Therapy for OCD and Perfectionism
Specialized OCD Treatment for Adults and Teens in Washington and Arizona
You've probably never told anyone the full truth about what goes on in your head. Maybe you've hinted at it, talked around it, or just white knuckled your way through it. Maybe you've even been to therapy before, but the OCD never really made it into the room. It got labeled as anxiety or depression and the OCD itself was never truly seen. But lately something has shifted. The thoughts are louder, the rituals are taking longer, and you're exhausted from keeping it all contained. Whatever is happening in your mind, you are not your thoughts. And you don't have to keep carrying this alone.
Serving clients throughout Washington and Arizona via telehealth, including Seattle, Bellevue, Tacoma, Spokane, Phoenix, Tucson, and Flagstaff.
Does This Sound Familiar?
Your mind latches onto intrusive thoughts and won't let go, no matter how hard you try to reason your way out of them
Things need to be a certain way or feel "just right" or the discomfort is unbearable
No matter how many times you ask for reassurance, it never feels like enough
You've had thoughts so dark or disturbing that you've never told a single person
You avoid certain situations, people, or places just to keep the anxiety at bay
You know your fears aren't rational but knowing that doesn't make them any less terrifying
If any of this sounds familiar, you’re in the right place!
OCD Therapy at Snow Globe Counseling is Different
OCD is a condition characterized by unwanted intrusive thoughts and repetitive compulsive behaviors, and it responds best to specific, evidence-based treatment rather than general talk therapy. In fact, without the right approach, therapy can sometimes make OCD worse by providing reassurance that feeds the cycle rather than breaking it. I have completed specialized OCD and ERP training through the IOCDF and NOCD, and am trained in Inference-Based Cognitive Behavioral Therapy (I-CBT), an approach that works especially well for clients who struggle with traditional ERP. This isn't general therapy with an OCD lens. It's specialized treatment designed specifically for how OCD works.
What OCD Actually Looks Like
Most people think of OCD as being overly clean or organized. But OCD is far more complex than that. All OCD involves intrusive thoughts, which are unwanted and distressing thoughts that feel impossible to ignore. What differs is what those thoughts latch onto and how compulsions show up in response. Here are some of the most common ways OCD shows up:
Harm OCD
Unwanted, disturbing thoughts about hurting yourself or someone you love, even accidentally. These thoughts feel terrifying precisely because they go against everything you value and you’re desperate for them to stop. Having them doesn't make you dangerous. It makes you human.
“Pure O”
OCD that lives almost entirely in your head. No visible rituals, just relentless mental compulsions, rumination, and intrusive thoughts that never seem to quiet down.
Relationship OCD
Constant doubt about your relationship. Do you really love your partner? Are they the right person? No amount of reassurance or analysis makes the uncertainty go away.
“Just Right” OCD and Perfectionism
Things need to feel a certain way or the discomfort is unbearable. This isn't about high standards. It's about the anxiety that shows up when things feel incomplete or wrong.
Moral and Religious Scrupulosity
An overwhelming fear of doing something wrong, sinful, or morally impure. This can look like excessive confession, prayer, or seeking reassurance that you're a good person. Scrupulosity looks different across faith traditions, and I welcome clients for whom religion and spirituality are an important part of their story.
OCD is endlessly creative and can latch onto almost anything that matters to you. If your experience doesn't fit neatly into one of these categories, that doesn't mean it isn't OCD! Whatever form it takes, it deserves real treatment. Reach out and let's figure it out together.
How We Treat It
ERP is the gold standard treatment for OCD. It works by gradually exposing you to the thoughts or situations that trigger your OCD while resisting the urge to engage in compulsions. Over time your brain learns that the feared outcome doesn't happen and that you can tolerate the discomfort without needing a ritual to feel safe. You won't be thrown into the deep end. We build up gradually, always at a pace that feels workable for you.
Exposure and Response Prevention (ERP)
For some clients, traditional ERP isn't the right fit. I-CBT looks at the story your mind is telling you and asks a different question: does this story actually hold up? Instead of facing fears directly, we examine the reasoning behind them and explore how OCD has convinced you to distrust your own senses and judgment. The goal is to reconnect you with who you actually are outside of the OCD narrative. This approach works especially well for clients with primarily mental compulsions or those who have tried ERP before and found it too overwhelming. Read more about how I-CBT works here.
Inference-Based CBT (I-CBT)
Acceptance and Commitment Therapy (ACT)
Fighting your thoughts is exhausting and it rarely works. ACT gets you out of the fight. Instead of trying to eliminate intrusive thoughts, we change your relationship with them so they lose their power over you. From there we focus on what actually matters to you. We explore your values, your relationships, the life you want to be living, and build toward that instead of organizing your life around avoiding fear.
What Sessions Look Like
A lot of people come to their first OCD session braced for the worst. They've read about ERP and they're worried they're going to be asked to do something terrifying right out of the gate. That's not how this works.
We start by getting to know your OCD. What triggers it, how it shows up, what compulsions you've been using to manage it, and what it's costing you in your daily life. Together we figure out which approach makes the most sense for you, whether that's ERP, I-CBT, or a combination of both, always with ACT woven throughout. Before we do anything else, you understand exactly what we're doing and why.
From there we work together at a pace that feels challenging but not overwhelming. You can talk about anything and everything, even the thoughts that feel too uncomfortable or scary to say out loud. This is a judgment-free space. No thought is too dark, too weird, or too embarrassing to bring into the room.
We're not here to erase your OCD. We're here to change your relationship with it so it loses its power over you. OCD may always be part of your story. But it doesn't have to be the whole story.
Frequently Asked Questions
-
Exposure and Response Prevention (ERP) is the gold standard evidence-based treatment for OCD. It works by gradually exposing you to the thoughts, images, or situations that trigger your OCD while helping you resist the urge to engage in compulsions. Over time, your brain learns that the feared outcome doesn't happen and that you can tolerate the discomfort without needing a ritual to feel safe. ERP doesn't eliminate intrusive thoughts, but it significantly reduces their power over your life. Alongside ERP, I weave in Acceptance and Commitment Therapy (ACT), an approach that helps you clarify what matters most to you and build a life guided by those values rather than by fear.
-
Regular talk therapy alone is not very effective for OCD and can sometimes make it worse by providing reassurance that temporarily relieves anxiety without addressing the underlying cycle. Specialized OCD therapy is more structured and involves actively working to interrupt the thought-compulsion loop rather than just talking about it. ERP does involve facing the things that trigger your OCD, but always gradually and at a pace you have input on. You won't be thrown into your worst fears on day one. I also incorporate ACT throughout sessions so the work always feels connected to something meaningful, not just symptom management.
-
I am not in-network with any insurance plans, but I provide a superbill after each session that you can submit to your insurance company for potential out-of-network reimbursement. Many clients receive partial reimbursement depending on their plan. I recommend calling your insurance provider before starting therapy to ask about your out-of-network mental health benefits, specifically your deductible, reimbursement percentage, and whether OCD treatment is covered. This can significantly offset the cost of specialized OCD therapy.
-
You can share as much or as little as you feel ready to. That said, OCD therapy works best when we can openly discuss the thoughts that are causing you distress, even the ones that feel too scary or embarrassing to say out loud. This is a completely judgment-free space. No thought is too dark, weird, or uncomfortable to bring into the room.
-
The length of OCD treatment varies depending on symptom severity, OCD subtype, and any co-occurring challenges. Most clients attend weekly sessions over the course of several months to a year, with the pace and duration shaped by their individual needs and progress. The goal is always meaningful, lasting change rather than rushing through a fixed timeline. Treatment length is something we track and discuss together throughout the process.
-
Yes. OCD can latch onto almost anything including fear of germs, moral scrupulosity, harm OCD, relationship OCD, and "just right" OCD. Whatever form your OCD takes, ERP can be adapted to address it. No matter what your intrusive thoughts are about, you deserve support. Many clients also experience anxiety alongside OCD, and this is addressed in therapy as well. Learn more about anxiety therapy here.
-
OCD is rooted in the brain's wiring and may never fully disappear, but it absolutely can become manageable. With ERP therapy, many people experience a significant reduction in the intensity and frequency of intrusive thoughts, and compulsions become much easier to resist. Think of it like waves. OCD may ebb and flow depending on stress, but with the right tools you can ride those waves instead of being swept away.