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  • Mental Health Issues
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    • Personality Disorders
    • PTSD
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    • Dating
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    • Relationships 101
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    • Burnout
    • Stress
    • Sleep
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    • Mindfulness
    • Yoga
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    • Starting Therapy
    • Types of Therapy
    • Best Online Therapy Services
    • Online Couples Therapy
    • Online Therapy for Teens
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    • Anxiety Medication
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    • Best Online Psychiatrist Options
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  • DiagnosisDiagnosis
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  • TherapyTherapy
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  • Additional TreatmentsAdditional Treatments
  • Severe OCD TreatmentSevere OCD Treatment
  • Support GroupsSupport Groups
  • Is There a CureIs There a Cure
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  • InfographicsInfographics

OCD Treatment: Therapy & Medication Options

Kerry Heath, LPC-S, NCC, CEDS-S

Written by: Kerry Heath, LPC-S, NCC, CEDS-S

Dena Westphalen, Pharm. D.

Reviewed by: Dena Westphalen, Pharm.D

Published: July 13, 2023

Although obsessive-compulsive disorder (OCD) is a serious and chronic disorder, there are impactful treatment options that offer positive outcomes. Both therapy and medication can effectively reduce symptoms and improve the quality of life for those dealing with this disorder. Consider seeking help and treatment from a licensed therapist and psychiatrist.

OCD can be treated with exposure and response prevention (ERP) and antidepressants like selective serotonin reuptake inhibitors (SSRIs).1 Studies of both ERP and SSRIs show that in the long-term, a substantial number of people with OCD have experienced a reduction of symptoms.2 If traditional treatment methods don’t produce the desired result, some may require more intensive treatment.

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How Is OCD Diagnosed?

OCD is diagnosed when someone experiences the recurrence of obsessive thoughts and repetitive behaviors, and when these thoughts and behaviors significantly impairs their life and ability to function. A psychiatrist or psychologist will diagnose OCD after a period of analyzing someone’s current symptoms and health history.

Why Is OCD Often Misdiagnosed?

OCD is often misdiagnosed because there is so much overlap in symptoms with complex trauma, anxiety, depression, and sometimes even ADHD.

What Is the Most Effective Treatment for OCD?

Generally, exposure and response prevention is the most effective type of treatment used to address OCD; however, the length of one’s illness, severity of symptoms, and treatment history all play a role in determining the best options.3 Other patients may choose to add medication management to their treatment plan to achieve greater impact on their progress.

OCD Therapy

Most often, OCD is treated with outpatient therapy. Positive results can be seen as soon as four to six months. There are instances in which clients will require longer outpatient treatment or a more intensive treatment setting depending on the severity of their condition.

Therapy techniques used to manage OCD are:3,4

Exposure & Response Prevention (ERP)

ERP is the gold-standard treatment for OCD. In ERP therapy, the client and therapist formulate a list of feared items (hierarchy of fears), then gradually expose the individual while avoiding the usual compulsive responses. This continues until they can manage the stimuli without the need to engage in the usual, ritualized behaviors.3,4

Habit Reversal Training

Habit reversal training (HRT) was originally used to help people manage symptoms of tic disorders and Tourette Syndrome. More recently, the treatment has been successful with OCD. HRT works to have the person challenge and end their compulsive behaviors through recording, awareness training, competing-response training, and habit-control motivation.9

Mindfulness-Based CBT

Mindfulness-based CBT trains people to have an observational instead of judgmental stance regarding thoughts, feelings, urges, and physical sensations. People with OCD are taught that the uncomfortable sensations are not the problem, but rather their reactions to them, they are encouraged to practice experiencing these sensations without engaging in rituals, avoidance, and reassurance-seeking behaviors.3,4

Acceptance and Commitment Therapy (ACT)

ACT is an approach to therapy that asks clients to be open to their negative feelings and accept them without judgment. It involves radical self-acceptance of all feelings and understanding that each emotion serves a purpose.

Psychodynamic Therapy

The use of psychodynamic therapy with OCD is a controversial subject with limited evidence-based psychodynamic therapy options. More recently, experts pointed to a specific form of psychodynamic therapy called short-term psychodynamic therapy (STPP) as a helpful option. This form of therapy uses 12 modules of treatment to effectively address OCD symptoms.10

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Medication for OCD

If necessary, your therapist will refer you or your loved one to a psychiatrist or psychiatric nurse practitioner who can prescribe appropriate OCD medications. People may make the decision to add medications due to continued struggles after several months of therapy with only moderate progress. Most people can self-refer to a PCP or psychiatrist to discuss medication. If not, your therapist or PCP can make a referral.

Medications that can be used to treat OCD include:6

  • Clomipramine (Anafranil)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Sertraline (Zoloft)
  • Citalopram (Celexa)

*This is not a comprehensive list. You should talk with your doctor or psychiatrist about any medications you are prescribed or interested in taking.

OCD Medication Side Effects

SSRIs have side effects, but they are generally more manageable than clomipramine. Although all SSRIs appear to be equally effective, some people may respond well to one and not another. In choosing among the SSRIs, the psychiatrist will consider the pros and cons, past treatment responses, and the presence of any other conditions.

OCD Medication for Children & Teens

The use of medication in children with OCD and adolescents with OCD is dependent upon the age of the child, the severity of their condition, and whether there are any comorbidities with OCD, such as depression, that require treatment with a selective serotonin reuptake inhibitor (SSRI) as well. If the child or adolescent has no other conditions and is young, CBT is suggested as the first option prior to utilizing medication. Medication is only added after a trial of CBT has been attempted with less than desirable results.8

Additional Treatments for OCD

For the patients who do not respond to the more traditional therapeutic approaches, there are several less common methods, including repetitive transcranial magnetic stimulation. Some of these approaches do not have as much evidence to support their success rates, but some people and their teams may find them helpful.

Other types of treatment plans for OCD include:5

  • Repetitive transcranial magnetic stimulation: A non-invasive type of deep brain stimulation that is used to treat OCD and depression.
  • Electroconvulsive therapy (ECT): A brief electrical stimulation of the brain while the patient is under anesthesia.
  • Deep brain stimulation: First used for Parkinson’s disease, deep brain stimulation (DBS) places electrodes in the brain that are controlled by a generator in the chest. The stimulation is constant with frequencies tailored to the individual.11
  • Cingulotomy: A type of brain surgery that is a last resort for those with OCD.12

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What is the best therapy for OCD?

Exposure And Response Prevention Therapy (ERP) – Do live video sessions with a therapist specialized in ERP, the gold standard treatment for OCD. Treatment from NOCD is covered by many insurance plans. Start With A Free 15 Minute Call

Learn More

Treatment for Severe OCD

Occasionally a patient will require more intensive outpatient or inpatient treatment due to the severity of their condition or the presence of unmanageable co-occurring disorders. Intensive outpatient consists of up to 10 hours of care each week. Inpatient care is usually reserved for the most severe cases.3

Intensive Outpatient Care

In intensive outpatient care, people usually meet with therapists, psychiatrists, and medical providers such as medical doctors or nurse practitioners who monitor their medications and health status. They will also participate in several hours of group therapy each week with other patients who have OCD. This allows them to hear from others dealing with the same condition. Family members may also participate in either group meetings or therapy appointments to learn how to support their loved ones.

Inpatient Hospitalization

In an inpatient setting, someone receives care from medical professionals 24 hours a day, seven days a week. One example is that someone with OCD may be so afraid of germs and contamination that they refuse to eat and require medical intervention. OCD can also exacerbate conditions such as anxiety and depression to the point that a person may become suicidal. Other times, the condition may be interfering with functioning to the point that intensive treatment is needed to break the OCD cycle.

Can OCD Support Groups Help?

Support groups utilize aspects of socialization and fellowship to help a person manage a challenging issue. Although OCD support groups lack professional clinicians and guidance, they may foster a sense of community and understanding that reduces loneliness and isolation linked to OCD. Support groups will generally not help reduce OCD symptoms, but they can improve other aspects of life. Online OCD resources can be a great place to start when looking for a support group.

Can OCD be Cured?

When you receive a diagnosis your first question is likely “can OCD be cured?”While OCD is likely genetic in origin, currently, we are not able to treat OCD at the genetic level to cure it.7 Consequently, the best option is therapy and/or medication for effectively managing the symptoms and achieving recovery and symptom management. OCD is a chronic condition, which means that without intervention the condition will not likely go away on its own. The severity of OCD varies greatly, yet with professional intervention, treatment outcomes are positive in most cases.8

Although OCD can lead to increased distress and anxiety, some OCD traits can be helpful and result in people achieving higher than average levels of success, as evidenced by several famous people with OCD.

Final Thoughts on Treatments for Obsessive-Compulsive Disorder

While OCD is a chronic disorder, there are many effective treatments. If you or someone you love is dealing with OCD, talk to a therapist who specializes in the treatment of OCD and anxiety disorders. Therapists are trained to utilize CBT and will make referrals as needed. Remember, you are not alone, and there are resources available to assist you and your family. Consider using an online therapist directory to find the right therapist for you.

Additional Resources

To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.

OCD Therapy

NOCD: Effective, Affordable, & Convenient OCD Therapy Do live, face-to-face video sessions with a therapist who specializes in treating OCD and get 24/7 support between sessions. NOCD is covered by many insurance plans and is available nationwide. Visit NOCD

Virtual Psychiatry

Talkiatry Get help from a real doctor who takes your insurance. Talkiatry offers medication management and online visits with expert psychiatrists. Take the online assessment and have your first appointment in days. Free Assessment

OCD Newsletter

A free newsletter from Choosing Therapy for those impacted by OCD. Get helpful tips and the latest information. Sign-Up

For Further Reading

  • Best Online OCD Resources
  • Best OCD Books
  • Best OCD Podcasts
  • Best Shows & Movies About OCD Behaviors
  • What Are the 4 Types of OCD?
  • Is OCD is a Disability?

SPONSORED

Why OCD Thoughts Feel Real

Every day, from the time I wake up to the time I go to bed, I’m overwhelmed by disturbing thoughts that I don’t want to have. They’re usually about things that matter a lot to me, and I’ve started doing specific things (sometimes over and over) just to make sure the thoughts won’t come true. I’ve also been avoiding situations that might bring the thoughts back. Why do I feel like this all the time? If you’re asking yourself this, you’re not alone.

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SPONSORED

What is Exposure & Response Prevention Therapy?

ERP therapy alters OCD’s pattern by addressing both obsessions and compulsions. In ERP, an individual is encouraged to confront the stimuli that trigger distress related to their obsessions while also resisting the urge to perform compulsions in an attempt to reduce their distress.

Read more
SPONSORED

Here is What A Typical Journey Through ERP Therapy Looks Like

If you’ve looked into help for obsessive-compulsive disorder (OCD), you’ve probably seen references to exposure and response prevention. ERP is the gold standard for OCD treatment. ERP therapy teaches you how to manage your OCD thoughts, images, and urges so they eventually stop bothering you as much. This lets you overcome your fear responses and regain the control that OCD tries to take away.

Read more

OCD Treatment Infographics

What Is the Most Effective Treatment for OCD? Treatment for Severe OCD Can OCD Be Cured?

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Sources Update History

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • ADAA. Obsessive-Compulsive Disorder (OCD). (2020). Obsessive-Compulsive Disorder (OCD) | Anxiety and Depression Association of America, ADAA

  • Burchi, E., Hollander, E., Pallanti, S. From Treatment Response to Recovery: A Realistic Goal in OCD, International Journal of Neuropsychopharmacology, 2018; 21(11): 1007-1003. https://doi.org/10.1093/ijnp/pyy079

  • Koran, L.M., Simpson, H.B.  Guideline Watch (2013) Practice Guideline for the treatment of patients with obsessive-compulsive disorder. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/ocd.pdf 

  • OCD Center of Los Angeles. (2019). OCD symptoms and treatment. https://ocdla.com/whatisocd

  • National Institute of Mental Health. (June 2016). Brain Stimulation Therapies. https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies

  • International OCD Foundation. (2021). Medications for OCD. https://iocdf.org/about-ocd/ocd-treatment/meds/

  • National Institute of Mental Health. Obsessive-compulsive disorder. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/

  • Wegner, A.P. (2006). What to do when your child has obsessive-compulsive disorder: Strategies and solutions. USA: Lighthouse Press.

  • Lee, M.T., Mpavaenda, D.N. and Fineberg, N.A. (2019, April 24). Habit Reversal Therapy in Obsessive Compulsive Related Disorders: A Systematic Review of the Evidence and CONSORT Evaluation of Randomized Controlled Trials. Frontiers in Behavioral Neuroscience. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491945/

  • Leichsenring, F. and Steinert. C. (2016, September 22). Psychodynamic Therapy of Obsessive-Compulsive Disorder: Principles of a Manual-Guided Approach. World Psychiatry. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5032496/

  • Alonso P, Cuadras D, Gabriëls L, Denys D, Goodman W, et al. (2015) Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Meta-Analysis of Treatment Outcome and Predictors of Response. PLOS ONE 10(7): e0133591. https://doi.org/10.1371/journal.pone.0133591

  • Lopes AC, Greenberg BD, Canteras MM, et al. Gamma Ventral Capsulotomy for Obsessive-Compulsive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2014;71(9):1066–1076. doi:10.1001/jamapsychiatry.2014.1193

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We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

July 13, 2023
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “How Is OCD Diagnosed?”, “Why Is OCD Often Misdiagnosed?”, and
“Acceptance and Commitment Therapy (ACT)”. New material written by Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C and reviewed by Kristen Fuller, MD.
February 21, 2023
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Revised “OCD Therapy”. Added “Can OCD Support Groups Help?” and “Can OCD be Cured?”. New material written by Eric Patterson, LPC and reviewed by Dena Westphalen, PharmD.
May 27, 2021
Author: Kerry Heath, LPC-S, NCC, CEDS-S
Reviewer: Dena Westphalen, PharmD
Show more

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