Everything You Need To Know About Online OCD Therapy
There's no OCD specialist anywhere near you, or the one nearby has a six-month waitlist. Online OCD therapy can open things up, as long as you know what to look for. This page covers whether it works, the tradeoffs, and how to find the right therapist.
By Nathan Peterson, LCSW, OCD therapistWhat is OCD?
OCD is made of obsessions (unwanted thoughts, images, or urges that bring anxiety, doubt, or disgust) and compulsions (whatever you do to get rid of that feeling). Compulsions can be things you do, like washing or checking, or things you do in your head, like reviewing or reassuring yourself. OCD can latch onto almost any theme, from contamination to harm to religion.
Does online OCD therapy work?
The treatment with the most research behind it for OCD is exposure and response prevention, or ERP. ERP works well online, because most of it happens in your daily life anyway. You and your therapist plan exposures on video, and you practice them at home, at work, or wherever OCD shows up. For how ERP works, see OCD treatment explained.
In some ways, doing exposures from home can be an advantage. Your triggers are right there.
What are the benefits of online OCD therapy?
- More specialists to choose from. You aren't limited to therapists within driving distance, so it's easier to find someone who treats OCD with ERP.
- Shorter waits. A wider pool can mean getting in sooner.
- Exposures where OCD happens. Your kitchen, your car, your bedroom.
- No commute. Easier to fit into work, school, or parenting.
- Privacy. Talking about intrusive thoughts can feel easier from your own space.
Downsides to know about
- Licensing. Therapists usually need to be licensed where you live, even online.
- Some exposures are easier in person. A good therapist will plan around this.
- You need a private spot. It's hard to talk openly with family in the next room.
- Tech hiccups. A shaky connection can interrupt a session.
How to find an online OCD therapist
Look for someone who specializes in OCD, not only anxiety in general. The International OCD Foundation has a directory at iocdf.org, and you can filter for online sessions. Questions worth asking before you book:
- Do you use ERP for OCD?
- How much of your caseload is OCD?
- How do you handle mental compulsions, like reviewing or reassurance?
- Are you licensed in my state?
- Do you take my insurance, or can you give me a receipt for out-of-network benefits?
If a therapist mainly talks about relaxation or getting to the root of your thoughts, keep looking. I know, it feels awkward to interview a therapist. They're used to it.
Pick two therapists from the directory who do ERP online and are licensed in your state. Email both today with the questions above. (No, you don't need the perfect email. Send it anyway.)
If therapy isn't an option right now, or you want to get started while you wait, that's what Master Your OCD is for.
Common questions about online OCD therapy
Is online therapy as good as in-person for OCD?
It can be. ERP translates well to video sessions, because most of the practice happens in your own life anyway. Some exposures are easier to do in person, and a good therapist will work that out with you.
Can I see an online therapist in another state?
Usually, therapists need to be licensed where you live, even for video sessions. When you search, filter by your state, and ask a therapist directly if they can see you.
Does insurance cover online OCD therapy?
It depends on your plan and the therapist. Telehealth is often covered. Call the number on your insurance card, and ask the therapist whether they take your plan or can give you a receipt for out-of-network benefits.
What if I can't afford therapy right now?
You can still start. A structured online OCD program, a book, and free videos can teach you ERP at your own pace. They also work while you wait for a therapist to open up.
