Therapy for Obsessive Compulsive Disorder
I offer specialized psychotherapy for Obsessive-Compulsive Disorder (OCD) for teens and adults in Kingston, Ontario. Treatment is structured, evidence-based, and specifically targeted to the OCD cycle.
Obsessive Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) affects approximately 1 in 40 adults and often begins during childhood, adolescence, or early adulthood.
OCD involves unwanted, intrusive thoughts, images, or urges (obsessions) and behaviours or mental rituals (compulsions) used to reduce distress or uncertainty. Over time, this cycle can become increasingly time-consuming and interfere with school, work, relationships, daily routines, and overall quality of life.
Despite its impact, OCD is often under-recognized and undertreated, and people may live with symptoms for years before receiving an accurate diagnosis and OCD-specific treatment.
Common OCD Presentations
Checking
Persistent uncertainty about whether something is correct, safe, or complete, leading to repeated checking or reassurance seeking.
“Just Right”
A need for things to feel right, complete, or acceptable, often leading to repeating, redoing, or correcting until they do.
Contamination
Fear of germs, illness, dirt, chemicals, or feeling contaminated, often followed by cleaning or avoidance.
Checking OCD
Checking OCD involves persistent uncertainty about whether something is correct, safe, complete, or happened the way you remember it. You might repeatedly check locks, appliances, work, messages, memories, or other details because it feels difficult to trust that checking once is enough.
Checking usually brings a brief sense of relief, but the doubt often returns, sometimes even stronger. Over time, repeatedly checking or asking others for reassurance can teach your brain that you need certainty before you can move on, which keeps the OCD cycle going.
“Just Right” OCD
“Just Right” OCD involves a strong feeling that something is off, wrong, incomplete, or not quite right, even when there may be no clear reason why. You might feel driven to repeat, redo, correct, count, or adjust something until it finally feels acceptable or “right.”
Following that urge can bring temporary relief, but the uncomfortable feeling often returns the next time something doesn’t feel right. Over time, repeatedly correcting the feeling teaches your brain that things must feel right before you can move on, which keeps the OCD cycle going.
Contamination OCD
Contamination OCD involves persistent fears or uncomfortable feelings about germs, illness, dirt, chemicals, bodily fluids, or other sources of contamination. You might feel driven to wash, clean, sanitize, change clothes, avoid certain objects or places, or ask others whether something is safe or clean.
Cleaning or avoiding contamination can bring temporary relief, but the fear or sense of contamination often returns. Over time, these behaviours teach your brain that the contamination really was dangerous and that cleaning or avoidance was necessary, which keeps the OCD cycle going.
Bad Thoughts OCD
Bad Thoughts OCD involves unwanted, intrusive thoughts, images, or urges that feel disturbing, frightening, inappropriate, or very different from who you believe yourself to be. You might become stuck wondering “Why did I think that?”, “What if this means something about me?”, or “What if I actually did something terrible?”
Trying to get certainty about these thoughts can lead to compulsions such as reviewing memories, analyzing what the thought means, avoiding triggers, confessing, seeking reassurance, or trying to replace a “bad” thought with a “good” one. These strategies may bring temporary relief, but they teach your brain that the thought is important or dangerous, which keeps the OCD cycle going.
Ordering OCD
Ordering OCD involves a strong need for objects or surroundings to be organized, positioned, symmetrical, or arranged in a particular way. You might feel driven to line things up, keep items in specific places, make things even or balanced, or repeatedly adjust objects when they don’t look the way they are supposed to.
Arranging things correctly can bring temporary relief, but the discomfort often returns when something is moved or out of place. Over time, repeatedly fixing or rearranging things teaches your brain that the discomfort needs to be corrected rather than tolerated, which keeps the OCD cycle going.
CBT for OCD
Values & Goals
Exposure and Response Prevention (ERP)
What is ERP?
Planned versus Unplanned ERP
Repeated Exposures
Over-Correcting
Harm Reduction
ERP Models
Habituation Model
Inhibitory Learning Model
Act & Values Based Model
Creating a Hierarchy
Moving Around Hierarchy
Distress Tolerance Resources
Resources
Obsessive Compulsive Disorder (OCD)
Centre for Addiction and Mental Health (CAMH)
The Centre for Addiction and Mental Health (CAMH) provides evidence-based information, assessment resources, treatment guidance, and educational materials related to Obsessive Compulsive Disorder (OCD). CAMH offers resources for individuals living with OCD, families, health-care professionals, and therapists.
Understanding OCD
CAMH provides an overview of OCD, including common obsessions and compulsions, possible causes, diagnosis, and treatment.
The resource also explains why OCD-specific treatment is important and provides information about Cognitive Behavioural Therapy (CBT), medication, recovery, and relapse prevention.
Learn About Obsessive Compulsive Disorder (OCD)
OCD: An Information Guide
CAMH’s Obsessive Compulsive Disorder: An Information Guide is a comprehensive resource for individuals experiencing OCD and their families and friends.
The guide explores:
- What OCD is
- Obsessions and compulsions
- Possible causes of OCD
- Cognitive and behavioural treatment
- Medication
- Recovery and relapse prevention
- The role of family and friends
Read OCD: An Information Guide
Download the OCD Information Guide (PDF)
A French-language version of the guide is also available through CAMH.
OCD Treatment
CAMH provides detailed information about evidence-based treatment for OCD.
First-line treatments include Cognitive Behavioural Therapy (CBT) specifically adapted for OCD and medication. Exposure-based approaches are an important component of specialized CBT for OCD.
The CAMH professional treatment section also discusses treatment planning, psychotherapy, medication, treatment resistance, and circumstances in which referral to specialized OCD care may be appropriate.
OCD Screening & Assessment Tools
CAMH provides access to several commonly used OCD assessment measures and clinical resources.
Available measures include:
- Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
- Obsessive-Compulsive Inventory–Revised (OCI-R)
- Florida Obsessive-Compulsive Inventory (FOCI)
These measures can help clinicians assess OCD symptoms and monitor symptom severity over time. They are not substitutes for a comprehensive clinical assessment.
Access OCD Assessment Tools & Resources
Self-Help & Recommended OCD Resources
CAMH maintains a collection of additional resources for people experiencing OCD, including recommended books, workbooks, online programs, and organizations specializing in OCD.
The collection includes resources focused on understanding OCD, managing uncertainty, and learning strategies based on Cognitive Behavioural Therapy and Exposure and Response Prevention.
Ontario Structured Psychotherapy Program
The Ontario Structured Psychotherapy (OSP) Program provides publicly funded Cognitive Behavioural Therapy for adults experiencing depression, anxiety, and anxiety-related concerns, including obsessive-compulsive concerns.
Services are available to eligible adults aged 18 and older who live in Ontario. Treatment options and level of care are determined according to individual needs and program eligibility.
Learn About Ontario Structured Psychotherapy
Accessing CAMH Services
CAMH provides specialized mental-health assessment and treatment services. Access CAMH is the centralized point of contact for information about CAMH programs, eligibility requirements, and referrals.
Not every CAMH service is available for every age group or presentation, and eligibility criteria may change.
For Health-Care Professionals
CAMH provides a dedicated clinical resource on recognizing, assessing, diagnosing, and treating OCD.
Topics include:
- Screening and assessment
- Diagnosis and differential diagnosis
- Cognitive Behavioural Therapy
- Pharmacotherapy
- Family accommodation
- OCD-related disorders
- When to refer for specialized treatment
- Clinical assessment measures
- Patient and family resources
Thompson Centre
The Frederick W. Thompson Anxiety Disorders Centre at Sunnybrook Health Sciences Centre specializes in the assessment and treatment of Obsessive Compulsive Disorder (OCD) and related conditions. The Centre also provides education and resources for individuals living with OCD, families, and health-care professionals.
OCD Information & Resources
The Thompson Centre provides information and resources to help individuals and families better understand OCD and evidence-based treatment.
OCD & Related Disorders Resources
Patient and family resources about OCD and related disorders, including educational materials, recommended books, online resources, support resources, and information about treatment.
OCD & Related Disorders Resource Map
The Thompson Centre’s OCD & Related Disorders Resource Map provides an overview of assessment and evidence-based treatment options. It includes information about standardized OCD measures, treatment guidelines, Cognitive Behavioural Therapy (CBT), medication, self-help resources, and when specialized treatment may be appropriate.
View the OCD & Related Disorders Resource Map
Specialized OCD Services
The Thompson Centre provides specialized assessment and treatment services for adults with OCD. Services vary according to symptom severity, treatment history, age, and location.
Available services include:
- Psychiatric consultation
- Outpatient group psychotherapy
- Cognitive Behavioural Therapy (CBT) for OCD
- Mindfulness-Based Cognitive Therapy (MBCT)
- Specialized services for severe and treatment-resistant OCD
- Intensive live-in and day treatment
Referral Information & Eligibility
Outpatient OCD Group Treatment
The Thompson Centre offers specialized group psychotherapy for adults with OCD.
For individuals with severe or treatment-resistant OCD, virtual group treatment may be available to eligible individuals throughout Ontario. Treatment groups use approaches including Cognitive Behavioural Therapy (CBT) specifically adapted for OCD.
Learn About Outpatient OCD Group Treatment
Intensive OCD Treatment Program
For adults experiencing severe and significantly impairing OCD, the Thompson Centre offers an intensive treatment program in both live-in and day-treatment formats.
Treatment is centred on Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention (ERP), with additional therapeutic and medication supports incorporated when appropriate.
This level of care may be considered when OCD is substantially interfering with everyday functioning and outpatient treatment has not provided sufficient improvement.
Learn About the Intensive OCD Treatment Program
Related Conditions
The Thompson Centre also provides specialized expertise and resources for several conditions related to OCD, including:
- Hoarding Disorder
- Body Dysmorphic Disorder (BDD)
- Trichotillomania (hair pulling)
- Excoriation Disorder (skin picking)
- Other body-focused repetitive behaviours (BFRBs)
Explore OCD & Related Disorder Resources
For Health-Care Professionals
The Thompson Centre provides clinical resources for professionals supporting individuals with OCD and related disorders. These include an OCD treatment algorithm for primary care, an OCD and Related Disorders Resource Map, information about standardized assessment measures, and guidance regarding specialized treatment and referrals.
Thompson Centre — Professional Information & Resources
Please note: Eligibility and referral requirements vary between Thompson Centre programs. Some services are available throughout Ontario, while others have geographic catchment requirements. Review the current eligibility criteria directly through Sunnybrook before seeking a referral.