What Does an OCD Specialist Actually Do? A Simple Explanation of What Happens in Therapy

If you’re looking for an OCD therapist, it’s worth asking about their experience treating OCD and what happens in therapy with them. You want someone who can recognise the patterns you’re caught in, including the ones that are difficult to explain or that happen entirely in your head.

Ariel Andersen, OCD & Exposure Therapy Specialist

Here are some things I would look for.

Experience with exposure and response prevention

Exposure and response prevention, or ERP, is an established treatment for OCD. It involves approaching situations, thoughts, or feelings that trigger distress and practising leaving out the compulsions you usually use to manage it.

Your therapist should be able to explain how this applies to your particular difficulties. You should understand what you’re practising, why you’re doing it, and how it connects to the changes you want in your life.

Someone you can talk to about intrusive thoughts

OCD can involve thoughts about harming someone, sex, religion, contamination, or doubts about a relationship. Some thoughts can feel so upsetting or shameful that you spend a long time deciding whether to tell anyone.

A therapist with experience in OCD should be familiar with these themes and able to discuss them calmly. They’ll ask questions to understand your experience and assess it carefully. You should have room to explain what’s happening without having to make it sound more acceptable first.

Attention to compulsions you might not recognise

Some compulsions are easy to see, such as repeated washing or checking. Others are much less visible.

You might replay a conversation to make sure you didn’t say something offensive, check your feelings towards your partner, or mentally argue with a thought until you feel reassured. You might spend hours searching online for an answer that finally feels convincing.

These are important parts of the assessment. A therapist needs to understand what you do in response to a thought, including the mental work that can leave you exhausted while appearing to do very little.

A plan for working with uncertainty

A difficult part of OCD treatment is practising how to leave a question unresolved.

For example, you might have checked that the door is locked and still feel an urge to go back. The work could involve continuing with your day while that doubt is present, following a plan you’ve agreed on with your therapist.

That can be uncomfortable. We spend time understanding what makes it difficult and choosing exercises that give you a useful place to start.

Clear explanations and a collaborative pace

You should be involved in planning treatment. Your therapist can help you choose exercises that are challenging enough to practise something new and manageable enough for you to engage with.

There should also be space to discuss what happens between sessions. If an exercise felt overwhelming, or you noticed yourself replacing one compulsion with another, that gives us information to work with.

I want clients to feel able to tell me when something is confusing, difficult, or unhelpful. We need that honesty to make the work useful.

Now That You Know What Happens, Here's Where to Find OCD therapy in Copenhagen

At Village Therapy, I offer OCD treatment using ERP in English. We start by understanding your symptoms, how they affect your life, and what you want help changing.

If you’d like to discuss working together, you can book an introductory call. You don’t need to have a polished explanation of what’s happening. We can start with what you’ve noticed.