Neurodivergent-Affirming OCD Therapy
OCD is not a personality quirk or a need for things to be tidy. It is a doubt disorder: an engine that manufactures "but what if," then demands a ritual to quiet it, over and over. This practice treats it with two evidence-based methods, Inference-Based CBT and neurodivergent-affirming ERP, delivered online to adults. One of them, I-CBT, uses no deliberate exposure at all. Whatever your theme, and however many therapists have not quite fit before, there is a way through that is built around how your mind actually works.
Help with: contamination & washing · checking · intrusive thoughts · relationship OCD · scrupulosity · perfectionism & "just right" · mental review & Pure O · emetophobia · BFRBs · and OCD in autistic and ADHD adults.
A real choice of method
Not exposure or nothing. You get I-CBT and affirming ERP, and we decide together which one fits, or whether to combine them.
Treatment without exposure
I-CBT resolves the doubt at its root with no deliberate exposure, an option most OCD care simply does not offer.
Neurodivergent-affirming
Autism and ADHD are respected, never targeted. Only doubt-driven rituals go on the plan.
One therapist, all the way
You work with one named specialist who knows your history, not a rotating match from a pool.
One engine, a thousand disguises
OCD wears endless costumes, but underneath every one it runs on the same mechanism: manufactured doubt, followed by a compulsion meant to make the doubt go away. Understanding that engine is what makes it treatable, no matter which theme it has chosen.
OCD themes I treat
OCD shows up differently for everyone. Many people arrive looking for their specific theme, so here are common ones, each with a dedicated page:
Related phobias and anxiety I also treat
These are anxiety disorders rather than OCD, but they run on the same doubt-and-avoidance engine and respond to the same methods, so they fit naturally alongside this work:
Body-focused repetitive behaviors (BFRBs)
BFRBs are their own category, related to OCD but distinct, and treated with dedicated methods (ComB and process-based work) rather than exposure:
Two ways in, chosen to fit you
Most OCD therapy offers one route: exposure. Here you have two evidence-based methods, and which one leads is a decision we make together, not a protocol you are handed.
I-CBT: no deliberate exposure
Inference-Based CBT treats OCD as a doubt problem: it traces how "maybe it's contaminated, maybe I left it on" gets manufactured against the evidence of your own senses, and resolves the doubt at its source. No flooding, no provoking anxiety on purpose, and trial outcomes comparable to established treatments, with particular strength for high-conviction themes. Read the full I-CBT introduction →
Weighing your options? Here's I-CBT vs ERP compared, and we'll settle it together in your free consult.
Affirming ERP: exposure you choose
Where avoidance has annexed real territory, chosen and well-paced exposure reclaims it, delivered with structural consent: your list, your pacing, a real veto, sensory pain never conflated with anxiety, and nothing sprung on you. Read the affirming ERP introduction →
OCD therapy that works with your neurodivergence, not against it
For neurodivergent adults, standard OCD therapy often gets one crucial thing wrong: it treats the neurodivergence as part of the problem. Here it never is. Autism and ADHD are respected, only the OCD is targeted, and the methods are built for how your brain actually works.
Adults who tried ERP and it did not fit
If exposure felt intolerable, or you white-knuckled through it and the doubt came back, that is information, not failure. I-CBT offers a genuinely different route, and affirming ERP offers a version built on consent rather than endurance.
Autistic and ADHD adults
A specialty within the specialty: telling OCD apart from autistic regulation and ADHD patterns so treatment never targets your neurotype, with methods rebuilt for neurodivergent nervous systems. The OCD for autistic adults page covers the sorting.
People whose OCD is mostly invisible
Mental review, moral scrupulosity, relationship doubt, "did I do something wrong" tribunals that run all day and show nothing outside. Fully treatable, and no exposure hierarchy required, because there is nothing external to expose yourself to.
Anyone carrying more than OCD
The anxiety, burnout, or ARFID that so often ride alongside OCD get treated in the same place, by the same person, rather than split across referrals that never talk to each other.
Not sure if this is OCD, or which treatment fits?
That is exactly what the free consultation is for. We will talk it through by phone, no pressure and no commitment, and you will leave with a clearer sense of your options.
Book a free 15-min consultationOCD therapy in your state
I see adults by telehealth in four states. Texas, Maine, and New Hampshire each have a dedicated OCD page with local detail on coverage, insurance, and access, and Montana has a general therapy page. Sessions are virtual, so you can join from anywhere in your state.
Insurance or private pay, your choice
Accepted insurance plans vary by state. Private pay rates are the same for individuals and couples, and for I-CBT or ERP.
Accepted plans differ by state, so verify your benefits first. The services page has the full breakdown.
The doubt is manufactured. The way out is real.
OCD is treatable, and there is more than one way through. Book a free 15-minute consultation and we will find the one that fits you.
Book a free 15-min consultation