Teletherapy, or online therapy, can be just as, if not more, effective as in-person treatment—even for obsessive-compulsive disorder (OCD), which requires a structured and specialized approach. Online OCD therapy allows for greater access to a wider range of specialists, and can help you address obsessions in the very environment where they may most often emerge: your home.
Online therapy has become a go-to option for many, because of how accessible, flexible, and convenient it can be. You don’t have to worry about commuting, sitting in a waiting room, or rearranging your day to make a session work—and many virtual platforms allow you to touch base with therapists in between sessions, which can be helpful for maintaining progress.
However, you may be wondering if online therapy works for obsessive-compulsive disorder (OCD) treatment?
The answer is yes—online OCD treatment can be just as effective as in-person therapy when using evidence-based approaches like exposure and response prevention (ERP) therapy. Virtual sessions can help you stay consistent, give you access to OCD specialists no matter where you live, and allow you to take on the challenge of exposures and response prevention from the comfort of your own home.
Read on to learn more about how ERP therapy works online, what to expect, and tips to make the most out of your virtual sessions.
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All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Is online OCD treatment effective?
According to Chief Clinical Officer at NOCD, Dr. Patrick McGrath, online treatment for OCD is not only more accessible than looking for an in-person specialist in your area, it can actually be more effective than in-person treatment.
Research involving the largest sample of children, adolescents, and adults to date supports this idea. Over 2,000 participants reported fast and tangible results, with some seeing up to a 40% reduction in symptoms in less than 12 sessions.
According to McGrath, doing ERP therapy from home can be highly beneficial because it allows “a therapist to work with their members in the settings and situations where their triggers are most likely present—and where obsessions or compulsions are most likely to occur.” He says this allows therapists to tailor treatment more to your needs.
However, in order for virtual OCD treatment to be effective, therapists must be trained in ERP therapy, and should know how to approach all types of intrusive thoughts. “Our therapists are trained to recognize and respond to every kind of intrusive thought imaginable, without judgment—including ones that are violent, sexual, or taboo,” says licensed therapist Tracie Ibrahim, MA, LMFT, CST.
So, how exactly does online ERP therapy work—and what can you expect from a virtual session?
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How online OCD treatment works
Regardless of whether you choose to do in-person or online OCD treatment, the core structure of ERP is the same. Online therapy is just adapted to make the most of a virtual setting.
ERP therapy is a specialized form of cognitive behavioral therapy (CBT) where you’ll work with a therapist to gradually expose yourself to fears that trigger intrusive thoughts, while resisting the urge to do compulsions.
In one of your earlier video calls with your therapist, you’ll work together to identify your fears and create what’s known as “an exposure hierarchy.” This will be a list of exercises meant to help you face your fears while resisting compulsions. The list will be ranked from the least anxiety-inducing to the most, and in future sessions, you’ll slowly work your way up, moving at your own pace.
For example, if your OCD manifests mainly around fears about contamination, your therapist might have you start by imagining touching something “contaminated,” while you sit in the relative safety of your own home. Then, you’d work up to actually touching the object—like a doorknob, kitchen counter, or your phone—without washing your hands afterward.
Since online OCD treatment already takes place in the space where many of your obsessions and compulsions likely occur (your home), it’s easy to plan exercises with your therapist for both in and out of session. Your therapist may even ask you to move around while you keep your phone or laptop video going, guiding you through tasks in the moment, just like they would in-person.
“I like to tell people to turn their laptops and show me their ERP exercises,” says Ibrahim. “If your compulsion is to wash your hands after touching something “dirty,” I want to watch you delay or resist your compulsions.”
The goal with OCD treatment is the same, whether it’s online or in-person: to help you build tolerance to the anxiety obsessions trigger, sit with discomfort, and reduce the need to engage in rituals to alleviate that anxiety. But, online therapy can also help you stay consistent by making it easier to find therapy appointments that meet your unique needs and schedule, and helping you implement the tools you use in the environment you spend the most time in.
How to make virtual OCD treatment work for you
Online therapy can be just as powerful as in-person sessions—especially when you create the right environment and mindset for it. Here are a few simple ways to make your virtual ERP sessions more effective:
- Take a short walk before your session: Moving your body, getting some fresh air, or simply stepping away from distractions for a few minutes can help clear your head and get you prepared to engage in therapy. Also, if you work from home or spend a lot of time at your computer, a short walk can offer a nice reset before diving into therapy, which requires a different mindset from other daily tasks.
- Join your session a few minutes early: Logging on a few minutes before your appointment gives you time to settle in and test your internet connection. That way, you won’t feel rushed. Think of it as your own personal waiting room.
- Carve out a specific time: Treat therapy like any other important appointment. Block off time in your calendar—not just for the session itself, but also for a few minutes before and after, and make sure anyone you live with knows not to bother you during that hour.
- Find a quiet, private space: Choose a spot where you feel comfortable speaking openly, free from distractions or interruptions. Use headphones if you need extra privacy. If you have a small space you can regularly set aside for therapy in your home, consider ways to make it feel especially comfortable or peaceful—like adding fresh flowers, calming scents, or sticky notes with written affirmations.
- Limit distractions: Silence notifications and put your phone on Do Not Disturb.
- Bring a notebook or journal: Sometimes, your therapist may give you homework to do between ERP therapy sessions. Jotting down these tasks, or other notes and goals can help you process what you’re working on, and what you need to do between sessions.
What to do in-between sessions
Homework is a common part of ERP therapy, whether in-person or virtual, and often includes continuing ERP exercises on your own—like practicing delaying or resisting a compulsion. “The whole purpose of doing ERP exercises in a session is to show you how to do it properly when you go do it as homework,” says Ibrahim.
The goal here is to remain self-aware, so you can catch yourself the moment that an urge to perform a compulsion arises, and make the conscious decision to resist or delay instead. This practice can be challenging and uncomfortable at first, but with time, you’ll develop the ability to tolerate the anxiety that comes with not acting.
By practicing consistently between sessions, you’ll gradually build confidence in your ability to tolerate discomfort, reduce the urge to perform compulsions, and break the OCD cycle over time.
Many online platforms (like NOCD) also offer tools and options for maintaining progress between sessions, or ways to connect directly with your therapist. If you’re feeling stuck, confused, or overwhelmed, don’t be afraid to take advantage of these resources.
Bottom line
Online OCD therapy can be just as effective as in-person treatment, and can offer added benefits. It’s flexible, convenient, and can make it easier for your therapist to understand your unique environment, and the obsessions and compulsions that most impact your home life. Regardless of how you choose to approach your OCD treatment, what’s most important is finding a therapist that specializes in ERP therapy who can create a tailored, personalized treatment plan specific to your needs.