Mental health conditions
Learn about the different types of therapy for OCD
With many different therapy approaches, it can be difficult to understand their differences and how they support people with OCD. Headway breaks it down.
By Ryan DeCook, LCSW • Clinically reviewed by Alyssa Peechatka, Ph.D.
Picture this: You’re searching online for “best OCD therapy” and you get an overwhelming amount of results. You see a ton of different therapy options and an endless list of therapists who specialize in OCD. Some therapists recommend methods like ERP, while others cite ACT or MBCT. Either way, you’ve never heard of those acronyms, so it’s not a fruitful search. In the end, you’re left worried you’ll make the wrong choice before you even begin.
When it comes to getting support for obsessive-compulsive disorder (OCD), the type of therapy you use really matters. Thankfully there are research-backed therapies that can help — and simple ways to find the right therapist. This guide breaks down the best options for therapy, plus how to find a specialist who’s right for you.
Key insights
1
There are several treatment approaches research has shown to be helpful with OCD, including exposure and response prevention, cognitive therapy, mindfulness-based cognitive therapy, and acceptance and commitment therapy. Each has its own distinct approach and benefits.
2
Working with the right therapist is crucial for effective OCD treatment. A therapist directory, such as Headway, can help you filter to find the best match for you.
How therapy treats OCD
OCD is defined by intense thoughts or urges that cause anxiety, followed by attempts to reduce that anxiety through avoidance or doing specific compulsions (behaviors, rituals, or mental actions). There’s usually a bit of relief after the behavior or mental action is carried out, but this tends to reinforce the whole cycle of OCD.
Therapy for OCD targets these thoughts, urges, and compulsions. One of the main focuses is changing how you respond to thoughts and urges. If you can change the thoughts or create some distance from them, it can reduce the intensity of the obsessive thoughts, the anxiety, and the power of the compulsions.
Therapists will often have clients face these intense thoughts and urges while having them resist acting on their anxiety-reducing compulsions. This teaches the brain that the situations are less dangerous than OCD makes them seem. It also reduces the feeling of having to use the rituals or compulsive acts because the brain learns that the accompanying anxiety can naturally rise and fall while being tolerated without having to use those compulsive actions.
The data backs this up. Research shows that approximately 60 to 85% of people who have gone through evidence-based treatment for OCD report notable and lasting reductions to their symptoms. Individual experiences vary, but many people report positive outcomes. One person writing for the International OCD Foundation reported that their results had been positive. “My insight has improved, and the time spent on compulsions has decreased,” they wrote.
What therapy approaches are best for OCD?
Research and guidelines from trusted organizations like the International OCD Foundation and the American Psychiatric Association give us a clear picture of the best treatments for OCD.
Exposure and response prevention (ERP)
ERP is considered the gold standard and the “first-line treatment” by most research and clinical guidelines in the mental health field. This treatment is done in a gradual, structured way with a therapist and has two main parts. This treatment is done in a gradual, structured way using exercises with two main parts. Within each exercise there's exposure, or deliberately facing something that triggers the obsession, followed by response prevention, or resisting the urge to do compulsions.
This allows a person to increase their ability to tolerate obsessions and anxiety over time, which ultimately reduces their anxiety and reliance on compulsive behaviors. It’s a great place to start if you’re new to treatment or if you’ve tried other treatment methods that haven’t helped your OCD.
Cognitive therapy (CT)
CT helps people identify unhelpful thoughts that fuel their obsessions and urges. They learn to examine these thoughts and develop a more balanced perspective, which can reduce the intensity of the obsessions, anxiety, and compulsions. CT is best for individuals who respond well to working with their thoughts and want to understand the “why” behind their experience.
Mindfulness-based cognitive therapy (MBCT)
There’s growing evidence that MCBT is a helpful treatment for OCD. In it, people are taught to observe their internal experiences (thoughts, emotions, and sensations) without judgment or reacting to those experiences. It helps people with OCD learn that thoughts are just thoughts, thus reducing their struggle against obsessions. This helps create more distance from obsessions and increase a person’s ability to refrain from compulsive actions. This can be a helpful option for someone who has not found enough relief from CT alone or if they want a complementary approach to pair with ERP.
Acceptance and commitment therapy (ACT)
ACT helps people to accept their intrusive thoughts and feelings while choosing actions guided by their values. This allows them to increase flexibility in their thinking and decrease their internal fight against obsessions and anxiety, eventually reducing symptoms of OCD. It’s useful for someone who has struggled with using ERP alone or wants a values-based type of therapy. Therapies such as ACT, MBCT, and CT are helpful as alternatives to ERP or in combination with ERP.
Which approach to treating OCD is right for you?
While you consider what option is best for you, there are some things to keep in mind: ERP is the most research-backed therapy for OCD, and is recommended as a go-to for treatment. Given this, it’s important to at least seriously consider trying ERP at some point. ERP can be challenging, but also provide great benefits. If you’re ready to dig into some discomfort, ERP is a great place to begin.
If you’re anxious about starting with ERP, you can try CT, ACT, or MBCT. These methods can bring some progress and feel more manageable. If you’re struggling with a lot of guilt, “what if” thinking, or over-responsibility, then CT or ACT can be a helpful approach to bring more flexibility to your thinking.
Consider your learning style. If you learn by doing, then ERP-heavy work can be a good path. If you like exploring the meaning of your beliefs and actions, then CT or ACT could be a good place to start.
Also look at your therapy history. If you’ve worked with any of these therapies and seen some benefit or ineffectiveness, that can inform your decision. You can always try one path of therapy, monitor the progress with your therapist, and then change course if you need to. Don’t feel stuck once you make your decision.
These considerations can inform conversations and decisions to make with your therapist, who can then help determine the best approach for your specific situation. A good therapist will do an assessment, try to understand your history, discuss your preferences, and be willing to go through pros and cons of each method with you. This collaborative decision-making can take some of the pressure off of you to have to know or decide everything before you start therapy.
How to find the right therapist for you
It’s one thing to understand the best therapy for your OCD treatment, it’s entirely another to find the best therapist to deliver that treatment. It takes looking for the right qualities and looking in the right places.
When searching for a therapist, you obviously want to ensure that OCD is a top specialization for them. It should not only be a checked box on their therapist profile, but they should call out OCD as a primary specialty in their description of themselves. They should note that they offer the types of therapy you are interested in. In other words, ERP, ACT, or whatever therapy you want to pursue should show up in their profile.
Other important questions to ask can include: Does their demographic profile (race, gender, age, etc.) match what you would feel comfortable with? Do they accept your insurance? Do they offer a convenient location (virtual or in person) and times that you are looking for?
Finding the right therapist is easier than you think. A solid place to start is by reaching out to your insurance company directly. They can give you a list of people who are in-network and are guaranteed to accept your insurance. You can also do a Google or AI search for quality therapists in your area who work with OCD. The quickest way to find a therapist and have the most control over your choices is using therapist directories such as Headway. They offer filters that can help you pare down to the right therapist for you.
Find the right OCD therapist for you
Starting OCD treatment takes courage, especially when you're not sure where to begin. But you now understand your options, and you don't have to navigate this alone. Headway is home to the largest network of insurance-accepting therapists in the U.S., which makes finding a qualified, empathetic, and affordable therapist for OCD easier than ever before.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2025 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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