OCD Treatment in Austin, Texas

If you are looking for help with obsessive compulsive disorder, you have probably already read the definitions. What is harder to find is an answer to a different question: what will actually happen in treatment, and is it likely to work.

This page tries to answer that. We are an Austin, Texas practice, and every session is by video, so you do not need to live near the office to work with us. We treat OCD across Texas and in other PSYPACT states.

The treatment we use is Exposure and Response Prevention, usually shortened to ERP. It is the approach with the strongest evidence behind it for OCD, and we are specifically trained in this approach.

What OCD actually is

OCD runs as a cycle. An intrusive thought, image or urge arrives and will not leave. It is unwanted and it causes real distress. Something has to be done to make the feeling stop, so an action follows, either visible or entirely inside the mind. The relief is genuine but brief, and the cycle tightens.

The part people are most often surprised by is that trying harder to not have the thought is what feeds it. That is not a personal failing. It is how the mechanism works, and it is the reason willpower alone does not resolve OCD.

The themes we see most often

OCD attaches itself to whatever matters most to a person, which is why the content varies so widely and why so many people go years without recognizing it. Themes we work with regularly include:

  • Contamination and illness
  • Harm, including fears of harming a loved one
  • Scrupulosity, meaning moral or religious obsessions
  • False memory, the fear of having done something you cannot clearly recall
  • Relationship doubt
  • Sexual orientation and identity themes
  • Symmetry, order and things needing to feel right
  • Perinatal and postpartum intrusive thoughts

The theme is not the disorder. The pattern is. Two people with completely different obsessions are doing the same thing, and the treatment for both involves similar approaches and tools.

If one of those sounds familiar, we have written about several of them in more depth: scrupulosity and moral OCD, false memory OCD, and what intrusive thoughts are and why having one says nothing about you.

What compulsions look like

Compulsions are the attempts to make the distress stop. Some are visible:

  • Washing, cleaning or checking
  • Repeatedly confirming that a loved one is safe
  • Counting, tapping, or repeating words or numbers
  • Arranging or redoing a task until it feels right

Many are not visible at all, and these are the ones most often missed:

  • Reviewing a memory, conversation or feeling for evidence
  • Mentally undoing or neutralizing a thought
  • Reassuring yourself that everything is fine
  • Asking other people whether everything is fine
  • Making mental lists

People who only have mental compulsions often assume they do not have OCD, or are told they have “pure O”. Mental rumination, reviewing, and evaluation are compulsions. They respond to the same treatment, and they are treatable.

What treatment looks like here

The first appointment is an assessment. We discuss the history of your symptoms, work out what the cycle looks like for you specifically, and collect data using standardized rating scales for anxiety and OCD such as the Yale Brown Obsessive Compulsive Scale.

Then we build a list together. Situations that trigger the obsession, ordered from the ones you could face this week to the ones that feel impossible right now. You are involved in building it, so nothing on it is a surprise.

Exposure is done with you, not to you. Nobody is ambushed. You will be asked to approach something difficult and to resist the compulsion that normally follows, starting at a level you agree to. It is uncomfortable. It is meant to be, briefly, and it gets easier in a way that talking about the fear does not achieve on its own.

Practice between sessions is where most of the progress happens. An hour a week is not enough on its own, and we will be honest with you about that from the start. Treatment typically takes 12 to 20 sessions, though this varies with symptom severity.

Family are involved where it helps, particularly with children and teens, and particularly where the household has been drawn into accommodating the OCD. That is common, it is not anyone’s fault, and it is workable.

Who we work with

Children through adults. Our clinicians are licensed psychologists, and you can read about each of them on our team page.

Questions to ask any OCD provider

Including this is deliberate. If you ask these questions of every practice you speak to, you will make a better decision, and we would rather you chose well than chose quickly.

Look for cognitive behavioral therapy and, specifically, Exposure and Response Prevention. If the answer is vague, or ERP is never named, be cautious.

Listen for a CBT graduate program or a post-doctoral fellowship in CBT and ERP, membership of the International OCD Foundation, the Anxiety and Depression Association of America, or the Association for Behavioral and Cognitive Therapies, and specialized OCD training.

A quarter or more is a good sign.

Pediatric OCD needs specific techniques and family involvement, and not every provider does it.

Getting started

The first step is a conversation, not a commitment.

Questions about insurance, session length and what to expect are answered on our FAQ page. You can also contact us directly.