If you’re thinking about getting help for OCD, you’re probably searching for the best therapy for OCD. Maybe you’ve already tried some things that didn’t quite work and you’re wondering what kind of therapy actually helps. Or whether it’s going to make things better or worse. Maybe you’re still not sure if this is even OCD.
This post answers the questions I get all the time from people who are thinking about starting therapy, but want to make sure it’s the right kind of help.
What Type of Therapy Is Best for OCD?
The best-studied and most recommended treatment for OCD is called Exposure and Response Prevention (ERP). It’s been around for decades and has a solid track record.
ERP works by helping you face the situations or thoughts that trigger your OCD without doing the usual rituals or safety behaviors. Over time, this helps your brain learn that you don’t actually need those compulsions to stay safe. But ERP can feel intense, especially if it’s done too fast or without enough context.
For people who have tried ERP and didn’t like it (or couldn’t tolerate it) there’s another option: Inference-Based CBT (ICBT). ICBT doesn’t involve exposure exercises. Instead, it helps you understand how OCD tricks you into believing something might be wrong, even when it isn’t. Then it teaches you how to step out of that OCD reasoning and come back to what you already know to be true.
ICBT is newer and not as well known, but the research so far is promising, and many people find it easier to stick with. You can read more about these two options and their similarities and differences.
Can Therapy Make OCD Worse?
It can. Especially if the therapist doesn’t know much about OCD or isn’t using the right approach.
Some types of therapy (especially more general talk therapy) can actually get tangled up in the OCD cycle. If your therapist doesn’t realize that things like reassurance-seeking, reviewing conversations, or trying to feel 100% certain are part of your OCD, they might accidentally encourage those patterns.
That’s not because they’re trying to make things worse. They’re just not trained in how OCD works.
This is why it’s so important to work with someone who specializes in OCD and uses evidence-based approaches like ERP or ICBT. The therapist matters just as much as the method.
Can OCD Be Cured with Therapy?
There’s no permanent cure for OCD. But therapy can help you get to a point where it’s not interfering with your life—and where you know what to do if it starts to flare up again.
You’ll always be someone whose brain leans toward doubt and over-responsibility. That part doesn’t disappear. But you can learn to spot when it’s happening, shift back into your real-world thinking, and make decisions based on what matters to you—not what OCD says matters.
Some people go through therapy and don’t need much follow-up. Others find they need ongoing maintenance to stay on track. Both are normal.
What Should I Look for in an OCD Therapist?
Here’s what actually matters:
- Training that’s specific to OCD. Not just a few hours or a webinar. Look for someone who has formal training in ERP, ICBT, or both.
- Real experience treating OCD. You can ask how many clients with OCD they’ve worked with and how often they treat it.
- Use of evidence-based approaches. If the therapist doesn’t mention ERP or ICBT, that’s a red flag. These are the only therapies with strong evidence for OCD.
- Clarity about compulsions. A good OCD therapist knows how to spot compulsions—especially the subtle ones like mental reviewing or reassurance-seeking—and helps you stop doing them.
- Consultation or continuing education. OCD work is specialized. The best therapists stay connected to others in the field and continue learning.
It’s okay to ask these questions in a consultation. In fact, you should.
What Specific Challenges Does Therapy Help With?
Here’s what most people with OCD are dealing with, whether or not they’ve named it that way:
- Getting pulled into distressing or unwanted thoughts or scary stories about how things could go wrong
- Feeling like you have to do something to “undo” or neutralize those thoughts or keep something bad from happening
- Struggling to feel certain about things you logically know are fine
- Avoiding situations or people (triggers) out of fear you might make a mistake or have to deal with OCD symptoms
- Feeling like your life has gotten smaller or harder to manage
- Spending hours caught up in mental loops or time consuming compulsions
Therapy helps you interrupt this cycle. Not by fixing every worry but by changing how you respond to it. You’ll learn how to recognize when OCD is showing up and how to get back to what actually matters to you.
A Final Note
If past therapy didn’t help, that doesn’t mean you failed. You may have just been doing the wrong type of work, or working with someone who had good intentions but didn’t really understand OCD. Therapy doesn’t have to go a certain way to be effective. Your trajectory will be different from other people’s and that’s okay. But when it works, you’ll know. You’ll stop feeling like you need to know for sure and start trusting your judgment again.
If you want to learn more about how to stop the OCD spiral you can watch a free mini-class here.