Online Therapy For Obsessive Compulsive Disorder: OCD Treatment

Can you do ERP with online therapy?

You can engage in exposure and response prevention treatment virtually with an online therapist or psychiatric provider. Online therapy is often more flexible and affordable than conventional in-person or face-to-face therapy without insurance. ERP,  evidence-based treatment approaches, may also be an ideal solution for some individuals who live in areas where it’s challenging to find a therapist or a qualified mental health professional. 

Does online therapy work for OCD, anxiety, and other mental health conditions?

Multiple research studies show that online therapy treatment options can be as effective as traditional in-person therapy for some people with obsessions and related disorders like obsessive-compulsive disorder (OCD). For example, a randomized controlled trial and recent study published in the Journal of Medical Internet Research found that participants experienced a significant improvement in symptoms of OCD, such as intrusive thoughts and repetitive behaviors, after three weeks of twice-weekly video therapy sessions. When followed by six weeks of once-weekly check-ins, participants experienced a 43.4% reduction in OCD symptoms, as well as a 44% reduction in depression and a 47% reduction in comorbid symptoms of anxiety disorders.

Participants also reported a 37.3% mean reduction in stress symptoms and a 22.7% improvement in overall quality of life after online OCD therapy. Positive outcomes were similar for people who reported mild, moderate, or severe cases and symptoms at the beginning of treatment. Positive outcomes persisted for a year or more in some cases after OCD treatment. Online therapy is also effective for treating a variety of other mental health conditions like depression, anxiety disorders, and post-traumatic stress disorder (PTSD).

In addition to providing evidence-based treatment approaches, online therapy offers convenience. Many platforms also allow you to switch psychiatric providers or therapists, and one may have individual or group therapy. 

What is the best obsessive-compulsive disorder (OCD) treatment?

The most effective treatment for OCD is psychotherapy (talk therapy) using cognitive behavioral therapy (CBT), particularly a specialized form called exposure and response prevention (ERP). In some cases, primary care physicians or a psychiatrist may prescribe OCD medication, such as selective serotonin reuptake inhibitors (SSRIs), to complement psychotherapeutic interventions like response prevention therapy. These types of treatment options can lead to clinically significant improvement in OCD patients, reducing and lessening unwanted thoughts and repetitive actions over time. 

Other types of OCD therapy and treatment include, but might not be limited to:

• Imaginal exposure (IE): IE uses mental images and visualization to expose an individual to the source of OCD anxiety or anxiety disorders, with the aim of desensitization before transitioning to ERP. 

• Habit reversal training: This type of training includes a multi-pronged combination of response awareness, introduction of a “competing response” (a substitutional behavior for the original OCD response), coping skills, positive reinforcement, relaxation techniques, and social support.

• Deep brain stimulation (DBS): DBS is an advanced surgical treatment for more severe cases of OCD patients and treatment-resistant OCD. With DBS treatment, doctors use a brain scan to identify the area causing OCD symptoms. Then, they implant electrodes in that brain area and connect them to a neurostimulator that delivers mild electrical signals. These signals help alleviate OCD symptoms and provide temporary relief. 

Each treatment plan must match and be appropriate based on the client’s medical history, mental health conditions, and risk factors to improve daily life and overall quality of life. Seeking professional help and guidance from a qualified mental health professional can help an individual get to know a more specific and personalized treatment plan for managing OCD and its symptoms effectively. 

Can you do ERP therapy on your own or with a mental health professional?

It is possible to engage in self-directed ERP therapy and experience temporary relief, but clinical evidence shows the method is most effective when facilitated by a mental health professional. There are several reasons why this might be, including challenges with finding and adhering to treatment options and techniques appropriate for the individual’s symptoms and mental health conditions. Further, ERP therapy may not be effective for everyone, even under the guidance of a therapist. For example, in treatment-resistant cases, a person may require additional, specialized care to achieve clinically significant improvement.

If you do try self-directed methods and don’t see an improvement in symptoms, such as unwanted thoughts, be sure to consult a therapist who can help design a personalized treatment plan tailored to your needs.  

Licensed clinical social workers, family therapists, licensed professional counselors, as well as psychologists and psychiatrists, can provide care for OCD and related disorders. However, it's helpful to ensure that the mental health provider you choose has experience with OCD and treatment modalities like ERP, bearing in mind that only a psychiatrist, primary care provider, or primary care physicians can prescribe OCD medication and offer medication management. Those receiving treatment with clinical social workers or other licensed therapists in individual practice — online or in-person — may also require coordinated care with a doctor or psychiatrist for medication management. 

There are also OCD subtypes, such as OCD primarily centered on obsessions involving contamination, symmetry, and unacceptability symptoms with intrusive mental images of violence, sex, or aggression. Many people with OCD also have another mental illness or mental disorder, such as an anxiety disorder. Having a treatment plan tailored to your particular concerns, challenges, and risk factors may help you address challenges in a more sustained way and improve your day-to-day life and overall quality of life. 

What is currently the most successful therapy for anxiety and obsessive-compulsive disorder?

Currently, ERP therapy is the first-line treatment for OCD. ERP is a form of cognitive behavioral therapy that involves gradual exposure to stimuli that provoke a reaction in people with OCD. It’s conducted in a controlled and safe environment, with careful attention to the patient’s distress levels. Research, including a randomized controlled trial, has shown that ERP can be good in helping individuals develop OCD coping mechanisms. 

The aim of ERP is to provide the patient with coping skills to manage anxiety symptoms and anxiety caused by exposure to the source of their OCD. With time, the patient can strengthen these skills and use them in everyday life, freeing them from the cycle of obsessive and unwanted thoughts and compulsive behaviors. In some cases, a primary care provider or psychiatrist may prescribe selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors as part of the client’s personalized treatment plan as additional support. 

Medical history, environmental factors, and brain chemistry are some of the factors that can influence how a client responds to ERP therapy. A careful initial evaluation from a qualified professional is needed to diagnose OCD and determine the most helpful and effective treatment plan. Medication management is also required for some people. The American Psychiatric Association recognizes ERP as one of the most effective treatments for mental health conditions related to anxiety and OCD. 

Is it possible to self-treat OCD?

It is possible, but there are several reasons why it’s not recommended. For example, ERP therapy involves exposure to thoughts, images, objects, or situations that provoke obsessive thinking and compulsive behaviors; therefore, it can be significantly uncomfortable. OCD is often accompanied by comorbid conditions or mental health conditions like depression. It requires a more complex intervention and treatment plan that addresses both disorders. Individuals without training in diagnosing and treating patients with mental health disorders may misdiagnose their symptoms. For example, physiological conditions like tic disorders or Tourette Syndrome can mimic symptoms of OCD, so only a psychiatrist or doctor aware of your medical history can accurately diagnose OCD. A thorough initial evaluation is needed to determine the most appropriate and necessary treatment for patients. 

 Some possible risk factors for developing OCD and related disorders are traumatic event experiences or stressful situations. Online communities and support groups can indeed help, but seeking professional help will give a specific guide for the treatment needed and explore those challenges for you to manage the anxiety caused by OCD symptoms. Another technique is cognitive restructuring, which can help patients and individuals process and understand their feelings and reframe any obsessive thoughts in a healthier manner. 

Others may think that they can handle self-treatment, but a safe environment is much needed with the guidance of a professional to ensure you have OCD treated the right way. Clinical research has shown that professional intervention leads to better outcomes than self-directed treatment.

Should I go to therapy if I have OCD?

Suppose you have obsessive-compulsive thoughts and behaviors that interfere with your daily functioning and quality of life. In that case, you should see a psychiatrist or therapist who can diagnose and treat your condition. Many patients who develop OCD struggle with the anxiety caused by intrusive thoughts, which can make daily tasks challenging for them. 

One randomized controlled trial suggests that only 4% of people with OCD who forego treatment experience symptom remission. Therapy may be included in a treatment plan, and in some cases, medication to help manage ongoing symptoms. Commonly, some individuals may feel embarrassed and inadequate talking about intrusive thoughts, but with the guidance of a professional, patients can receive the right care. 

If you have plans and are considering therapy, you should check if the provider is in-network with your insurance. A mental health professional can always help you with your feelings and emotions and address certain words or thoughts in your mind that trigger distress. 

How do I cure my OCD naturally?

OCD is a chronic condition that exists on a spectrum of severity. Although there is no cure, there are things one can do to reduce the symptoms and cope with OCD causes as they arise in daily life. Managing OCD naturally involves not only active engagement in psychotherapy but also self-care and often changing one’s lifestyle habits. Here are some tips:

• Do your “homework”

Often, therapists who treat OCD assign their patients small, achievable self-help goals outside of therapy, including tasks and homework assignments to try in between sessions. These assignments are part of the treatment plan designed to help OCD sufferers face and confront their fears gradually. 

For example, they might ask them to complete self-assessments and worksheets, journal their experiences, or reflect on certain words or thoughts that trigger distress. In the next session, they will review the results and any thoughts and feelings the patient might have experienced while completing their homework assignments.

Some patients may feel embarrassed sharing their intrusive thoughts, but this is a safe way to process their feelings and understand the exact causes of their compulsions. If therapy is part of your treatment plan, it is good to check with your provider whether they are in-network with your insurance company. There are cases as well in which a psychiatrist may recommend medication alongside therapy to manage OCD. 

• Practice mindfulness and meditation

Mindfulness involves staying present in the moment and observing your thoughts without judgment. This can help OCD sufferers become more aware of obsessive thoughts without reacting to them, potentially reducing resulting compulsive behaviors. Understanding the exact causes of these thoughts can help individuals process their emotions and feelings more healthily. 

Regular meditation practices like deep breathing, progressive muscle relaxation, and guided visualizations can reduce anxiety and support overall mental health. Combining mindfulness with guidance from a psychiatrist may help to manage the symptoms. Medication may also be recommended in some cases. If you ever feel embarrassed because of your intrusive thoughts, mindfulness can be a good way to help. 

• Eat a nutritious diet

Eating a well-balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins can support overall brain health. Also, limit or avoid caffeine and sugar, as they can increase anxiety and possibly exacerbate OCD symptoms. Diet can impact feelings of stress and mental clarity. Be sure to consult your psychiatrist or physician before changing your diet, especially when you are taking medication or if you struggle to reduce your caffeine intake. 

• Exercise regularly

Regular exercise can boost mood, reduce anxiety, and improve overall mental health. Activities like walking, running, or swimming can be helpful, but research shows that any type of moderate aerobic exercise can significantly reduce symptoms of OCD. Additionally, mind-body activities like yoga and tai chi combine physical and mindfulness activities, which can help reduce OCD symptoms. Talk to your doctor or psychiatrist to see which types of exercise are the best for you, especially if you are taking medication, as specific exercises may complement your overall treatment plan. 

• Improve your sleep hygiene

Prioritize good sleep hygiene by maintaining a consistent sleep schedule, creating a relaxing bedtime routine, and ensuring your sleep environment is conducive to rest. Try relaxation techniques like deep breathing or progressive relaxation before bed to improve sleep. If you have sleep problems, consulting a psychiatrist may help identify the factors affecting your sleep. They may recommend medication as well to improve your sleep. 

• Try cognitive exercises

Your therapist may recommend activities like journaling to record obsessive thoughts and compulsions. This can help you identify patterns and sources of distress, which you can later reflect upon to gain perspective and challenge obsessive-compulsive beliefs. If obsessive thinking becomes overwhelming, consulting a psychiatrist may help in developing additional coping strategies. Consider writing down things you are grateful for daily to focus on positive aspects of your life and shift your mindset away from obsessive thinking. In some cases, medication may also be recommended to support therapy and help manage symptoms more effectively. Positive affirmations can also help challenge unhelpful thinking patterns and reinforce positivity. 

• Do things that nourish and bring you joy

Activities like creative projects, hobbies, exercise, and participating in group activities like volunteering or social outings can distract from obsessive thoughts. It also provides a healthy outlet for emotions. Spending time with friends and family and getting outside regularly for some fresh air can bring joy. Studies suggest that spending time in nature can help reduce stress and improve symptoms related to anxiety and depression. A psychiatrist can tell you how to incorporate the activities you have in mind. Consider hiking, gardening, camping, walking a dog, or simply spending time at the park. If problems arise, talking with your psychiatrist for additional support and recommendations may help. 

What triggers OCD?

There are several possibilities for what may cause OCD thoughts and behaviors. For example, daily stress, sadness or depression, traumatic experiences, significant life changes, and certain environmental factors like high-pressure or chaotic environments. Some physical factors might also contribute to OCD symptoms. Hormonal fluctuations, such as those occurring during puberty, pregnancy, or menopause, can generate or worsen symptoms. Excessive use of caffeine, nicotine, or other stimulants, as well as alcohol and recreational drugs, can exacerbate OCD symptoms. Illness or physical health issues might also lead to increased obsessive thoughts and compulsive behaviors. Consulting a psychiatrist can help recognize and assess these factors. 

How do you treat OCD without medication?

Successful OCD treatment without medication often involves a commitment to psychotherapy, lifestyle changes, and a self-care regimen that addresses your physical and mental well-being. However, consulting a psychiatrist can help determine the best treatment approach without recommending any medication to take, ensuring that therapy and lifestyle adjustments effectively manage symptoms.