Can OCD be Treated Via Video Therapy? by Robyn Tamanaha, LMFT

Obsessive Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts, images, and urges that involuntarily and unwelcomely enter an individual’s mind. In an effort to alleviate the tension caused by these various persistent stressors, individuals will begin to engage in repetitive behaviors, also known as compulsions. The entire experience of this cycle of compulsions can take up at least two hours of someone’s day. This can highly interfere and disrupt major areas of their life, such as work, school, relationships, and basic self care needs. Fortunately, OCD can be effectively treated with Exposure & Response Prevention (ERP).

Understanding OCD Treatment

Triggers are natural occurrences that lead to the individual's intrusive thoughts and obsessions. Through exposure exercises, individuals will intentionally confront these normal triggers, activating their obsessions. An key component of the exposure exercise is response prevention- resisting the urge to engage in compulsions. During this stage of ERP, the therapist assists the client with response prevention, which is essential for ultimately breaking the OCD cycle. Through this, the client will start by experiencing low distress level exposures and eventually work their way towards more challenging exposures.  Overtime, without treatment, this compulsive behavior will only continue to build as a vicious cycle. However, through ERP, the individual can eventually take control of their life, rather than be ruled by their OCD.

Can OCD be treated with video therapy?

OCD can be treated via video, just as effectively as in-person therapy. As stated above, ERP necessitates exposures that trigger distress, enabling individuals to practice refraining from compulsions. Below are a few examples of how video therapy can be utilized: 

Example #1: Contamination OCD

Suppose an individual struggles with contamination OCD, wherein they constantly fear  they will get sick. Because of the intrusive thought of becoming ill, the individual washes their hands immediately after touching the doorknob in their home. During in-person therapy, we could facilitate imaginal exposure. In this case, I would ask the individual to visualize touching the doorknob without immediately washing their hands. This in-person experience may be helpful with learning how to absorb discomfort, but our ERP treatment would be limited. However, with video therapy, the individual would be present in their home environment and would have immediate access to that specific doorknob that is leading to their compulsion. By having the individual touch the doorknob once with their bare hand without washing, I would be teaching them how to sit with distress and how to refrain from compulsions. 

Example #2: Symmetry/Order OCD

Let's consider an individual with symmetry/order OCD, who feels compelled to have items in their home perfectly aligned, maintained, or placed in a very specific way. This can include having all of the labels of items in their pantry facing forward, dishes placed in their dishwasher in a particular order, or items in their bedroom set in a specific area.  In-person therapy could include imaginal exposure or visual aids to simulate disorderly situations that would otherwise trigger them. Like earlier mentioned, this in-person technique would help with learning how to sit with the discomfort, but would limit the ERP treatment. In the case of video therapy, they have the opportunity to be in the comfort of their own home while having access to the specific personal belongings that need to be placed a certain way. Exposures could involve taking personal belongings and moving them to a different location, or turning one of the pantry items so the label faces a different direction from all the others. This is when we take in that discomfort, and I guide them with refraining from compulsions. 

Example #3: Combinations of OCD Subtypes

It is not uncommon for an individual to simultaneously experience multiple subtypes of OCD. An individual with both contamination and symmetry/order OCD might make sure that any item, once taken out of a specific location to wear outside of the home, is handled a specific way. Once back inside the home, they might immediately take off their clothes and place them in the laundry basket to avoid sitting on their bed with those clothes on. They may also go wash their hands immediately. In person therapy would include imaginal exposures, watching episodes or videos that show very disorganized and unsanitary homes. They could also visualize sitting on their bed in the same clothes worn outside, which would temporarily help them learn how to handle the discomfort and distress. Video therapy exposures, however, may look like the following: touch an item in the laundry basket without washing the hands, place one shoe slightly outside of its designated location, stand next to the bed with a pant leg touching part of the mattress. Using these techniques, they will be learning how to manage the discomfort and distress they are experiencing during our session, and how to refrain from engaging in compulsions. 

You don’t have to do this alone. I specialize in treating Obsessive Compulsive Disorder and use Exposure & Response Prevention with my clients. If you are interested in receiving therapy with me, let’s schedule a free 15-minute phone consultation.

I can provide therapy. My office is located in Irvine, which is near Newport Beach, Orange, Fountain Valley, Costa Mesa, Anaheim, Huntington Beach, Mission Viejo, Laguna Niguel, Aliso Viejo, Laguna Hills, Tustin, Seal Beach, and beyond. I provide video therapy to individuals who live in California, including Orange County, San Diego, Los Angeles, Santa Barbara, San Francisco, at more. I work with OCD, anxiety, depression, bipolar disorder, and Asian American & Pacific Islanders.

Disclaimer: This information is being provided to you for educational and informational purposes only. The topics being discussed are meant as a self-help tool for you own use. It is not psychotherapy or counseling. This information is to be used based on your own judgment. If you need to speak with a professional, you should find one local to you and contact them directly.