OCD — Assessment & Treatment

Does This Sound Familiar?

You check the stove — again. You replay a conversation, wondering if you said something wrong. You avoid certain thoughts, words, or situations because the anxiety they trigger feels unbearable, or because something terrible might happen if you don't. You have doubts even about minor decisions. You may even know, on some level, that your fears don't quite make sense — but that knowledge does nothing to quiet them

If this resonates, you may be experiencing OCD. And contrary to what many people believe, OCD is not about being neat or organized — it is a serious, potentially debilitating condition that can take over every area of your life. The good news is that it is one of the most treatable conditions in clinical psychology.

What Is OCD?

OCD (Obsessive-Compulsive Disorder) is a common mental health condition affecting approximately 2% of the population. It is characterized by recurring intrusive thoughts, images, or impulses — called obsessions — that cause significant anxiety or distress, followed by repetitive behaviors or mental acts — called compulsions — performed to reduce that distress.

Obsessions commonly involve contamination fears, concerns about accidentally causing harm, unwanted taboo or intrusive thoughts, or an excessive need for order, symmetry, or certainty. Compulsions may involve washing, checking, arranging, repeating actions, counting, reviewing, or avoiding situations that trigger obsessions. OCD can appear in childhood, adolescence, or adulthood, and its presentation can shift significantly over time.

OCD is frequently misunderstood — both by the general public and, critically, by many clinicians. A landmark 2025 report by the International OCD Foundation found that up to 75% of OCD cases go undetected or undiagnosed by clinicians, and that only 2% of individuals with OCD receive ERP — the gold standard treatment — while more than 80% receive no evidence-based treatment at all. If you have been struggling for years without answers, or have received treatment that didn't help, you are not alone — and it is not your fault. Accurate diagnosis by a clinician with specific OCD expertise is the essential first step toward effective treatment. You can read the full report here: America's OCD Care Crisis — IOCDF, 2025.

My Expertise in OCD

I am internationally recognized for my research and clinical expertise in OCD. I serve on scientific committees for the International OCD Foundation (IOCDF) and contribute to clinical guidelines, research initiatives, and training programs worldwide.

In 2026, I co-authored a commissioned State of the Art Review on the Management of OCD, published in the BMJ — one of the most prestigious medical journals in the world. This comprehensive review covers the full landscape of evidence-based treatments for OCD, including CBT and ERP, pharmacological approaches, and emerging interventions, and is intended as a definitive clinical reference for specialists and researchers internationally. You can read the full paper here: Management of Obsessive-Compulsive Disorder in Adults — BMJ, 2026.

My published research also spans OCD mechanisms, neuropsychology, and comorbidity — particularly the clinically important overlap between OCD and ADHD, including the development of the Executive Overload Model, which explains how OCD symptoms can lead to problems in attention and executive function — which is why individuals with OCD are frequently misdiagnosed with ADHD, and why accurate differential diagnosis is essential.

I have published over 70 peer-reviewed articles and book chapters on OCD and related conditions, and I regularly present my findings at international conferences and invited talks in the US and Europe. This depth of expertise means that when I assess and treat OCD, I bring research-level understanding of its mechanisms, presentations, and evidence-based treatment to every clinical encounter.

Assessment

OCD is frequently misdiagnosed or overlooked. A thorough, accurate assessment is essential before beginning treatment.

My evaluation includes:

A comprehensive clinical interview examining the nature, content, and severity of obsessions and compulsions, their history, and their functional impact on daily life, relationships, and work.
Validated OCD rating scales and structured diagnostic interviews to assess symptom severity, subtype, and patterns.
Assessment of co-occurring conditions, including anxiety disorders, ADHD, depression, and body-focused repetitive behaviors, which frequently co-occur with OCD and affect the overall clinical picture.
Neuropsychological evaluation, when indicated, to assess cognitive functioning and clarify diagnostic questions — particularly when ADHD or other conditions are suspected alongside OCD.
A clear diagnostic formulation and personalized, evidence-based treatment recommendations.

Treatment

OCD is highly treatable. With the right approach, most individuals experience a meaningful and lasting reduction in symptoms, improved daily functioning, and a significantly better quality of life.

The most empirically supported psychological treatment for OCD is Cognitive-Behavioral Therapy (CBT) with Exposure and Response Prevention (ERP). ERP is a structured, evidence-based approach in which individuals gradually face feared triggers without performing compulsions — allowing the brain to learn new associations and naturally reduce distress over time.

Alongside ERP, treatment also incorporates the cognitive component of CBT, which focuses on identifying, evaluating, and reframing the dysfunctional beliefs and appraisals that drive and maintain OCD. People with OCD often hold characteristic distorted beliefs — such as an inflated sense of responsibility, thought-action fusion (the belief that having a thought is equivalent to acting on it), intolerance of uncertainty, and perfectionism. Addressing these beliefs directly — rather than simply performing exposures — leads to deeper, more durable change.

Treatment focuses on:

Understanding the mechanisms that drive and maintain OCD, including the role of avoidance and compulsions in strengthening obsessional fear.
Developing a personalized hierarchy of feared situations and triggers.
Gradually and systematically engage in exposures, paced according to your readiness and tolerance.
Identifying and evaluating the dysfunctional beliefs and appraisals that fuel obsessions and compulsions.
Reducing reliance on compulsions and safety behaviors that maintain OCD over time.
Building long-term resilience and tools to manage setbacks independently.

Treatment is collaborative, transparent, and focused on meaningful functional improvement — not simply symptom reduction, but helping you reclaim the life OCD has been limiting.

Who Is This For?

This service is appropriate for adults who:

Experience recurring intrusive thoughts, obsessions, or compulsions that cause distress or interfere with daily functioning.
Have been diagnosed with OCD and are seeking specialized, evidence-based treatment.
Are unsure whether their symptoms represent OCD or another condition, such as anxiety or ADHD.
Have previously tried treatment without success and are looking for a more specialized, effective research-informed approach.
Want a clinician who combines world-class research expertise with practical, compassionate clinical care.

In-Person & Telehealth Services

I offer OCD assessment and treatment in person in Austin, TX, as well as via secure telehealth throughout Texas and Florida. Research consistently supports the effectiveness of telehealth-delivered ERP and CBT for OCD, making specialized OCD treatment accessible regardless of your location.

Frequently Asked Questions

Is OCD treatable? Yes — OCD is one of the most treatable conditions in clinical psychology. With evidence-based ERP treatment, most individuals experience a meaningful reduction in symptoms and a significant improvement in daily functioning and quality of life.

What is ERP and is it difficult? ERP (Exposure and Response Prevention) involves gradually confronting feared situations without performing compulsions. It requires effort and commitment, but it is done collaboratively, at a pace that respects your readiness. The discomfort is temporary — the gains are lasting.

How is OCD different from being a perfectionist or "just anxious"? OCD involves specific intrusive thoughts and compulsive responses that follow a recognizable pattern. While anxiety and perfectionism can, and frequently do co-occur with OCD — and are sometimes confused with it — OCD has distinct mechanisms and requires a specific treatment approach. A careful evaluation is the best way to determine what is driving your symptoms.

Does OCD co-occur with ADHD? Yes — OCD and ADHD can co-occur, though this is less common than many people assume. In many cases, however, OCD symptoms may result in symptoms similar to ADHD. I have specific research and clinical expertise in this overlap, including published work on dual diagnosis, misdiagnosis, and how to distinguish these conditions accurately.

Do you accept insurance? I do not accept insurance at this time. As an out-of-network provider, I can provide a detailed statement you can submit for potential partial or full reimbursement depending on your plan.

Ready to Take the Next Step?

If you are struggling with OCD and are looking for specialized, internationally recognized assessment and treatment in Austin, TX — or via telehealth anywhere in Texas or Florida — I would be glad to hear from you.

Contact Me