Looking for an OCD therapist can feel vulnerable, especially if much of what you experience happens inside your mind.
You may have spent years trying to understand your thoughts, questioning whether your struggles “count” as OCD, or worrying about how someone would respond if you shared them.
You might also be looking for a particular kind of support: practical help with obsessive loops, alongside space to explore the emotional and relational concerns that matter to you.
Finding the right therapist involves considering their understanding of OCD, how they work, and whether you feel able to be open with them. Here are some things to look for as you begin.
Look for someone who understands the less visible forms of OCD
OCD can involve compulsions that other people rarely notice. These may include mentally reviewing conversations, repeating mentally a compulsive thought-based mantra, checking your feelings, replaying memories, or repeatedly trying to determine what a thought says about you.
Someone may appear calm while spending hours internally debating a question they feel they must resolve. Another person may repeatedly seek reassurance about their relationship, morality, health, or identity.
A therapist who understands OCD should be able to help you recognize both the intrusive doubts and the responses that keep drawing you back into them. This matters when you have been describing your experience as “overthinking” without realizing that some of the thinking itself may be compulsive. iocdf.org
You could ask: “How do you work with OCD when most of the compulsions happen mentally?”
Ask how the therapist approaches OCD treatment
It is reasonable to ask a therapist to explain how they would help. You do not need to arrive knowing every treatment acronym, but you should be able to understand the purpose of the work.
OCD-specific approaches include Exposure and Response Prevention (ERP) and Inference-Based Cognitive Behavioural Therapy (I-CBT). ERP helps people practise encountering triggers without responding through compulsions. I-CBT focuses on the reasoning processes through which imagined possibilities become obsessional doubts.
Some therapists work primarily within one approach; others integrate OCD-specific strategies with additional forms of therapy.
Useful questions include:
- What experience do you have working with concerns like mine?
- Which OCD treatment approaches inform your work?
- How would we decide whether the approach is helping?
The answers should give you a clearer sense of what you would actually be doing together.
Notice whether you can talk about thoughts that feel difficult to share
OCD can involve thoughts that feel deeply embarrassing, frightening, or at odds with your values. You may worry that saying them aloud will change how the therapist sees you.
You deserve a thoughtful, non-judgmental response. A therapist familiar with OCD should understand the importance of assessing intrusive thoughts in context, including whether they are unwanted and how you respond to them.
You do not have to disclose every detail during an initial consultation. You might begin by saying, “I have intrusive thoughts that I find difficult to talk about. Is that something you work with?”
Pay attention to how the therapist responds. Do they give you room to explain? Do they ask questions respectfully? Can they discuss difficult material without shaming you?
Look for warmth alongside help changing the cycle
The therapeutic relationship matters. Alongside a therapist’s understanding of OCD and their treatment approach, consider how you feel with them. Do you feel heard, respected, and relatively comfortable being yourself? Can you imagine sharing something vulnerable without feeling judged?
You may need time to build trust, and therapy will sometimes feel challenging. Even so, there should be room for warmth, encouragement, and honest conversations about what feels helpful or difficult. You should feel able to question a strategy, express discomfort, or ask for more support.
In my practice, I place real importance on this relational foundation. How we work together matters alongside the methods we use. I want you to feel supported as we understand your OCD and work toward change.
You could ask: “How do you build a supportive therapeutic relationship, and how would we address it if something in therapy didn’t feel helpful?
Consider whether there is room for your broader emotional life
You may want help with OCD while also needing space for grief, attachment difficulties, low self-worth, or relationship patterns or dynamics. These concerns can deserve attention within the same course of therapy.
In an integrative approach, schema and depth therapy can provide a framework for exploring emotional patterns such as perfectionism, hyper-responsibility, your mood and emotional life, relationship concerns, or fears of rejection.
The purpose of deeper exploration should be clear. It should support your life and relationships without turning sessions into another effort to decode every intrusive thought.
A useful question is: “Can we address other emotional concerns while keeping the OCD work focused?”
Explore how pace and progress will be discussed
Therapy can involve discomfort, especially when you begin changing familiar responses to doubt. You should be able to discuss that discomfort openly and understand why a particular strategy is being suggested.
A collaborative therapist will make room for your questions, explain the rationale for the work, and review difficulties with you. If an exercise feels too difficult, that becomes something to understand and work through together.
It also helps to define what progress would mean in your daily life. Perhaps you want to spend less time reviewing conversations, make decisions with less checking, or be more present with your partner.
Include practical fit in your decision
Fees, availability, session frequency, and the option of virtual appointments all affect whether therapy is sustainable. For virtual therapy, confirm that the therapist is authorized to work with you in the province where you will be located during sessions.
An initial consultation can help you gather this information and get a sense of the relationship. You do not need perfect clarity before beginning - just enough information to make a considered choice, with room to discuss the fit as the work develops.
My integrative approach to OCD therapy
In my practice, I have worked with adults experiencing OCD for over 12 years, including less visible presentations involving rumination, internal debate, and mental compulsions - sometimes informally called "Pure O".
My approach draws on OCD-specific treatment, including I-CBT and collaborative ERP, alongside psychoeducation, mindfulness, and metacognitive skills. Depending on your needs and interest, we may also explore schemas, attachment patterns, and broader emotional concerns through depth therapy.
Brainspotting can be optionally incorporated as an adjunct for treatment of stress, emotional distress, or trauma.
Together, we will consider how OCD operates in your life, identify what keeps the cycle going, and choose strategies that connect with your goals. There is room to understand your wider experience while practising concrete changes in how you respond to obsessive doubt.
I offer virtual individual therapy for adults, currently in Ontario and New Brunswick. If you are considering OCD therapy, you are welcome to get in touch to discuss what you are looking for and whether working together may be a good fit.
Additional OCD Resources
If you'd like to learn more about intrusive thoughts and OCD, you may find these resources helpful:
- Pure O OCD: When Your Thoughts Won't Leave You Alone
- Religious and moral OCD
- Relationship OCD (ROCD)
- The Orphan Archetype & OCD
- Can you have OCD and be an HSP?
- The Quiet Forms of OCD: When the Compulsions Live in the Mind
- OCD Therapy in Ontario
- Why Do Intrusive Thoughts Feel So Real
____________________________________
Rebecca Steele | Smart Therapy®
Registered Social Worker, Psychotherapist (MA, MSW, RSW, CCC)
Rebecca Steele is a psychotherapist based in Waterloo, Ontario, offering virtual therapy to adults across Ontario and New Brunswick. She supports adults experiencing anxiety, obsessive-compulsive disorder (OCD), relationship patterns, self-worth, emotional neglect, and high sensitivity (HSP traits). Her work integrates depth psychology, emotion-focused and psychodynamic approaches with other evidence-informed treatment to help clients better understand themselves and create lasting change. She may also incorporate the Enneagram as a tool for self-understanding and personal growth.
Looking for Additional Support?
If you're located in Ontario or New Brunswick and are looking for support with mental health concerns, therapy may be the best fit. Book a therapy appointment here.
If you're outside Ontario and New Brunswick, or are primarily seeking support for personal growth, self-understanding, life transitions, or creating meaningful change rather than treatment for a mental health condition, coaching may be a better fit.
