Specialized, neuroaffirming OCD therapy using ERP, I-CBT, and ACT

If you have spent hours replaying conversations, analyzing your intentions, questioning your memories, researching for reassurance, reviewing whether you did something wrong, or trying to reach absolute certainty about something that matters deeply to you, you may already know that OCD is about much more than handwashing or keeping things organized.

At Zen Psychological Center, we provide specialized OCD treatment in Maryland for adults using evidence-based approaches including Exposure and Response Prevention (ERP), Inference-Based Cognitive Behavioral Therapy (I-CBT), and Acceptance and Commitment Therapy (ACT).

Our OCD therapists provide online therapy for adults throughout Maryland, making specialized OCD treatment available through telehealth.

Our approach is collaborative, individualized, and neuroaffirming. We recognize that OCD treatment should not require you to ignore legitimate sensory, disability, or neurodivergent needs in the name of challenging anxiety. At Zen, we help you understand your unique flavor of OCD, why it feels so relevant to you, and pull yourself out of the obsessive thought cycle of OCD. While traditional OCD treatment often focuses on compulsions, we combine this with a cognitive approach, helping you recognize the obsessive thought patterns before they even turn into compulsions.

🔗 You can find more information about OCD here

Did you know that it can take approximately 14 to 17 years from the onset of OCD symptoms for someone to receive an appropriate diagnosis and effective treatment?

The International OCD Foundation identifies several reasons for this delay, including stigma, people hiding symptoms, limited public understanding of OCD, misdiagnosis, and difficulty finding clinicians with specialized OCD training.

One reason OCD can be so difficult to recognize is that it does not always look like the version of OCD portrayed in movies or on television.

OCD is not simply being neat, organized, particular, or concerned about germs.

For many people, OCD is largely invisible.

🔗 You can find more information about OCD here

OCD involves obsessions and compulsions.

Obsessions can include intrusive and unwanted thoughts, images, impulses, sensations, or doubts that create significant distress and interfere with your day to day functioning. These experiences frequently center around things that are deeply important to the person, which is precisely why they can feel so frightening and convincing.

A person may begin asking:

What if that thought means something about me?
What if I hurt someone?
What if I made the wrong decision?
What if I don’t really love my partner?
What if I secretly wanted that to happen?
What if I’m a bad person?
What if I remembered something incorrectly?
What if I can never be completely certain?

The person then attempts to resolve the doubt or reduce the distress through a compulsion.

And compulsions are not always visible.

Some compulsions are easy to recognize, such as checking a lock repeatedly, washing one’s hands, asking someone for reassurance, or repeating an action until it feels “right.”

Others happen almost entirely internally.

You might:

• replay conversations repeatedly
• review memories
• analyze whether you said something wrong
• reconstruct past events
• imagine hypothetical situations
• create imaginary conversations and analyze how you would respond
• repeatedly examine your intentions
• mentally check how you feel
• compare current feelings with past feelings
• research something repeatedly
• attempt to prove or disprove a fear
• repeatedly ask yourself what a thought “means”
• seek certainty about your character, identity, relationships, health, or morality

This is one reason people with primarily mental compulsions can go years without recognizing that they have OCD.

You do not have to wash your hands 50 times a day to have OCD.

Intrusive thoughts associated with OCD can feel particularly disturbing because they frequently involve topics that conflict with a person’s values, identity, relationships, or sense of who they are.

Having an intrusive thought does not mean that you want the thought to happen or that the thought represents a hidden desire.

The distress often comes from the doubt that follows:

“But what if it does mean something?”

That doubt can lead to analyzing, checking, reassurance seeking, avoidance, researching, confessing, reviewing, or other attempts to obtain certainty.

OCD treatment helps you understand and interrupt this cycle.

OCD can occur alongside Autism and ADHD, and research supports meaningful overlap between OCD and Autism.

At Zen Psychological Center, we conceptualize OCD within a broader neuroaffirming framework and recognize that some individuals seeking OCD treatment also have Autism, ADHD, sensory processing differences, executive functioning difficulties, or other neurodivergent experiences.

This matters when developing treatment.

A behavior that looks like avoidance may sometimes reflect a legitimate sensory need. A preference for predictability is not automatically an OCD compulsion. Repetitive behaviors can serve different functions. Executive functioning difficulties may affect someone’s ability to complete therapy exercises. Autistic routines and focused interests should not automatically be pathologized as OCD.

Effective treatment requires understanding why a behavior is happening, not simply trying to eliminate anything that appears repetitive or unusual.

At Zen Psychological Center, we approach OCD treatment within a broader Neuroaffirming framework. We recognize that some people with OCD are also autistic, have ADHD, experience sensory processing differences or executive functioning difficulties, or have other neurodivergent experiences. These experiences can interact with OCD in complex ways, and we do not assume that every routine, sensory need, need for predictability, or repetitive behavior is an OCD symptom that needs to be changed.

All of our clinicians who treat OCD bring professional experience working with obsessive-compulsive disorder, and most also bring lived experience with OCD. This combination of clinical expertise and firsthand understanding informs a thoughtful, collaborative approach to treatment that respects both the complexity of OCD and the individual experiencing it.

We also recognize that there is no single therapeutic approach that will be the right fit for every person. Treatment is individualized based on your symptoms, experiences, needs, preferences, and treatment goals.

Our clinicians use specialized approaches to OCD treatment, including Exposure and Response Prevention (ERP), Inference-Based Cognitive Behavioral Therapy (I-CBT), and Acceptance and Commitment Therapy (ACT). We work collaboratively to distinguish OCD-driven fears and compulsions from neurodivergent traits and needs, with the goal of reducing the distress and interference caused by OCD without treating neurodivergence itself as something that needs to be eliminated.

Meet Our OCD Therapists

OCD treatment at Zen Psychological Center is provided by clinicians with specialized experience in obsessive-compulsive disorder. Our team includes therapists trained in Inference-Based Cognitive Behavioral Therapy (I-CBT), Exposure and Response Prevention (ERP), and Acceptance and Commitment Therapy (ACT), with treatment tailored to each person’s needs, preferences, and goals.

Brittany Goff, MSW, LCSW-C, Director of Clinical Services, specializes in OCD, autism, ADHD, and Neuroaffirming care. Her OCD treatment incorporates I-CBT and ERP, and she brings both extensive professional experience and lived experience to her work.

Bruce Kirby, LCSW-C, is a Licensed Clinical Social Worker and Board Certified Supervisor specializing in OCD and anxiety. He provides I-CBT and ERP and works with adults, adolescents, and families.

Leilani Nguyen, LCSW-C, is a Licensed Clinical Social Worker and Board Certified Supervisor whose areas of expertise include OCD, ADHD, anxiety, trauma, and chronic conditions. Her approaches include I-CBT, ERP, ACT, somatic therapy, and Neuroaffirming care.

Jasmin Cooke, LCSW-C, specializes in OCD as well as anxiety, autism, ADHD, trauma, and depression. Her approach to OCD treatment incorporates I-CBT, ERP, and ACT.

Victoria Holland, LMSW, works with adults experiencing OCD, ADHD, autism, anxiety, and identity-related concerns. Her clinical work incorporates I-CBT and ERP within a collaborative, individualized approach.

Breauna Carter, LCSW-C, works with adults experiencing OCD, anxiety, stress, and related concerns. Her treatment approaches include I-CBT and ERP alongside other individualized therapeutic approaches.

Our OCD therapists provide telehealth services to clients in Maryland, making specialized OCD treatment accessible online. To learn more about our clinicians, their backgrounds, and their areas of expertise, visit our Meet Our Clinical Team page.

Meet Our Clinical Team →

Request an Appointment →

Many people with OCD spend years hiding their thoughts because they are afraid of what another person might think if they said them aloud.

Specialized OCD therapists understand that intrusive thoughts can involve subjects that feel frightening, shameful, taboo, violent, sexual, religious, moral, or deeply inconsistent with someone’s identity.

Having an intrusive thought is not the same as wanting, endorsing, or intending it.

You deserve a space where you can discuss your experiences with a clinician who understands OCD and knows how to assess intrusive thoughts within the appropriate clinical context.

OCD does not come in just one form. While the underlying cycle of obsessions, doubt, anxiety, and compulsions is similar, the content or theme of OCD can vary widely from person to person. Some people experience one primary theme, while others experience several themes that shift over time.

Common OCD themes can include Harm OCD, Responsibility OCD, Relationship OCD, Scrupulosity or Moral OCD, False Memory OCD, Contamination OCD, Health OCD, Sexual or Taboo-Themed OCD, Pedophilia-Themed OCD, Sexual Orientation OCD, Gender Identity OCD, Religious OCD, Existential OCD, Real Event OCD, Meta OCD, Sensorimotor or Somatic OCD, Sensory OCD, Just-Right OCD, Symmetry OCD, Perfectionism OCD, Checking OCD, Reassurance-Seeking OCD, Magical Thinking OCD, Memory OCD, Emotional Contamination OCD, OCD focused on mistakes, uncertainty, or making the wrong decision.

OCD can attach itself to almost anything that feels important, threatening, uncertain, morally significant, or personally meaningful. The theme may change, but the underlying OCD process often remains the same.

If you would like to learn more about the many ways OCD can present, including common obsessions, compulsions, and mental rituals associated with each theme, visit our OCD Subtypes & Themes Resource Page.

Zen Psychological Center offers a completely self-guided OCD course designed to help you better understand OCD, learn treatment concepts, see visual examples, and track your progress as you work through the material at your own pace.

Our therapists also integrate this course into OCD treatment at Zen, allowing our clients to reinforce concepts between sessions, work through visual examples, and monitor their progress throughout treatment. Clients receiving services at Zen Psychological Center receive complimentary access to the course and the Zen Psychological Center app as part of their care.

Not a Zen Psychological Center client? You can still access the course. Our self-guided OCD course is available for individual purchase, allowing you to work through the educational material independently and on your own schedule.