OCD is best treated with exposure and response prevention (ERP) therapy, which typically takes two to three months to provide clinically significant results. Severity of symptoms and frequency of treatment may impact the length of treatment.
When it comes to navigating obsessive-compulsive disorder (OCD), deciding to get treatment is important. You should be proud of yourself for taking on the challenge. Still, the decision to reach out to a therapist is only the first step of a longer journey to get well, and it can be helpful to get a better sense of what lies ahead. You may be wondering what your first therapy sessions will look like, how much time they will typically take, or how long it will be until you start to see improvements.
The most effective form of treatment for OCD is exposure and response prevention (ERP) therapy, a specialized form of cognitive behavioral therapy (CBT) that helps you face your fears while resisting compulsions. Approximately 2.3% of people in the world currently live with OCD, and 80% of those who treat it with ERP experience a reduction in symptoms within eight to 16 weeks. That being said, every experience with OCD is unique.
“Everyone’s OCD journey is different, but with the help of a trained provider, treatment for OCD can begin to take effect relatively quickly,” says Dr. Patrick McGrath, PhD, Chief Clinical Officer at NOCD. Keep reading to learn what to expect during the therapeutic process, and how soon you may see results.
When is treatment needed?
OCD is a treatable but complex mental health condition characterized by two key symptoms: obsessions and compulsions. Obsessions are thoughts, sensations, images, feelings, or urges that are intrusive, unwanted, and lead to distress. Compulsions are repetitive, physical and/or mental behaviors that a person feels the urge to perform in response to an obsession. When left untreated, OCD symptoms can get worse.
You may be experiencing OCD if:
- You engage in ritualistic, repetitive behaviors.
- Your levels of anxiety, depression, and fear feel unmanageable, and interfere with your daily functioning.
- Your obsessions and compulsions take up excessive amounts of time.
- Your symptoms cause significant distress.
If you think you may have OCD, it’s important to not only get help, but to get the right help. Diagnosis is an important first step to accessing treatment—and finding relief from symptoms. But, misdiagnoses can be common, because many therapists never receive proper training on OCD, and symptoms can resemble those of other mental health conditions.
OCD is best diagnosed by an OCD specialist, but you can also start with an evaluation with a general practitioner or a mental health professional. Specialists often use structured interviews, like the DIAMOND, to ensure diagnostic criteria for OCD from the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) is met. They may also rely on tools like the Dimensional Obsessive-Compulsive Scale (DOCS) to better understand the severity of your symptoms. These tools confirm the diagnosis and provide valuable insights to guide care and measure progress.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
What is the most effective treatment for OCD?
The most effective form of treatment for OCD is ERP—a specialized type of cognitive behavioral therapy. Unlike traditional talk therapy, which can make OCD symptoms worse by analyzing intrusive thoughts instead of letting them be, ERP is highly effective at treating OCD.
How does ERP work?
ERP works by gradually exposing you to your fears, so you can learn how to experience obsessive thoughts without engaging in compulsions. A trained therapist who specializes in OCD will take the time to understand your symptoms and create a hierarchy of exposure exercises specifically for you—starting with the fears that cause the least distress, and working your way up.
You’ll be given tools to resist performing compulsions, such as tips to engage in “self-talk” that can help you better accept uncertainty, and feel less anxious about it. Only when you’re comfortable with initial exposure exercises will your therapy progress so you can conquer bigger fears. Ultimately, ERP can help you regain control over your life, instead of feeling like your decisions are ruled by OCD.
Why you should partner with an ERP therapist
Treatment, as with diagnosis, is best managed by a trained therapist. While it may feel tempting to design your own ERP exercises, working on your own too soon can mean taking on too much too quickly—which could cause you to give up on treatment entirely. With an ERP therapist, you’ll learn to confront your fears gradually in a more controlled setting, before employing those skills on your own.
“When you’re ready, you’ll bring these lessons that you work on with your therapist back into your everyday life,” says Dr. McGrath.
The result is amazing: Your fearful thoughts lose their power over you, and your need to engage in compulsions goes away.”
Dr. Patrick McGrath
How long does ERP therapy typically take?
It depends on the severity of symptoms, but ERP therapy often takes two to three months of treatment to achieve clinically significant results. “A person who is highly motivated for change, has strong social support, or is experiencing low to moderate symptoms may be able to achieve their desired results in a shorter amount of time,” says NOCD therapist Heather Brasseur, LHMC, LPC.
Most therapy members see improvements after meeting twice a week for 8 to 12 one-hour sessions. “However, individual timelines can vary significantly, and reaching a clinically significant reduction may take slightly longer,” says Brasseur. A clinically significant result is a 35% reduction across two measurements in the DOCS. Still, many people feel better more quickly—and may even notice immediate results.
However, Brasseur explains other factors can impede therapeutic progress, or lengthen the amount of time it may take to feel impacts: “Someone with more severe symptoms, difficulty understanding or accepting the principles of ERP, limited social support, or who is attending treatment at someone else’s request may have a longer treatment trajectory.”
People with severe OCD might need elevated care before entering into individual therapy. That may mean entering into an initial residential, partial hospitalization program, or intensive outpatient program before beginning ERP therapy. Brasseur says that people navigating multiple diagnoses, or stressful life events may also find their path to recovery a little bit lengthier.
At the end of the day, however, treatment can be life changing—even if it doesn’t produce overnight results. Remember to have patience, and know that your mental health is deserving of this time investment.
Community discussions
Will I need to do ERP forever?
OCD is a chronic condition, so there is no guaranteed cure. But, in time, you can feel significant relief from symptoms, and gain the skills needed to navigate life with more ease. ERP therapy typically doesn’t go on forever, but you may continue to check in with a therapist throughout your life—as symptoms can wax and wane.
Ultimately, the goal of ERP is to teach you the skills to rely less on your therapist over time. After the severity of your OCD symptoms lessen, your therapist should help you find strategies for sustaining your results, while slowly reducing how often they see you. For some people, this might take a few months. For others, it may be a few years. Intrusive thoughts or compulsive behaviors may still arise, but you will eventually learn to resist them and move on with your day.
Bottom Line
ERP therapy can take time, but that time is well spent learning how to best manage your obsessions and compulsions. A specialized therapist can teach you the practices necessary to resist compulsions and lessen the impact of intrusive thoughts. Intrusive thoughts may come and go, but ERP therapy can help you control your reactions better. While you may always practice ERP to manage OCD, that doesn’t mean you’ll be in therapy forever.
Key Takeaways
- It usually takes two months of ERP therapy to see an improvement in OCD symptoms.
- ERP therapy is the most effective treatment for OCD, because you learn how to react to obsessions without compulsing.
- You won’t need to be in ERP therapy forever, but the skills you learn in therapy will stay with you for a lifetime.