Contamination & checking
The most publicly recognized OCD presentations — but often the ones where clients feel least safe seeking help, because the specifics feel embarrassing to name. ERP proceeds carefully, at a pace you can tolerate.
Focus Area Focus
OCD therapy.
Evidence-based Exposure and Response Prevention (ERP) for adults, teens, and children navigating obsessive thoughts, compulsive rituals, and the exhaustion of a mind that won’t quit.
ERP is the gold-standard treatment for OCD. It works — the research is unambiguous. It also asks something specific of you, and it requires a clinician trained to hold that specific work.
OCD is one of the most treatable anxiety disorders when it is treated well — and one of the most often mistreated when it is not. Meta-analyses across adult and pediatric samples consistently show Exposure and Response Prevention (ERP) as the most effective psychotherapy for OCD, with large effect sizes across contamination, checking, taboo intrusive thoughts, and less well-known presentations like relationship OCD and somatic OCD. What ERP asks of a client is specific: to face what the OCD is trying to protect against, without performing the ritual that briefly relieves it. That is genuinely hard work at any age — and it is why ERP is best delivered by a clinician who understands the exact shape of the OCD in front of them, and can tailor pacing to a child, a teen, or an adult accordingly.
Areas of focus.
Intrusive thoughts (harm, taboo, existential)
Unwanted violent, sexual, religious, or existential thoughts that horrify the person having them — and are, precisely because they horrify, not the same as intent. ERP treats the anxiety, not the thought.
Relationship OCD
Compulsive doubt about whether you love your partner, whether they love you, whether you are “really” attracted, whether this is “the right” relationship. Distinct from ordinary relationship uncertainty in intensity and disruption.
Health anxiety & body-focused OCD
Persistent worry about undiagnosed illness, with checking behaviors that briefly relieve and then reinforce. Distinct from medical vigilance in how much time and attention it consumes.
Somatic OCD
Hyperawareness of automatic body processes — blinking, swallowing, breathing, heartbeat — that becomes intolerably distressing. Under-recognized clinically, and responsive to ERP when named as OCD.
How we work.
What ERP actually looks like
A carefully paced protocol: identify the obsession, identify the compulsion, and gradually expose the client to the trigger while blocking the compulsive response. Discomfort in service of freedom, not the other way around.
Response prevention vs. accommodation
One of the most under-discussed aspects of OCD treatment is what family members do around it — the reassurance, the checking-on-behalf-of, the accommodations that briefly help and quietly worsen. Effective ERP names this pattern explicitly.
Braiding trauma work when needed
A meaningful subset of OCD cases have an underlying trauma history that shapes how severely and how early the OCD emerged. When trauma is present, ERP is delivered alongside trauma-informed stabilization — not either/or.
Ready to begin ERP?
Book a free 15-minute consultation with Enid Wilson, LMFT. For help finding the right fit or to speak with the clinical director, call or text (916) 990-2326 or email [email protected].
Telephone
(916) 990-2326
Email
[email protected]
Research Cited
- “Exposure and Response Prevention for OCD: A Meta-Analytic Review of Treatment Outcomes.” Clinical Psychology Review, 2020.
- “Family Accommodation in Obsessive-Compulsive Disorder: A Review.” Journal of Anxiety Disorders, 2019.
- “The Relationship between Childhood Trauma Experiences and OCD Symptom Severity.” PMC, 2023.