Online Cognitive-Behavioral Therapy (CBT) for OCD: A Comprehensive Guide

Introduction to Online Cognitive-Behavioral Therapy (CBT)

Have you thought about starting online Cognitive-Behavioral Therapy (CBT) for OCD treatment? If you are considering this, you are not alone! Many people are turning to online therapy sessions as they are effective, accessible, and convenient. If you want to learn more about online CBT sessions for OCD treatment, read on!

As with any other type of therapy, you want to ensure that you work with the best-fit therapist in a manner that allows you to feel safe and make progress.

There are different factors to consider. We will review a lot of them in this comprehensive guide!

Understanding Obsessive-Compulsive Disorder (OCD)

We can learn about OCD by reading important statistics provided by the International OCD Foundation (IOCDF). OCD is a mental health disorder that can emerge during preschool years as well as during adulthood. However, OCD onset often occurs in late adolescence or early adulthood. 

According to the IOCDF:

• Approximately 2% of the population across the world suffers from symptoms of OCD
• OCD affects about 2.2 million adults in the United States

It has also been estimated that approximately 1% of the Canadian population will experience OCD. The occurrence of OCD is split fairly equally among women and men. OCD symptoms can be extremely debilitating and can impact one’s relationships and daily functioning. 

Decades of research have shown that CBT is an evidence-based intervention that helps individuals with OCD symptoms and enhances their quality of life. When starting treatment for OCD, you will learn about OCD and how it impacts your life. 

Technological advances have allowed for OCD treatment to be delivered during online CBT sessions. This allows for enhanced convenience, accessibility, and flexibility. All while ensuring that you receive effective and confidential treatment – in your own home!

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), OCD has various subtypes based on the presence of reported obsessions and compulsions. During OCD therapy, you will learn psychoeducation regarding OCD and anxiety. This can help you to better understand what OCD is and why you are experiencing your symptoms. 

When you experience time consuming obsessions and/or compulsions, this can lead to frequent disruption in daily functioning. It also warrants a further assessment of whether symptoms are meeting the criteria for Obsessive Compulsive Disorder. Speak with a healthcare provider who can properly assess and diagnose your symptoms. Psychologists are an example of a type of healthcare provider who can properly assess symptoms you are experiencing.  

The various types of intrusive thoughts that teens and adults might experience in the context of OCD may include:

• Contamination or germ-related obsessions (i.e., thoughts that objects are contaminated; “that doorknob has deadly germs on it” )
• Harm-related intrusive thoughts (i.e., ”I might harm someone” or “I might stab someone” )
• Symmetry or ordering obsessions (i.e., thoughts about how objects should be organized and lined up)
• Sexual-intrusive thoughts (i.e., unwanted sexual thoughts; “I might be a paedophile”) 

In response to these obsessions, individuals develop a variety of compulsions. These may include:

• Cleaning or washing compulsions (in response to thoughts of germs or contamination)
• Mental review or “figuring it out” compulsions (in response to trying to understand distressing thoughts or actions completed)
• Checking compulsions (in response to thoughts of perfectionism or needing to ensure something is completed in a certain way)
• Reassurance-seeking or confessing “bad thoughts” (in response to “taboo” OCD-related thoughts)

The list above is not exhaustive and OCD can actually be about anything and everything!

The Benefits of Online CBT for OCD

Many benefits exist when it comes to online CBT for OCD treatment. Online therapy sessions allow individuals to be able to receive therapy despite challenges they may face. Individuals do not have to worry about long commutes or missing more time from work than needed. Individuals can also access therapy if they have physical limitations. Adolescents are able to join a therapy session shortly after school without worrying about needing to get to their therapist’s office. The convenience and accessibility of online therapy sessions are remarkable. 

Online therapy for OCD counselling also allows for excellent rapport and personal connection due to excellent technological advances in teletherapy platforms. At Forward Thinking Psychological Services™, we use the Owl practice teletherapy platform. It allows for high quality virtual therapy sessions, screen sharing of information as well as a user-friendly system that people can navigate. 

Online CBT for OCD has also been shown to be effective. This is critical. It is imperative to ensure that the treatment you are signing up for is supported by research. This can increase your confidence and comfort in pursuing this type of treatment for OCD. Online CBT for OCD therapy is delivered to both adolescents and adults. 

Finally, working with individuals within their home environment is highly effective. This allows therapists to conduct exposure therapy coaching sessions with triggers within the person’s own environment. This can help you to gain a sense of mastery during exposure work with high stress triggers with the help of your therapist. Recreating these situations in an office setting can be impossible. Yet another benefit of Online CBT OCD treatment!

Choosing the Right Online CBT Platform

What is the best CBT platform for OCD counselling? Here are some things you should look for during online therapy sessions for OCD treatment:

• Make sure the platform is secure and compliant with privacy policies in your province; you can ask your therapist for more information!
• Ensure that there is good connectivity and you can hear and see your therapist well
• Take some time to become familiar with the platform so you can easily login and join your sessions on time; if you have any trouble, ask your therapist 
• If you feel comfortable and connected with your therapist, then you can be confident it is the right platform with the right therapist!

Getting Started: The Initial Assessment and Treatment Planning

Online Cognitive-Behavioural Therapy involves an initial assessment and ongoing treatment planning. Online CBT for OCD treatment also incorporates CBT techniques that are unique to OCD counselling. 

In the initial assessment, you will meet with your therapist to complete a clinical interview. Your therapist will gather essential information about your presenting issues, psychological history, relationships, work and education history, and daily functioning. You may also be sent self-report measures to complete to provide more information. This information will be synthesized and presented to you as a treatment plan for OCD therapy.

Core Components of Online CBT for OCD: Behavioural Strategies and Cognitive Techniques

Different techniques will be used by your OCD therapist during online CBT treatment for OCD.

Behavioural strategies are focused on reducing avoidance and rituals through exposure therapy for OCD. This is referred to as Exposure and Response Prevention (ERP) therapy and is a key component of CBT for OCD. The types of skills and strategies you will learn through this intervention include:

• Psychoeducation about OCD and anxiety
• The CBT model of OCD and how your symptoms fit within that model
• Psychoeducation and exposure therapy for OCD and what to expect
• Creation of an OCD exposure therapy hierarchy – this will help you learn how to approach triggering events and situations on a daily basis
• Coached in-session exposure therapy for OCD
• Planning ERP therapy for OCD out of session

Online CBT for OCD treatment is a wonderful way to have your therapist work with you right where your triggers exist. This could be in your own home, in a grocery store, or when you are taking a bus. You can easily take your therapist with you through the unbelievable portability of online therapy sessions

Cognitive strategies are also an essential component of online therapy sessions for OCD treatment. The types of skills and strategies you will use in this type of approach include:

• Tracking intrusive thoughts and resulting compulsions/rituals
• Learning OCD-related appraisals and how these are responsible for amplifying the OCD symptoms
• Reframing OCD-related appraisals to gain perspective on your OCD
• Learning about your core fears and core beliefs connected to your OCD

Another evidence-based intervention for OCD is Inference-Based CBT (I-CBT). This is a cognitive approach to OCD in which the focus is on the idea that obsessions are inferences and “possibilities”. In this type of OCD therapy, we focus on obsessional doubts and explore how we create stories built on our belief in these doubts and we do not use our five senses to trust what is actually happening in the moment. Instead, we can rely on our imagination and possibilities as opposed to recognizing what is occurring in reality. 

If you are an adolescent or adult learning ICBT for OCD treatment, you will learn these types of skills and strategies:

• Discussing the difference between uncertainty, typical doubt, and obsessional doubt
• What is your obsessional sequence and how to recognize it
• Creation of alternate stories and how they can help you during treatment for OCD
• Recognize when you leave reality and enter into the OCD bubble – where you are listening to the story created by your OCD and engaging in rituals as a result
• Understand inferential confusion and the role it plays in keeping your OCD alive
• Difference between “possibility” and “probability”
• Your vulnerable self (who are you afraid you might be?) and your true self  (who are you actually?) and how those relate to OCD and recovery

Overcoming Challenges and Maximizing Success in Online CBT

Fortunately, there are not many challenges to ensuring success when you begin with online CBT for OCD!

Ensuring a best fit OCD therapist is very important to begin with. You should feel comfortable asking questions when you begin therapy so you can ensure that you are proceeding in a manner that feels comfortable. You want to make sure that your OCD therapist is well trained in the provision of treatment for OCD. This would often mean that your therapist has undergone formal OCD therapy training as well as supervision and ongoing consultation.

You should ask questions about their experience with treatment for OCD. Have they seen individuals with similar symptoms that you are experiencing? Do they provide OCD therapy to both adolescents and adults – this might be relevant for you or a family member.  These types of questions will maximise your success as you will feel confident in the services being provided to you. 

Conclusion: Embracing a New Era of Therapy

This blog reviewed a great deal of information to highlight the effectiveness of online CBT for OCD treatment. In summary:

• Online CBT for OCD therapy is highly accessible, flexible and effective
• You can find your best fit OCD therapist by inquiring about your therapist’s skill set, training in treatment for OCD and knowledge regarding evidence-based treatments
• Make sure that the online platform you are using is familiar to you and don’t be afraid to ask any questions that you might have!

Now that you know so much about CBT for OCD treatment, you might be wondering where you can find it! Does FTPS provide online CBT for OCD therapy? We certainly do! We provide online therapy sessions across Canada, specifically in Ontario and BC. We work with youth and adults who are experiencing moderate to very severe symptoms of OCD. 
Contact us and learn more about our team as well as our CBT offerings for OCD therapy. We look forward to hearing from you!