what might be supportive and regulating. We want to consider rituals and repetitive behaviors based on their functions. We want to consider sensory differences and how this can contribute to the mistrust of the senses we see in OCD…and so much more.

ADHD

Like with Autism, we want to fully explore a sensory profile, support executive functioning, and provide other neuro-affirming supports. It is common for OCD to latch onto components of ADHD as part of the OCD reasoning process, and we want to tease out what is really happening in the here and now, vs. something that happened out of context, in another situation or at another time.

Trauma

It can be hard to do ERP or I-CBT when there is an active trauma response. It is especially hard to see past traumatic experiences as irrelevant and out-of-context. Sometimes we may start with treating trauma first or pause OCD treatment if needed to use Written Exposure Therapy or EMDR to reprocess trauma.

Anxiety

Anxiety is common companion to OCD. Whether it is social anxiety, generalized anxiety, or anxiety sensitivity. Sometimes we need to carefully see what is OCD and what is anxiety related to reasonable doubts or real life concerns. We can then consider how to treat the anxiety. (I-CBT is specific to OCD, not anxiety. ERP can work well for both.)

Body Dysmorphic Disorder

There is not a lot of research yet about using I-CBT for BDD. However I-CBT conceptualizes BDD as a body focused OCD. and I-CBT has been used to successfully help people resolve their BDD. If you will be working with me anyway using I-CBT for your OCD, we can also see if it is helpful applying it to your BDD.