Obsessive-Compulsive (OCD) Counselling in Southwark, London

Photo of Tehani Benjamin, Psychologist, HCPC - Clin. Psych.
Tehani Benjamin
Psychologist, HCPC - Clin. Psych.
Online Only
I have lived experiences and specialist training in OCD.
At the heart of my work, I strive to create a warm and compassionate space for clients from all walks of life. I work with clients presenting with various challenges including relationship difficulties, self-esteem issues, anxiety and low mood. I also have experience working with complex mental health and co-morbid difficulties, including trauma and childhood abuse. Whether your issue feels vague or specific, therapy can help you understand how the past informs current patterns, develop coping skills to process difficult feelings, and nurture the internal strengths and resources that we all hold.
I have lived experiences and specialist training in OCD.
At the heart of my work, I strive to create a warm and compassionate space for clients from all walks of life. I work with clients presenting with various challenges including relationship difficulties, self-esteem issues, anxiety and low mood. I also have experience working with complex mental health and co-morbid difficulties, including trauma and childhood abuse. Whether your issue feels vague or specific, therapy can help you understand how the past informs current patterns, develop coping skills to process difficult feelings, and nurture the internal strengths and resources that we all hold.
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Photo of Jonny Say, Counsellor, MBACP Accred
Jonny Say
Counsellor, MBACP Accred
Online Only
I am co-director for the Integrative Centre for OCD Therapy www
I use ACT and CFT to work with a broad range of difficulties. I am a specialist therapist on ACT/ERP for OCD. I also have specialist training in Trauma, Anxiety, Depression, Bereavement, stress based work issues, High Achievers, Addiction and Relationship challenges.
I am co-director for the Integrative Centre for OCD Therapy www
I use ACT and CFT to work with a broad range of difficulties. I am a specialist therapist on ACT/ERP for OCD. I also have specialist training in Trauma, Anxiety, Depression, Bereavement, stress based work issues, High Achievers, Addiction and Relationship challenges.
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Photo of Alexander Hegazy, Psychotherapist, MSc, MBABCP
Alexander Hegazy
Psychotherapist, MSc, MBABCP
Online Only
Some of your concerns may include OCD, panic, rumination, and related symptoms e
I am a Cognitive Behavioural Psychotherapist with a background in Psychology. I am specialised in working with the distress caused by anxiety and depression particularly OCD. I also offer a Schema Therapy informed CBT approach. I have 15 years experience of working in NHS and privately within London and the South East.
Some of your concerns may include OCD, panic, rumination, and related symptoms e
I am a Cognitive Behavioural Psychotherapist with a background in Psychology. I am specialised in working with the distress caused by anxiety and depression particularly OCD. I also offer a Schema Therapy informed CBT approach. I have 15 years experience of working in NHS and privately within London and the South East.
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Photo of Dr Jessica C Bird, Psychologist, PhD, HCPC - Clin. Psych.
Dr Jessica C Bird
Psychologist, PhD, HCPC - Clin. Psych.
Serves Area
My areas of expertise include the psychological treatment of OCD, paranoia, psychosis, PTSD, anxiety/phobias, and sleep problems.
I offer specialist psychological assessment and therapy. The therapy I offer is based on cognitive behavioural therapy (CBT) and EMDR, whilst always being tailored to the individual client and based on a personalised formulation of their needs. I offer sessions online or in person in London near Monument station and in East Dulwich.
My areas of expertise include the psychological treatment of OCD, paranoia, psychosis, PTSD, anxiety/phobias, and sleep problems.
I offer specialist psychological assessment and therapy. The therapy I offer is based on cognitive behavioural therapy (CBT) and EMDR, whilst always being tailored to the individual client and based on a personalised formulation of their needs. I offer sessions online or in person in London near Monument station and in East Dulwich.
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Photo of Craig Bell, Psychotherapist, MA, MBACP
Craig Bell
Psychotherapist, MA, MBACP
Serves Area
I often work with issues such as anxiety, depression, relationship issues, shame, intrusive thoughts, OCD, attachment and identity issues, addiction and more.
I’m a down-to-earth, open-minded and warm person. Originally from Scotland, I lived in multiple countries before settling in London. My personal journey with psychodynamic therapy has been transformative in many ways—it’s why I became a psychotherapist.
I often work with issues such as anxiety, depression, relationship issues, shame, intrusive thoughts, OCD, attachment and identity issues, addiction and more.
I’m a down-to-earth, open-minded and warm person. Originally from Scotland, I lived in multiple countries before settling in London. My personal journey with psychodynamic therapy has been transformative in many ways—it’s why I became a psychotherapist.
07446 646933 View 07446 646933
Photo of Kathryn Budd, Psychotherapist, MBABCP
Kathryn Budd
Psychotherapist, MBABCP
Online Only
With more than a decade of experience in the NHS, I have spent the last five years working in an NHS talking therapies service and most recently in a specialist NHS anxiety service with a particular focus on obsessive-compulsive disorder ( OCD).
My background also includes working with individuals facing eating disorders and disordered eating, allowing me to bring a comprehensive understanding of various mental health challenges.
With more than a decade of experience in the NHS, I have spent the last five years working in an NHS talking therapies service and most recently in a specialist NHS anxiety service with a particular focus on obsessive-compulsive disorder ( OCD).
My background also includes working with individuals facing eating disorders and disordered eating, allowing me to bring a comprehensive understanding of various mental health challenges.
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Photo of Ann Twomey - CBT Online, Psychotherapist, MSc, MBABCP
CBT Online
Psychotherapist, MSc, MBABCP
Online Only
What ever the issue, panic disorder, chronic worry, OCD, eating disorder, low mood....
Hello and welcome, as a BABCP accredited CBT therapist, I work with my clients to offer a supportive and confidential online space. Online therapy is exactly the same as in-person therapy, but you do it from the convenience of your own space. My approach is tailored to your needs. I used tried and trusted evidenced based therapies to help you meet your needs.
What ever the issue, panic disorder, chronic worry, OCD, eating disorder, low mood....
Hello and welcome, as a BABCP accredited CBT therapist, I work with my clients to offer a supportive and confidential online space. Online therapy is exactly the same as in-person therapy, but you do it from the convenience of your own space. My approach is tailored to your needs. I used tried and trusted evidenced based therapies to help you meet your needs.
028 9694 3930 View 028 9694 3930
Photo of Dr Ritu Sethi, Psychologist, PsychD, HCPC - Couns. Psych.
Dr Ritu Sethi
Psychologist, PsychD, HCPC - Couns. Psych.
Southwark, London SE1
My professional experiences have also rendered me highly skilled to support individuals to address a range of difficulties including, but not limited to, anxiety, depression, interpersonal difficulties, low self-esteem, OCD, trauma and bipolar disorder
I am a Chartered Counselling Psychologist, registered with the Health and Care Professions Council (HCPC) and British Psychological Society (BPS). Whatever the challenges you may be experiencing, I strive to foster a safe, respectful, and non-judgemental space, where you feel able to talk freely about your experiences. I endeavour to support you to work towards personal growth, develop resilience and feel empowered to break free from recurring patterns, to create lasting meaningful change. I have a deep passion and commitment to enable people to feel heard, gain a better understanding of the self and navigate life’s challenges.
My professional experiences have also rendered me highly skilled to support individuals to address a range of difficulties including, but not limited to, anxiety, depression, interpersonal difficulties, low self-esteem, OCD, trauma and bipolar disorder
I am a Chartered Counselling Psychologist, registered with the Health and Care Professions Council (HCPC) and British Psychological Society (BPS). Whatever the challenges you may be experiencing, I strive to foster a safe, respectful, and non-judgemental space, where you feel able to talk freely about your experiences. I endeavour to support you to work towards personal growth, develop resilience and feel empowered to break free from recurring patterns, to create lasting meaningful change. I have a deep passion and commitment to enable people to feel heard, gain a better understanding of the self and navigate life’s challenges.
020 4572 4049 View 020 4572 4049
Photo of Katie Fowler, Psychotherapist, MBABCP
Katie Fowler
Psychotherapist, MBABCP
Southwark, London SE1
I have extensive experience in working with Trauma, OCD and Low Self-Esteem.
I have a warm, friendly and compassionate approach to therapy. We will work together to think about how to make positive changes in your life. I offer both CBT and IPT. CBT provides a structured approach that will help you manage your mental health differently. IPT can help with processing changes in relationships, arguments and bereavement.
I have extensive experience in working with Trauma, OCD and Low Self-Esteem.
I have a warm, friendly and compassionate approach to therapy. We will work together to think about how to make positive changes in your life. I offer both CBT and IPT. CBT provides a structured approach that will help you manage your mental health differently. IPT can help with processing changes in relationships, arguments and bereavement.
020 4572 3985 View 020 4572 3985
Photo of Dr George Samoilis, Psychologist, PsychD, HCPC - Couns. Psych.
Dr George Samoilis
Psychologist, PsychD, HCPC - Couns. Psych.
Southwark, London SE1
I have extensive experience working across a range of presentations, including depression, anxiety, OCD, gender identity, attachment issues, neurodiversity, trauma and relationship difficulties.
As a compassionate and collaborative psychologist, I create a safe space where you feel comfortable exploring your presenting issues.My approach is flexible ,focusing on collaboration with you to make sense of your concerns drawing from therapeutic modalities such as Humanistic, CBT, Psychodynamic ,Mentalization & Attachment. I am based at London Bridge.
I have extensive experience working across a range of presentations, including depression, anxiety, OCD, gender identity, attachment issues, neurodiversity, trauma and relationship difficulties.
As a compassionate and collaborative psychologist, I create a safe space where you feel comfortable exploring your presenting issues.My approach is flexible ,focusing on collaboration with you to make sense of your concerns drawing from therapeutic modalities such as Humanistic, CBT, Psychodynamic ,Mentalization & Attachment. I am based at London Bridge.
020 3835 4439 View 020 3835 4439
Photo of Jonathan Balbes, Psychotherapist, UKCP Trainee
Jonathan Balbes
Psychotherapist, UKCP Trainee
Southwark, London SE1
I have broad experience in treating many difficulties that include but are not limited to depression, anxiety, psychosis, obsessive behaviours, work-related stress and performance anxiety.
I am an experienced clinician with over a decade of practice across diverse settings, including psychiatric care at Priory Hospital, outpatient psychotherapy, child and adolescent mental health services, specialised psychosis outreach, and addiction treatment. Over the course of my career I have taken up different roles, from practitioner to clinical lead/supervisor, and treated a range of symptoms. These include chronic depression, anxiety, complex trauma, panic attacks, obsession, burnout, gender dysphoria, phobias, loss, and sexual difficulties.
I have broad experience in treating many difficulties that include but are not limited to depression, anxiety, psychosis, obsessive behaviours, work-related stress and performance anxiety.
I am an experienced clinician with over a decade of practice across diverse settings, including psychiatric care at Priory Hospital, outpatient psychotherapy, child and adolescent mental health services, specialised psychosis outreach, and addiction treatment. Over the course of my career I have taken up different roles, from practitioner to clinical lead/supervisor, and treated a range of symptoms. These include chronic depression, anxiety, complex trauma, panic attacks, obsession, burnout, gender dysphoria, phobias, loss, and sexual difficulties.
020 4572 3601 View 020 4572 3601
Photo of Melissa Thompson, Counsellor, DCounsPsych, MBACP
Melissa Thompson
Counsellor, DCounsPsych, MBACP
Southwark, London SE1
I specialise in the following areas anxiety/generalised anxiety disorder, depression, stress, bereavement, trauma, low self esteem, abuse, bipolar, obsessive compulsive disorder and relationship problems.
Reaching out for help can be hard but it is an important step in the right direction towards living your life fully. Sometimes trying to navigate through life alone can be confusing and speaking to friends or family can often be too difficult, this is why talking to a neutral professional counsellor can provide you with the support you need. I offer a safe, confidential and non-judgemental space where you can explore the areas of your life that you are struggling with. By exploring your thoughts, feelings and behaviours of the past and present I can help you gain better self-awareness and overcome the obstacles weighing you down.
I specialise in the following areas anxiety/generalised anxiety disorder, depression, stress, bereavement, trauma, low self esteem, abuse, bipolar, obsessive compulsive disorder and relationship problems.
Reaching out for help can be hard but it is an important step in the right direction towards living your life fully. Sometimes trying to navigate through life alone can be confusing and speaking to friends or family can often be too difficult, this is why talking to a neutral professional counsellor can provide you with the support you need. I offer a safe, confidential and non-judgemental space where you can explore the areas of your life that you are struggling with. By exploring your thoughts, feelings and behaviours of the past and present I can help you gain better self-awareness and overcome the obstacles weighing you down.
020 8138 0228 View 020 8138 0228
Photo of Apostolos Polymerou, Psychotherapist, MSc, MBABCP
Apostolos Polymerou
Psychotherapist, MSc, MBABCP
1 Endorsed
Southwark, London SE1
I offer evidence-based treatment for a range of mental health problems such as Depression, PTSD, OCD, GAD, Social Anxiety and non-underweight Eating Disorders.
Changing as a person, adjusting or becoming more accepting of problems can be a daunting process. So, in therapy we will develop a shared understanding of your needs, emotions and what contributes to your problems. I will motivate you to take steps in the direction that matters to you by applying CBT strategies. EMDR can also unstuck you from traumas.
I offer evidence-based treatment for a range of mental health problems such as Depression, PTSD, OCD, GAD, Social Anxiety and non-underweight Eating Disorders.
Changing as a person, adjusting or becoming more accepting of problems can be a daunting process. So, in therapy we will develop a shared understanding of your needs, emotions and what contributes to your problems. I will motivate you to take steps in the direction that matters to you by applying CBT strategies. EMDR can also unstuck you from traumas.
020 3988 4304 View 020 3988 4304
Photo of Shane Mackay, Psychotherapist, MA, MBACP
Shane Mackay
Psychotherapist, MA, MBACP
Southwark, London SE1
I have worked with a diverse variety of people that have experienced C-PTSD, depression, grief, anxiety, bipolar disorder, various personality disorders, identity-related issues (race, gender and sexuality), obsessive & intrusive states, hearing voices, paranoia, suicidality and many other attachment-based wounding and relational issues
After qualifying thirteen years ago I worked for City & Hackney Mind (Mental Health Charity) for seven years as the Clinical Services Manager of the Psychological Therapies Team as well as the Clinical Supervisor for a large team of trainee/qualified counsellors/psychotherapists. My approach mainly draws on Psychoanalysis, Somatic & Neurobiological approaches along with Philosophy & Critical Theory. My approach is GSRD (Gender, Sexuality, Relationship Diversity) affirmative meaning i have a passion for and extensive experience supporting Queer & LGBTQI+ as well as other non-heteronormative ways of living/being.
I have worked with a diverse variety of people that have experienced C-PTSD, depression, grief, anxiety, bipolar disorder, various personality disorders, identity-related issues (race, gender and sexuality), obsessive & intrusive states, hearing voices, paranoia, suicidality and many other attachment-based wounding and relational issues
After qualifying thirteen years ago I worked for City & Hackney Mind (Mental Health Charity) for seven years as the Clinical Services Manager of the Psychological Therapies Team as well as the Clinical Supervisor for a large team of trainee/qualified counsellors/psychotherapists. My approach mainly draws on Psychoanalysis, Somatic & Neurobiological approaches along with Philosophy & Critical Theory. My approach is GSRD (Gender, Sexuality, Relationship Diversity) affirmative meaning i have a passion for and extensive experience supporting Queer & LGBTQI+ as well as other non-heteronormative ways of living/being.
020 3870 4138 View 020 3870 4138
Photo of Nakita Jangra, Counsellor, MBACP
Nakita Jangra
Counsellor, MBACP
Southwark, London SE1
Clients come to see me for a wide range of reasons, including: • Anxiety • Depression • ADHD • Relationship difficulties (family, romantic, work-related) • OCD • Trauma (including childhood, sexual abuse, or domestic abuse) • Sexuality and spirituality • Loss of meaning or direction • PTSD and Complex PTSD • Attachment issues
Experienced Counsellor for Individuals and Couples Over 10 Years Supporting Clients Through Life’s Challenges Whatever may be troubling you, I’m here to help. With over a decade of experience working with both individuals and couples, I offer a supportive, confidential space where you can explore whatever difficulty you’re facing.
Clients come to see me for a wide range of reasons, including: • Anxiety • Depression • ADHD • Relationship difficulties (family, romantic, work-related) • OCD • Trauma (including childhood, sexual abuse, or domestic abuse) • Sexuality and spirituality • Loss of meaning or direction • PTSD and Complex PTSD • Attachment issues
Experienced Counsellor for Individuals and Couples Over 10 Years Supporting Clients Through Life’s Challenges Whatever may be troubling you, I’m here to help. With over a decade of experience working with both individuals and couples, I offer a supportive, confidential space where you can explore whatever difficulty you’re facing.
020 3871 8591 View 020 3871 8591
Photo of Stella Jean Compton Dickinson, Psychotherapist, PhD, MBACP
Stella Jean Compton Dickinson
Psychotherapist, PhD, MBACP
Southwark, London SE1
I can help you to understand better your relational patterns and habits, from which to develop effective ways of managing work-related stress, relational challenges, depression, grief, generalised anxiety and OCD.
Cognitive Analytic Therapy (CAT) is GP recommended for relationship challenges. I have effectively treated people of all ages suffering with anxiety, depression, bereavement, eating disorders, self-harm and relationship problems. I specialise in mentoring young people towards achieving their goals. I work with performing artists, professionals in sport, law, science, finance, healthcare and high-stress media occupations. I am an ACAT accredited, UKCP, BACP psychotherapist registered with the professional standards authority, providing CAT, CBT integrative and longer-term counselling from two lovely clinic venues and online.
I can help you to understand better your relational patterns and habits, from which to develop effective ways of managing work-related stress, relational challenges, depression, grief, generalised anxiety and OCD.
Cognitive Analytic Therapy (CAT) is GP recommended for relationship challenges. I have effectively treated people of all ages suffering with anxiety, depression, bereavement, eating disorders, self-harm and relationship problems. I specialise in mentoring young people towards achieving their goals. I work with performing artists, professionals in sport, law, science, finance, healthcare and high-stress media occupations. I am an ACAT accredited, UKCP, BACP psychotherapist registered with the professional standards authority, providing CAT, CBT integrative and longer-term counselling from two lovely clinic venues and online.
020 3962 1809 View 020 3962 1809
Photo of Leah Fung, Psychotherapist, MSc, MBABCP
Leah Fung
Psychotherapist, MSc, MBABCP
2 Endorsed
Southwark, London SE1
I work with adults and specialise in post-traumatic stress disorder (PTSD) and trauma related anxiety and depression such as social anxiety, panic disorder, obsessive compulsive disorder, body dysmorphic disorder, health anxiety, emetophobia (vomit phobia), specific phobias, agoraphobia, generalised anxiety disorder.
I integrate principles of acceptance and commitment therapy, compassion focused therapy and polyvagal theory with CBT and EMDR. I am passionate about the integrative approach with the body and mind. If bringing yoga practices such as breath work, movement or philosophy is helpful and invited, this can bring a further holistic approach to your therapy.
I work with adults and specialise in post-traumatic stress disorder (PTSD) and trauma related anxiety and depression such as social anxiety, panic disorder, obsessive compulsive disorder, body dysmorphic disorder, health anxiety, emetophobia (vomit phobia), specific phobias, agoraphobia, generalised anxiety disorder.
I integrate principles of acceptance and commitment therapy, compassion focused therapy and polyvagal theory with CBT and EMDR. I am passionate about the integrative approach with the body and mind. If bringing yoga practices such as breath work, movement or philosophy is helpful and invited, this can bring a further holistic approach to your therapy.
01483 694470 View 01483 694470
Photo of Dr Erika Annabelle Pratte, Psychologist, PhD, HCPC - Couns. Psych.
Dr Erika Annabelle Pratte
Psychologist, PhD, HCPC - Couns. Psych.
Southwark, London SE1
I work with people of all ages with many concerns, ranging from existential, relationship, confidence, all the way to psychological conditions such as OCD & different types of depression.
Clients who come to me can expect a psychologist who is empathic, open-minded, extensively and comprehensively trained, research based but not overly so, and motivated to be a therapeutic influence in their lives. I focus on neuroaffirmative ADHD and autism assessments, and additionally provide psychotherapy and diagnosis for mental health disorders.
I work with people of all ages with many concerns, ranging from existential, relationship, confidence, all the way to psychological conditions such as OCD & different types of depression.
Clients who come to me can expect a psychologist who is empathic, open-minded, extensively and comprehensively trained, research based but not overly so, and motivated to be a therapeutic influence in their lives. I focus on neuroaffirmative ADHD and autism assessments, and additionally provide psychotherapy and diagnosis for mental health disorders.
020 4538 3005 View 020 4538 3005
Photo of Dr Thomas Italiano, Psychotherapist, PsychD, MBABCP
Dr Thomas Italiano
Psychotherapist, PsychD, MBABCP
1 Endorsed
Serves Area
Challenges may manifest as anxiety, OCD, depression, trauma, or simply a sense of exhaustion, burnout, or feeling lost.
With over 20 years of experience in mental health, I draw on a range of therapeutic modalities to meet your unique needs, whether as an individual or a couple. I integrate evidence-based therapies such as CBT, ACT, and CFT, alongside body-focused methods like EMDR and Brainspotting to address trauma and stress on a deeper, physiological level.
Challenges may manifest as anxiety, OCD, depression, trauma, or simply a sense of exhaustion, burnout, or feeling lost.
With over 20 years of experience in mental health, I draw on a range of therapeutic modalities to meet your unique needs, whether as an individual or a couple. I integrate evidence-based therapies such as CBT, ACT, and CFT, alongside body-focused methods like EMDR and Brainspotting to address trauma and stress on a deeper, physiological level.
020 3984 8085 View 020 3984 8085
Photo of Francesca Smith, Psychotherapist, MBABCP
Francesca Smith
Psychotherapist, MBABCP
4 Endorsed
Serves Area
I provide 1:1 sessions to adults over 18 years of age, experiencing emotional and psychological difficulties, such as anxiety (including health anxiety, social anxiety and OCD), depression, Post-Traumatic Stress Disorder (PTSD), Complex PTSD, low self-esteem and work-related stress.
I am a highly empathic, friendly and professional therapist with over 14 years experience. I offer an accepting & safe space to help clients overcome the barriers that stop them living life the way they want to. I utilise traditional CBT, EMDR & other approaches, such as Acceptance and Commitment Therapy (ACT), compassion focused therapy, attachment-informed EMDR and Parts work, to offer a flexible and individualised treatment process. I love what I do and have always wanted to be a therapist, I often fell into this role in my personal life and have dedicated my life to supporting others to live the life they want.
I provide 1:1 sessions to adults over 18 years of age, experiencing emotional and psychological difficulties, such as anxiety (including health anxiety, social anxiety and OCD), depression, Post-Traumatic Stress Disorder (PTSD), Complex PTSD, low self-esteem and work-related stress.
I am a highly empathic, friendly and professional therapist with over 14 years experience. I offer an accepting & safe space to help clients overcome the barriers that stop them living life the way they want to. I utilise traditional CBT, EMDR & other approaches, such as Acceptance and Commitment Therapy (ACT), compassion focused therapy, attachment-informed EMDR and Parts work, to offer a flexible and individualised treatment process. I love what I do and have always wanted to be a therapist, I often fell into this role in my personal life and have dedicated my life to supporting others to live the life they want.
01603 578931 View 01603 578931
Obsessive-Compulsive (OCD) Counsellors

How long does OCD treatment take?

Obsessive-Compulsive Disorder (OCD) is often treated on a weekly or twice-weekly schedule, depending on symptom severity and the client’s preferences. Some clients may start to see a noticeable improvement in symptoms in as little as six weeks, but it’s also possible, especially in more severe cases, for treatment to take several months to a year before significant progress is made.

What happens if OCD is not treated?

Some people with OCD, especially those with mild symptoms, may find that they are able to adapt reasonably well to life with the condition, even if their symptoms never resolve completely. However, many people, particularly those whose symptoms are severe at the outset, find that their obsessions and compulsions grow more intrusive with time, making it harder to maintain relationships, hold down a job, or navigate the world successfully.

Are there medications for OCD?

Medication can be used to treat OCD. The class of drugs most often prescribed are selective serotonin reuptake inhibitors, or SSRIs, which include fluvoxamine, fluoxetine, and sertraline, among others. In cases of treatment-resistant OCD, other classes of medication, such as tricyclic antidepressants or atypical antipsychotics, may be prescribed. Medication is frequently used in conjunction with therapy.

Can OCD come back after treatment?

Yes. Major life transitions, periods of stress, or other factors can cause symptoms to return or, if they were never fully eradicated, to ramp back up in intensity. For some, these relapses are brief and do not require additional treatment; identifying specific triggers and practicing the skills learned in therapy can help speed their course. For others, returning to therapy for a brief period can help address the underlying stress and strengthen coping mechanisms.