What to Expect From OCD Counseling in Boston, MA: A Step-by-Step Introduction to Healing
If you’ve been diagnosed with OCD — or even if you suspect you might have it — it’s important to work with a therapist who’s trained to treat OCD. The evidence-based treatments for OCD are ERP (Exposure and Response Prevention), ACT (Acceptance and Commitment Therapy), and/or ICBT (Inference-Based CBT). Many OCD specialists are trained in all these therapies, but ERP for OCD has been around longer, so more therapists tend to be familiar with it.
Unfortunately, OCD is still widely misunderstood — even by well-intentioned therapists. Many don’t have the right training and end up using interventions that simply don’t work for OCD. On average, it takes 10- 17 years for someone to be properly diagnosed and then actually receive the right treatment. Sadly, that was true for me, too.
Guiding Your Way Through Treatment
It took me about 15 years to get the treatment I really needed. I had therapists who knew I had OCD but didn’t tell me my diagnosis — and worse, they tried using the wrong types of therapy, which only left me feeling more hopeless because I wasn’t getting better. I started to believe I’d never find a therapy that could actually help.
That painful journey deeply informs how I practice today. It’s why I approach OCD counseling with both clinical expertise and lived empathy. I understand the OCD brain. I may not have your exact OCD — because you’re a unique person — but I do know what it’s like to live with a sticky, intrusive, relentless mind. More importantly, I don’t want others to go through what I went through in therapy.
Why I Believe Your Healing Matters
I’m also an idealist. I truly believe we can have a better, more compassionate world — and I believe that helping people move into recovery is part of how we get there. When people aren’t trapped in constant mental pain, they have more capacity to be present, to love, and to contribute. It is my humble opinion that your healing matters, not just for you, but for the world around you.
Alright, enough about my opinions. Let’s talk more about you, dear reader.
The Good News About OCD Counseling
Here’s the good news: even though OCD is still misunderstood and can be incredibly painful to live with, it is very treatable. With evidence-based treatment, motivation to apply the tools from therapy, and some healthy habits, people recover all the time. Also, awareness around OCD is growing, and it seems more people are getting the right help sooner.
That said, I know access to care can be a real barrier — most OCD specialists don’t take insurance. If you don’t currently have access to a specialist, I recommend using OCD workbooks and going through them with your therapist. There’s also amazing podcasts, support groups, free resources on social media, and e-courses. I’ve listed some helpful resources here:
OCD Resource List (with my personal takes)
1. The Self-Compassion Workbook for OCD
by Kimberley Quinlan, LMFT
What I love about this book is that it gives you a step-by-step guide on how to be kinder to yourself while doing really difficult things—like facing your fears during exposures. Being kind to yourself while experiencing distress has so many benefits. One of the biggest? It actually reduces distress and helps you build a more nurturing relationship with yourself, which makes you feel more grounded and comfortable in your own skin.
I believe that doing ERP without self-compassion can lead to perfectionism—and that’s a slippery slope into doing treatment compulsively. That’s right: if you get too rigid with OCD treatment and don’t allow for human emotions, setbacks, and mistakes, you might find yourself turning the treatment itself into a compulsion. Self-compassion helps minimize that tendency.
2. The ACT Workbook for OCD
by Marisa T. Mazza, PsyD
This is a great introduction to using Acceptance and Commitment Therapy (ACT) skills to manage intrusive thoughts and build acceptance while doing exposures. It pairs really well with The Self-Compassion Workbook for OCD because both emphasize acceptance—of your thoughts, your emotions, and yourself—so you can stop fighting and start coexisting with discomfort.
3. The Mindfulness Workbook for OCD
by Jon Hershfield, MFT & Tom Corboy, MFT
I love this book because it offers detailed examples of different OCD themes and how to apply mindfulness to each one. It helped me so much in my own OCD journey. If you're trying to better understand how mindfulness fits into OCD treatment, this one is a must-read.
4. I-CBT Workbook
by Brittany Goff, LCSW-C
Brittany has a real gift for teaching Inference-Based CBT (I-CBT) in a way that’s easy to grasp. If you’ve already done a lot of ERP work and still feel stuck, I highly recommend exploring I-CBT with this workbook. It’s clear, relatable, and practical.
5. The Anxious Truth
by Drew Linsalata
I LOVE this book. I’ve read it multiple times and still go back to specific pages to refresh myself on certain concepts. It’s helped me enormously—both professionally and personally. Somehow, it’s a total page-turner even though it's about applying clinical skills, which is often a little dry. I especially recommend it if you're dealing with panic attacks, phobias, or social anxiety—all of which are common alongside OCD.
6. Overcoming Unwanted Intrusive Thoughts
by Sally M. Winston, PsyD & Martin Seif, PhD
This book is fantastic for learning how to manage obsessions, intrusive thoughts, and mental compulsions. It helps you understand why you latch onto certain thoughts, what habits make it harder to turn away from obsessions, and how to stop engaging in internal debates with OCD.
7. Dr. Michael Greenberg's Work
Dr. Greenberg’s work has been life-changing for me—both as an OCD therapist and as someone living with OCD. I highly recommend checking out his writing on his website and learning more about Rumination-Focused ERP. He breaks down how to manage rumination, which I honestly believe is the most important part of learning how to manage OCD and anxiety. He also shares great insights on The OCD Stories podcast.
8. The OCD Stories Podcast
If you haven't heard of The OCD Stories podcast and you're feeling alone in your OCD journey, I highly recommend giving it a listen. It features amazing therapists, advocates, and people with lived experience who share practical tools, insights, and—maybe most importantly—a reminder that you're not alone.
9. The International OCD Foundation
The International OCD Foundation has so many useful articles, information on support groups, events, and therapists in your area.
Keep in mind that if you read or listen to different therapists, you may come across conflicting perspectives or advice. The deeper you explore any subject, the more you'll notice that people can disagree on certain points. Take in what genuinely resonates with you—what makes sense and supports your growth—and feel free to leave behind anything that doesn’t align with your journey.
More on What to Expect from OCD Therapy
Whether you’re doing ERP or ICBT, OCD therapy can feel much more educational, and it often has more of a coach-like vibe than a traditional "let’s-analyze-your-past" kind of feel. While it can absolutely be meaningful to explore when your OCD started or what may have triggered it, that insight alone isn’t what treats OCD.
This is why treatments like EMDR or Somatic Experiencing—while incredibly effective for trauma—usually aren’t enough on their own when it comes to OCD. That doesn’t mean they aren’t valuable or that trauma work isn’t important (it absolutely is—I’m a big fan of both the above interventions), but if OCD is the primary issue, it needs to be treated with an approach specifically designed for OCD. As research continues to evolve, we’re learning more about innovative clinical interventions for OCD, such as Internal Family Systems (IFS) for OCD and Metacognitive Therapy. That said, one thing remains clear: if you have access to an OCD specialist, working with them is one of the most effective steps you can take.
Integrating Multiple Therapy Modalities
Many therapists have training in multiple modalities and can integrate things like EMDR, IFS, or Somatic Experiencing into an OCD treatment plan if that’s what the client needs. Others might work in collaboration—so someone sees an OCD specialist and another therapist to support them in processing trauma or managing other concerns.
I can’t emphasize this enough: mental health treatment is not one-size-fits-all. Some people need a multi-pronged approach, and that’s totally valid. But no matter what your treatment path looks like, if you are struggling with OCD, an OCD-specific approach needs to be one of the core ingredients.
How OCD Therapy Differs From Other Therapies
At this point, you might be wondering other ways OCD treatment is different from other therapies. Well, in my experience, most people come into therapy expecting to reflect, process, and talk through things — and while there is space for that in specialized OCD therapy, the focus is more on learning skills and understanding the mechanics of OCD. The idea is that you need to deeply understand how OCD works and then practice using tools consistently in order to get better. That’s where the coach-like energy comes in.
But here’s the cool part: your OCD therapist is still a therapist. Most likely, they’ll be just as warm, compassionate, and supportive — if not more so — than any coach you’ve worked with. And OCD doesn’t exist in a vacuum. You’re a whole person, with other things going on in your life that deserve attention, too.
Treating the Whole Person with OCD Counseling in Boston, MA
In my practice, I welcome that. We follow where the energy is — whether it’s OCD, depression, trauma, BFRBs, relationship issues, or stress. Often, once OCD symptoms start to stabilize, other unresolved issues begin to surface, and I work with my clients on those areas, too. And if something comes up that’s outside my scope or expertise, I refer out to trusted professionals. I do this because I don’t want others to go through what I went through — working with a therapist who wasn’t equipped to treat what I actually needed help with.
What to Expect During the OCD Assessment
In OCD therapy, you’ll most likely start with an assessment where your therapist asks questions about your obsessions and compulsions.
Obsessions are unwanted thoughts, images, or urges that are hard to turn away from—no matter how much you want them to stop. Compulsions (also called rituals) are the things you do to try to stop those thoughts or reduce the distress they cause.
Using the Y-BOCS to Gain Clarity
To better understand what your OCD looks like, your therapist may ask open-ended questions or guide you through a structured assessment called the Y-BOCS (Yale-Brown Obsessive Compulsive Scale). This tool helps with diagnosing OCD, or if you’ve already been diagnosed, it gives your therapist a clearer picture of your specific symptoms, triggers, and core fears. It also helps you identify your obsessions and compulsions and become more aware of how OCD shows up in your life. It’s actually very common for clients to say something like, “Wow, I do do that—I just never realized it was an obsession or compulsion.”
Exploring ICBT Assessment Tools
If you’re working with an ICBT therapist, they might use a different assessment called the Inferential Confusion Questionnaire (ICQ). This one helps identify patterns of inferential confusion—a key concept in ICBT—and, similar to the Y-BOCS, it can support diagnosis and provide deeper insight into how your OCD functions.
During the assessment — which usually takes 1 to 2 sessions — I also ask clients to begin logging their obsessions and compulsions. This is a common homework assignment given by OCD therapists. Again, the goal is to get a clearer picture of your unique OCD symptoms and to begin increasing your awareness of OCD-related behaviors.
Why is awareness so important?
Often, these behaviors have become automatic after years of living with untreated OCD. When something becomes automatic, it tends to go unnoticed — and we can’t change something we are not even aware of. So a major part of the assessment process is helping clients become more conscious of these behaviors.
To support this awareness-building, therapists often use a combination of tools, including:
The Y-BOCS (Yale-Brown Obsessive Compulsive Scale).
The ICQ (Inventory of Compulsive Behaviors Questionnaire).
A daily log of obsessions and compulsions.
These tools give us a more comprehensive picture of how OCD is showing up in someone’s day-to-day life.
Choosing a Treatment Approach: ERP or ICBT
After the initial assessment, I usually offer clients a choice between two evidence-based treatment options: ERP (Exposure and Response Prevention) or ICBT (Inference-Based Cognitive Behavioral Therapy) — unless there’s a clear clinical reason to recommend one over the other.
I’ll provide a clear overview of both ERP and ICBT so clients can make an informed decision about what feels right for them. I prioritize giving clients as much choice as possible in their treatment journey, as offering choice and honoring autonomy are central to trauma-informed care.
Want to learn more about ERP? Read my blog: What Is ERP? Why Boston Therapists Use Exposure and Response Prevention to Treat OCD
Interested in ICBT? You can read more in my blog: ICBT for OCD in Boston, MA: Why Structured, Evidence-Based Care Makes a Difference
Accessible OCD Counseling in Massachusetts & California
You don’t have to live in Boston to begin working through OCD. I provide virtual counseling for adults across Massachusetts and California, so specialized support is always within reach—no commute, no barriers, just compassionate guidance wherever you are.
In OCD therapy, we focus on helping you break free from cycles of fear and uncertainty, learn to sit with discomfort, and rebuild confidence from within. Whether you’re starting therapy for the first time or returning after a break, you can access the same evidence-based care and genuine support—right from the comfort of home.
Ready to Take the First Step?
If you're struggling with OCD and are ready to explore treatment options, I’m here to help. As an OCD therapist, I offer virtual OCD counseling to help you begin healing from wherever you are. Whether you're curious about ERP, ICBT, or just want to understand your symptoms better, the assessment process is a great place to start.
Here are the steps toward healing:
Schedule a free 15-minute consultation to discuss what’s been challenging and learn what to expect from OCD counseling.
Start virtual therapy sessions from anywhere in MA or CA, personalized to your experiences and goals.
Begin developing tools, confidence, and hope as you move toward lasting relief and freedom from OCD’s grip.
More Supportive Resources for Your OCD Journey
In addition to individual OCD therapy, I provide complementary resources to help you navigate life beyond our sessions. The Common OCD Themes page offers a deeper understanding of the intrusive thoughts and behaviors many people experience, helping you recognize patterns and feel less alone in your struggles. Meanwhile, the OCD and Social Life page explores how OCD can affect relationships, friendships, and dating—offering strategies for connection and confidence while managing anxiety.
These additional supports are designed to enhance your therapeutic work, giving you practical tools, education, and encouragement to continue healing and growing between sessions.
