By Elizabeth McIngvale, Ph.D. 

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The International OCD Foundation (IOCDF) hosts a wonderful treatment provider search that can be used when looking for an OCD provider in your area:

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Treatment for OCD

Exposure with Response Prevention also known as ERP is the gold standard treatment for OCD. ERP is a specific form of Cognitive Behavioral Therapy (CBT) for OCD. The basic principles of ERP for OCD is to face your fears without engaging in rituals (exposure + ritual prevention). ERP is challenging and might sound much simpler than it often is. This should be done in a slow and systematic way and a hierarchy (a list of your fears in order of least anxiety-provoking to most anxiety-provoking) is often used to help you plan exposures from your lowest levels working your way up to your high-level exposures. ERP and hierarchy building should be done with an OCD specialist. Exposures should be something that anyone is willing to do, should not be a surprise to the person with OCD and often are done together with the individuals and their clinician.

Important ERP steps:

  • Understand your OCD and OCD symptoms
  • Identify a fear to work on
  • Develop an OCD hierarchy for your fear
    • Rank exposures for your fear on a scale from 1-10
    • 1 should be at the bottom of your hierarchy and should be the least anxiety-provoking exposures and 10 is at the top and should be the most challenging exposures
  • Begin exposures with ritual prevention
    • Systematically work your way up your hierarchy starting with the lower level exposures and working your way up to the high-level exposures.
    • Exposures should be done without rituals. If it is too difficult for you to do an exposure without ritualizing, start with a lower level exposure which you can do without rituals.
    • An exposure should be repeated multiple times without any rituals. Once an exposure no longer causes distress/anxiety (you find this exposure boring) you can move up to the next higher-level exposure
    • Continue this approach until you reach the top of your hierarchy at which point you can move onto another OCD hierarchy if you have one or can begin relapse management for your OCD
    • ERP should be practiced daily. It is important even when you are in the management stage, that when you feel triggered, or have the urge to ritualize you practice and engage in ERP.
    • Repeated exposures with ritual prevention will allow you to habituate to a fear. Anytime you engage in a ritual both the fear and OCD cycle are reinforced.

Levels of Treatment: 

Intensive Outpatient Program (IOP)–Typically 3 hours a day/5 days a week with a length of stay of 6 to 8 weeks however each program and individual’s treatment may differ

Partial Hospitalization Program (PHP)–Typically 6 to 7 hours a day/4 to 5 days a week with a length of stay of 4 to 6 weeks however each program and individual’s treatment may differ

Residential–Reside on-site at the location of treatment, the average length of stay can be between 30 and 90 days for adults; and ranges from 2 weeks to 5 months, with a typical stay lasting 6-8 weeks for Children/Adolescentshowever each program and individual’s treatment may differ


Additional Articles and Resources:

How is OCD Treated?

DISCLAIMER: The content found here is intended to serve as educational content and is not intended to replace therapy. For treatment-related questions, please be sure to work with your local provider or contact a local clinician.

Videos: OCD Treatment

Choose a title below to view related OCD videos

Jonathan S. Abramowitz, PhD, ABPP, explains that the first line treatment for OCD is Cognitive Behavioral Therapy (CBT), specifically Exposure and Response Prevention (ERP). There is medication for OCD, but they don't work as well as therapy does.

Exposure with Response Treatment is the gold standard in treating Obsessive Compulsive Disorder (OCD). CBT and CT alone will not be successful. Visit the for a free interactive ERP tool.

Throstur Bjorgvinsson, PhD, ABPP, explains that the most effective treatment is cognitive behavioral therapy (CBT), specifically exposure and response prevention (ERP). There is medication that can be helpful, but ERP has been proven as the best treatment for OCD.

Dr. McIngvale shares her personal experience with OCD treatment. It is different for everyone because everyone responses differently to treatment. She explains CBT with ERP and engaging in treatment is worth the results.

Dr. Eric Storch explains treatment options such as Cognitive Behavioral Therapy (CBT) with Exposure and Response Prevention (ERP) and medication. Visit for more educational videos and resources about OCD and other mental health disorders. Visit for a free interactive tool that walks users through the ERP steps to manage OCD.

Learn the difference between Cognitive Therapy (CT), Cognitive Behavioral Therapy (CBT), and Exposure and Response Prevention (ERP). Discover the best treatment option for Obsessive Compulsive Disorder (OCD).

Jonathan Grayson, PhD, discusses that there is treatment available for OCD. Both the American Psychological Association and the American Psychiatric Assosiation both agree that ERP is the best treatment for OCD. If you are doing CBT, it's best to make sure that it's specifically ERP.

Throstur Bjorgvinsson, PhD, ABPP, explains that cognitive behavioral therapy, or CBT, is a form of psychotherapy. It is effective in treating many different disorders, though CBT is done differently for different disorders.

Dr. Elizabeth McIngvale does a live exposure using SUD levels and demonstrates how to go all in to an exposure. This was apart of the International OCD Foundation's #faceyourfear challenge. This is real and personal. Help spread the word and educate the public about #OCD and face your fear. Dr. Elizabeth McIngvale does a live exposure. Exposure with Response Prevention (ERP) is the most effective treatment for OCD.

You're not alone. Hope and help are available.

Ben Eckstein, LCSW, discusses the use of exposure and response prevention (ERP) when treating contamination obsessive-compulsive disorder (OCD). He explains hierarchies, which are the ratings of triggers that cause the least amount of anxiety to the most amount anxiety.

Dr. Bjorgvinsson gives an example of Exposure with Response Prevention, creating a hierarchy, doing exposures, and more.

Ben Eckstein, LCSW, describes cross-contamination. During cross-contamination, a person touches something that is contaminated. He then touches another part of his body in order to "spread" that contamination. While this can be distressful for someone with OCD, it's a great tool to use for therapy.

Dr. Jonathan Abramowitz, PhD discusses how to create a hierarchy, Subjective Units of Distress (SUDs) and the benefits of moving around your hierarchy.

Dr. Jonathan Abramowitz, PhD discusses the purpose of exposures, building confidence with exposures and the importance of challenging your anxiety appropriately.

Dr. Jonathan Abramowitz, PhD discusses how long should we sit with our anxiety when doing exposures and provides us with an explanation of habituation.

Elizabeth McIngvale, Ph.D. shares how to work towards achieving your highest level exposure.

Dr. Jonathan Abramowitz, PhD shares how to know that ERP is working and what progress may look like.

Throstur Bjorgvinsson, PhD, ABPP, says that CBT treatment usually takes 12-20 sessions that last from 50 minutes to 90 minutes. Treatment can potentially last longer depending on the severity and complication of a person's OCD.

Throstur Bjorgvinsson, PhD, ABPP explains that residential treatment is needed if outpatient therapy is not enough. Someone may also do residential treatment if they have time off of work or cannot find resources around where they live.

Throstur Bjorgvinsson, PhD, ABPP, first explains that residential treatment is not the same as inpatient treatment. He then goes into what treatment might be needed for a person with OCD.

Throstur Bjorgvinsson, PhD, ABPP discusses that there are currently two programs in the United States that specialize in children and adolescence with severe OCD. Residential treatment is very helpful for some children with severe OCD.

Elizabeth McIngvale, Ph.D. talks with Jason Spielman Psy.D. about understanding when to increase or minimize treatment.

Throstur Bjorgvinsson, PhD, ABPP, says that trust and honestly between a person and his therapist is extremely important. There are some cases where there is little to no trust between a therapist and patient, or in some cases, the therapist is not qualified to be working specifically with OCD.

Throstur Bjorgvinsson, PhD, ABPP, discusses that in order to be successful in treatment for OCD, one needs to be honest with himself about what he is struggling with. There needs to be trust and collaboration between the therapist and patient.

Dr. Elizabeth McIngvale talks about getting through OCD treatment. She explains sometimes getting through treatment can be scary, though, and challenging but the moment you start actively participating in ERP treatment, you will start to learn to manage your OCD and take back your life.

Dr. Elizabeth McIngvale along with Dr. Chad Brandt will be discussing intensive short-term approaches to OCD treatment.

Jonathan Grayson, PhD. discusses how every person with OCD wants to be 100% certain of something. However, instead of trying to gain 100% certainty, a person should try to learn to live with uncertainty.

Jonathan Grayson, PhD. explains how nothing in life is certain. A person with OCD wants to be 100% certain of something, but in reality, nothing is 100% certain. Instead of trying to be 100% certain of something, a person needs to be aware that life is full of uncertainties.

Elizabeth McIngvale, Ph.D. discusses sitting with the uncertainty when doubting when your doubting your diagnosis.

Elizabeth McIngvale, Ph.D. shares some tips on how to not let OCD surprise you and how to be ready for anything OCD throws at you.