You might spend hours checking, replaying conversations or trying to feel certain, only for another doubt to pull you back in. Even when nobody else can see it, OCD can leave little room for anything else.
I’ve been treating OCD for over 15 years, including severe and persistent OCD and the mental rituals that can be easy to miss.
Alongside regular appointments, I also offer longer sessions and intensives, allowing us to practise together, work through setbacks and adapt treatment as we go.
OCD therapy for adults
Katrina Frost
Clinical Psychologist and OCD Therapist
How I work with OCD
I have a doctorate in clinical psychology, further training in ERP and experience treating severe and persistent OCD. I pay close attention to hidden compulsions, including reviewing memories, checking feelings or mentally “undoing” thoughts.
We’ll start by understanding what keeps your OCD going, drawing on these approaches to guide treatment:
Exposure and Response Prevention (ERP): A first-line treatment for OCD. We face triggers while practising responding without compulsions, including mental rituals. We plan these steps together, so you understand what we’re doing and why.
Motivational Interviewing: You can want relief and still feel frightened of letting go of compulsions. We explore what makes change difficult and your reasons for moving forward.
Acceptance and Commitment Therapy (ACT): Practising how to leave unwanted thoughts unanswered and do more of what matters to you, even when doubt or discomfort shows up.
EMDR: We address the underlying core fears rooted in past experiences and work to reduce the distress associated with current symptoms and make other treatments easier.
I also work with Christians whose OCD centres on faith, sin or salvation. We can work on the checking and rituals while respecting the faith that matters to you.
Treatment can feel daunting. We’ll work through it together, with the aim of building a life that isn’t controlled by OCD.
OCD Treatment Intensives
Sometimes you need more support putting ERP into practice. Intensives give us more time to work together on the situations, doubts and rituals that are difficult to tackle between appointments.
Research shows that structured intensive ERP programmes can substantially reduce OCD symptoms.
Who might it suit?
An intensive may be worth considering if:
OCD is taking over your life. Rituals, mental reviewing or avoidance are interfering with work, relationships or ordinary tasks.
You need more guidance with ERP. You want to make changes, but find it difficult to put treatment into practice between appointments.
Progress has stalled. You’ve been attending therapy but remain caught in the same patterns. We look at what has been tried and whether a different level of support would help.
A concentrated period fits your circumstances. You’d prefer to set aside dedicated time for treatment, perhaps by arranging leave or working around other commitments.
The options
Daily sessions: 30–90 minutes per appointment.
Sessions 3–4 times per week: 30 minutes to 3 hours per appointment.
Two-day intensives: Up to eight hours each day, usually scheduled on Fridays and Saturdays or Fridays and Mondays.
Planned around you
We’ll work out the length, frequency and focus of sessions around what you need and what fits your life. Because each intensive is different, structures and fees vary too. Longer treatment sessions have a lower hourly rate to keep it affordable. I’ll talk you through the proposed plan and costs before you decide to go ahead.
Ways OCD Can Show Up
OCD presents in a near-endless number of ways. Here are some of them
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“What if I’ve spread it through the house?”
Touching something sets off a mental trail of everything you’ve touched since: your phone, your clothes, the kitchen bench. You might wash repeatedly, avoid particular places or feel you need to clean everything. The concern can be germs, chemicals or anything at all.
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“What if I missed something and someone gets hurt?”
You check the stove repeatedly, reread an email long after sending it, or retrace a drive to make sure you didn’t cause an accident. You’ve already checked, but the doubt comes back. Leaving it alone can feel like taking a risk you’d never forgive yourself for.
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“I can’t move on until it feels right.”
You keep adjusting an object, rewriting a sentence or repeating a movement. You may not be able to explain what’s wrong, just that it feels unfinished or uncomfortable.
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“What if I hurt someone?”
An unwanted thought or image leaves you frightened about what you might be capable of. You might avoid knives or being alone with someone you love. Hours can go into examining your thoughts, reviewing your behaviour or seeking reassurance that you wouldn’t act on them.
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“Why did I think that? What does it mean about me?”
An unwanted sexual thought leaves you distressed and searching for an explanation. You might repeatedly check your reactions, revisit memories or test whether you felt attraction. Certain people or situations can become things you avoid because you’re afraid of the thoughts they might bring up.
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“Did I do something wrong? Can I be sure I’m forgiven or saved?”
You might replay a conversation to work out whether you were completely honest, or restart a prayer because an unwanted thought interrupted it. Confessing, apologising or asking for reassurance brings some relief, until another doubt leaves you feeling you need to do it again.
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“What if I don’t really believe? What if I’ve got it wrong?”
Questions about God, the Bible or Christian teaching begin to feel urgent and impossible to leave unanswered. You might spend hours reading arguments, comparing interpretations or checking how convinced you feel. You keep searching for an answer that will settle the doubt completely, but each answer seems to open up another question.
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“Do I love them enough? How can I know for sure?”
You keep checking your feelings, comparing your relationship with other people’s or asking for reassurance that you’re with the right person. You might ask,“Did I feel enough? Was that how I was supposed to feel?” The questions become difficult to leave alone.
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“What does something I did years ago say about me now?”
You keep revisiting something you actually said or did, trying to work out how bad it was, whether you caused harm and what it means about you. You might repeatedly confess, ask others to judge what happened or mentally put yourself on trial. Each answer seems to leave another detail to investigate.
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“What if I did something terrible and don’t remember?”
A gap in your memory or an image that pops into your mind becomes something you feel you must investigate. You might reconstruct an evening minute by minute, check messages or repeatedly question other people. You’re trying to establish exactly what happened, but each round of checking leaves room for another “what if?”
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How can I be completely sure who I’m attracted to?”
You repeatedly check your reactions to people, revisit past relationships or test what different thoughts and images make you feel. A passing feeling becomes something you need to analyse. This can happen to people of any sexual orientation. Questioning your sexuality isn’t itself OCD; the difficulty is becoming caught in distressing doubt and repeated attempts to settle it.
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“What if I’m attracted to children?”
Unwanted thoughts involving children leave you frightened about what they might mean. You might monitor your physical reactions, repeatedly review past interactions or avoid children altogether. Ordinary family moments can become situations you dread because you’re watching yourself so closely. Shame and fear of being misunderstood can make this particularly difficult to talk about.
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“What if something happens to my baby and it’s my fault?”
During pregnancy or after a baby arrives, fears about harm, contamination or making a mistake can become consuming. You might repeatedly check your baby’s breathing, spend hours researching risks or avoid caring tasks because of frightening, unwanted thoughts. Checking and trying to prevent every possible danger can leave little opportunity to rest or enjoy time together.
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“I can’t finish until I’m certain it’s right.”
You rewrite an email, restart a task or check your work repeatedly because a possible mistake feels impossible to leave. Something that should take minutes can consume hours. You might delay starting altogether because you know how difficult it will be to stop correcting, reviewing or trying to reach a feeling of certainty.
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“I don’t do obvious rituals. I just can’t stop going over things.”
Compulsions can happen silently: reviewing memories, checking your intentions, arguing with a thought or reassuring yourself repeatedly. This is sometimes called “Pure O”, although that name can be misleading because mental compulsions are still part of the cycle. Other people may see very little of the effort it takes to get through your day.
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“What if something has been missed?”
You repeatedly check your body, search symptoms online or go over what you told the doctor. Reassurance may help briefly, before another question appears: “Did I explain it properly? What if the test missed something?” Trying to rule out every possibility can take up more and more of your day.