How Occupational Therapists Can Help Your OCD

How Occupational Therapists Can Use ERP to Help with Obsessive-Compulsive Disorder (OCD)

Understanding OCD and Its Impact

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) aimed at reducing anxiety or preventing a feared outcome. These symptoms can significantly interfere with daily routines, relationships, and quality of life.

Occupational Therapists play a vital role in the treatment of OCD—especially through the use of Exposure and Response Prevention (ERP), one of the most evidence-based treatments for OCD.

What Is Exposure and Response Prevention (ERP)?

ERP is a specialized form of Cognitive Behavioural Therapy (CBT) designed to help individuals gradually face their fears and resist the urge to engage in compulsions. The emphasis on this type of therapy is the behavioural component. Over time, this process helps the brain learn that anxiety naturally decreases without performing the rituals.

For example, someone who fears contamination might work toward touching a doorknob and refraining from washing their hands immediately afterward—under the supportive guidance of their therapist.

How Occupational Therapists Integrate ERP Into Practice

Occupational therapists are uniquely positioned to integrate ERP within the context of a person’s daily life and functional goals. Here’s how Occupational Therapists can effectively support clients with OCD:

1. Functional Assessment of Triggers

Occupational Therapists begin by understanding how obsessions and compulsions affect self-care, productivity, and leisure. For example, an individual might spend hours engaging in compulsions, struggle to complete work tasks due to intrusive thoughts, or avoid social situations out of fear their obsession might come true.

This holistic assessment helps tailor ERP exposures that are person-centered and directly related to meaningful life activities.

2. Graded Exposure Plans

Occupational Therapists collaborate with clients to design graded exposure hierarchies—lists of feared situations ranked from least to most distressing.
Some examples of behavioural exposures:

• Touching an item perceived as “dirty” without immediately washing.

• Leaving home without checking locks multiple times.

• Using public restrooms or touching shared objects.

Through structured ERP sessions, the Occupational Therapist supports the client in approaching anxiety-provoking tasks safely and gradually, helping them regain confidence in everyday occupations. It is important to note that your therapist works through your hierarchy at your pace. Although it may feel challenging it should never be incredibly distressing. Your feedback throughout is important.

3. Response Prevention Strategies

In addition to exposure, Occupational Therapists integrate response prevention—refraining from performing compulsions such as handwashing, checking, or seeking reassurance.
The Occupational Therapist provides emotional regulation tools, grounding techniques, acceptance and mindfulness strategies to tolerate the discomfort that arises during exposure.

4. Building Daily Routines and Coping Skills

ERP alone is most effective when combined with occupational therapy’s focus on functional recovery. Occupational Therapists help clients rebuild balanced routines, improve sleep, eating, and self-care, and engage again in valued activities that OCD may have disrupted.

5. Collaborative, Holistic Care

Occupational therapists often work alongside psychologists, psychiatrists, and family members to ensure a coordinated approach. The Occupational Therapist’s focus on participation, autonomy, and quality of life helps bridge the gap between clinical progress and real-world functioning.

Benefits of ERP With an Occupational Therapist

• Personalized treatment focused on your daily life and goals.

• Supportive, practical guidance during real-world exposures.

• Improved independence in home, work, and social settings.

• Long-term anxiety reduction and increased tolerance for uncertainty.

Key Takeaway

ERP is one of the most effective, research-supported treatments for OCD—and occupational therapists are uniquely equipped to deliver it within the context of everyday living. By addressing both the emotional and functional aspects of OCD, OTs help clients reclaim their routines, relationships, and sense of control.

Frequently asked questions (FAq)

1. What is ERP therapy for OCD?
Exposure and Response Prevention (ERP) is a form of CBT that helps people face their fears and reduce compulsive behaviours by gradually exposing them to anxiety triggers without performing rituals.

2. Can occupational therapists provide ERP for OCD?
Yes. Occupational Therapists trained in mental health can integrate ERP techniques to help clients manage OCD symptoms while improving participation in daily activities.

3. How is ERP with an Occupational Therapist different from ERP with a general therapist?
While both use evidence-based ERP methods, Occupational Therapists focus on function and daily living, helping clients apply ERP skills in real-world contexts such as hygiene routines, work tasks, and social interactions. Its not just talking, we bring therapy to life.

4. How long does ERP treatment take?
ERP is typically delivered over several months to a year or more, depending on symptom severity and readiness for exposure. Progress is gradual but highly effective with consistent participation.

5. Is ERP effective for all types of OCD?
Yes. ERP has strong research support across various OCD presentations, including contamination fears, checking, intrusive thoughts, and symmetry obsessions.

Want more information about therapy for OCD? Check out this past blog post:

Therapy for University Students: Supporting Mental Health and Academic Success

University can be one of the most rewarding and transformative times in life. It is a period of academic growth, self-discovery, and independence. At the same time, this stage often brings challenges that can significantly affect mental health and overall well-being. From managing deadlines and exams to navigating social pressures and adjusting to new environments, many students struggle with stress, anxiety, and feelings of uncertainty.

If you are a student, or a parent of a student at an Ontario University, it is important to know that support is available. Psychotherapy can help students develop the tools they need to succeed academically while maintaining emotional balance.

Why Student Mental Health Matters

Research shows that university students are experiencing higher levels of stress than ever before. According to the Canadian Association of College and University Student Services, more than half of students report overwhelming anxiety, while nearly one in four report being diagnosed or treated for a mental health condition.

Left unaddressed, ongoing stress can lead to burnout, lower academic performance, and even physical health concerns. By prioritizing mental health early, students can build resilience, develop coping strategies, and feel more confident in managing life’s challenges.

Common Challenges for University Students

Students may face a wide range of challenges during their time in university, including:

• Academic pressure: Heavy workloads, exams, and performance expectations can lead to chronic stress and perfectionism.

• Adjustment difficulties: Transitioning away from home, living independently, or adapting to campus life can create loneliness or homesickness.

• Social pressures: Navigating friendships, dating, and social comparison (including online and on social media) may increase anxiety.

• Financial stress: Rising tuition and living costs, along with part-time work demands, can affect focus and energy levels.

• Uncertainty about the future: Making career choices or planning life after graduation can feel overwhelming.

These stressors are common, but without support, they may contribute to mental health concerns such as anxiety, depression, or burnout.

How Therapy Supports University Students

Therapy offers students a confidential, supportive environment where they can process their experiences, explore challenges, and develop practical skills. Depending on individual needs, therapy may focus on:

• Stress and time management: Tools to balance academic workloads and reduce overwhelm.

• Anxiety and mood regulation: Cognitive behavioural therapy and mindfulness strategies to manage racing thoughts, worry, or low mood.

• Identity development and self-confidence: Space to explore personal values, beliefs, and sense of self in this time of development.

• Healthy relationships: Skills for setting boundaries, improving communication, and navigating conflict.

• Resilience building: Strategies for adapting to setbacks and maintaining balance during stressful times.

For many students, therapy is not only about addressing immediate concerns but also about building lifelong coping skills.

When Should Students Consider Therapy?

It is common for students to wonder if what they are feeling is “serious enough” to seek support. Therapy can be helpful at any stage, but it may be especially beneficial if a student:

• Frequently feels overwhelmed by stress or pressure.

• Struggles with motivation, concentration, or sleep.

• Experiences ongoing anxiety or low mood.

• Finds it difficult to manage relationships or social situations.

• Notices changes in appetite, energy, or overall well-being.

• Wants to build resilience and coping tools before challenges escalate.

Reaching out early can help prevent stress from turning into more significant difficulties.

What to Expect in Student Therapy

Starting therapy may feel intimidating, particularly for students accessing support for the first time. Generally, therapy for students involves:

• A confidential and non-judgmental space to discuss concerns openly.

• A collaborative approach, with the therapist and student identifying goals together.

• Practical strategies to manage stress, anxiety, or relationship challenges.

• Tailored support, whether through short-term skills-based work or longer-term exploration of deeper concerns.

Therapy is not a one-size-fits-all process, it is designed to meet the unique needs of each student.

Therapy for Students in Brooklin, Whitby, and the Durham Region

Cedar Tree Therapy is located in Brooklin (Whitby/Durham Region) however provides therapy for university students all over Ontario . Sessions are tailored to the realities of post-secondary life, offering both immediate coping tools and long-term strategies for emotional well-being. Even if you are a student who lives away at school, we are happy to see you virtually for therapy.

Frequently Asked Questions (FAQ) About Student Therapy

1. Do I need a referral to start therapy as a student?

You do not need a referral to begin therapy. Students can reach out directly to book a session.

2. Is therapy only for students experiencing severe mental health concerns?

Not at all. While therapy can support students dealing with significant concerns such as anxiety or depression, it is equally valuable for those managing stress, building resilience, or navigating life transitions.

3. How often should students attend therapy?

The frequency of sessions depends on individual needs. Some students benefit from weekly sessions, while others find bi-weekly or monthly appointments helpful.

4. Will therapy interfere with my academic schedule?

Therapy is designed to work around your schedule. Cedar Tree Therapy offers flexible appointment times and virtual sessions, to accommodate student availability.

5. What types of therapy are most effective for students?

Evidence-based approaches such as Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT) skills, and mindfulness-based techniques are often effective in supporting student concerns. The approach is always tailored to the individual.

6. How can parents support a university student considering therapy?

Parents can encourage open dialogue, provide reassurance that seeking support is a sign of strength, and offer practical help with booking appointments or managing logistics such as looking into insurance coverage.

Taking the Next Step

If you are a university student — or the parent of one — and are seeking support, therapy can provide the tools and guidance needed to manage stress, maintain mental health, and thrive academically..

A Compassionate Path to Eating Disorder Recovery

Eating disorders are complex. They are not just about food, weight, or appearance—they are deeply rooted in emotional pain and, often, a need for control or safety. Whether you or someone you love is struggling, know this: eating disorders are rarely simply about the food.

As a therapist who specializes in eating disorder treatment, I’ve had the privilege of walking beside clients through some of their most vulnerable moments. This work has shown me over and over again that recovery is not only real, but transformative. If you’re reading this and wondering whether healing is truly possible, I want you to know: it is.

Understanding Eating Disorders: More Than Meets the Eye

Eating disorders come in many forms and affect people across all ages, genders, body types, ethnicities, and backgrounds. They are not always visible from the outside. People of all body shapes and sizes can experience eating disorders.

Some of the most common eating disorders include:

• Anorexia Nervosa: Characterized by restriction of food intake, intense fear of gaining weight, and a distorted body image.

• Bulimia Nervosa: Involves cycles of binge eating followed by the compensatory behaviour of purging.

• Binge Eating Disorder (BED): Involves recurring episodes of consuming large quantities of food, often rapidly and to the point of discomfort, without compensatory behaviors.

• Avoidant/Restrictive Food Intake Disorder (ARFID): A pattern of eating disturbances often tied to sensory issues or fear of aversive consequences, not driven by body image concerns.

• Orthorexia (not yet officially recognized in the DSM): An unhealthy obsession with "clean" or "healthy" eating that can severely disrupt a person’s life.

While each disorder has unique traits, they all share a common thread: emotional distress expressed through food and the body.

Myths That Get in the Way of Healing

Eating disorders are surrounded by harmful myths that can delay treatment and deepen shame. Let’s dispel a few:

• “You don’t look like you have an eating disorder.” Eating disorders do not have a “look.” People of all sizes can experience eating disorders.

• “It’s just a phase.” Eating disorders are serious mental health conditions that require professional support and are not to be brushed off. They are the most fatal psychiatric illness.

• “If they would just eat, they’d be fine.” Recovery is not just about eating differently, it’s about healing psychologically as well.

• “They’re just doing it for attention.” There is immense shame that comes with an eating disorder and it is a mental illness that no one would willfully choose.

Letting go of these myths opens the door for empathy, intervention, and hope.

What Recovery Really Looks Like

Recovery from an eating disorder is not a straight line. It’s more like a winding path—filled with highs and lows, setbacks and breakthroughs. That’s not a sign of failure. It’s how real, meaningful change works.

Here’s what recovery may involve:

1. Reconnecting with the Body

Many people with eating disorders feel disconnected from their bodies—either ignoring hunger cues or feeling at war with their physical selves. In recovery, we begin to rebuild trust with the body: listening, responding, and caring for it rather than controlling or punishing it.

2. Addressing the Root Causes

Eating disorders often serve a function: numbing emotional pain, providing a sense of control, or coping with trauma, anxiety, or low self-worth. Therapy creates space to explore and heal these underlying issues.

3. Rewriting the Inner Dialogue

The inner critic in eating disorders can be relentless. Part of recovery is learning to challenge that voice and cultivate a new one- one rooted in compassion, curiosity, and self-acceptance.

4. Creating a Life Beyond the Disorder

As healing progresses, clients begin to rediscover who they are beyond the eating disorder - reconnecting with passions, relationships, values, and dreams that may have been buried or put on hold.

What Progress Looks Like (Even When It’s Hard to See)

Recovery looks different for everyone and progress can take many forms. Sometimes, it might look like one of these things:

• Eating in a social setting with friends despite feeling anxious

• Choosing rest instead of compulsive exercise

• Recognizing a trigger before acting on it

• Crying instead of restricting

• Feeling an emotion fully, without numbing

These moments are profound victories. They may seem small, but they are the building blocks of sustainable healing.

For Those Who Love Someone Struggling

If someone you care about is living with an eating disorder, you may feel confused, helpless, or scared. You don’t need to have all the answers but your support makes a difference.

Here’s what can help:

• Listen without judgment.

• Avoid comments about weight, food, or appearance. Take a neutral stance to all bodies and food.

• Educate yourself about eating disorders. Meet with an eating disorder therapist yourself to gain a deep understanding of this psychiatric illness.

• Encourage professional help

• Practice patience. Recovery takes time and there will be ups and downs

Taking the First Step

If you’re considering therapy- or just wondering if your relationship with food and body is something to look at- that curiosity is enough. The first step doesn’t have to be big. It might be a phone call. A journal entry. A conversation.

And if you’re further along in your healing, know that setbacks don’t erase progress. Every part of your story matters. Every part deserves care.

Final Thoughts: You Are worthy of recovery

Eating disorders often leave people feeling like the eating disorder is their safe place for finding their worth, validation and comfort.

Recovery is about coming home to yourself. It’s about learning that you are enough as you are- not because of your weight, your achievements, or your willpower- but simply because you exist. You are worthy.

If you or a loved one is navigating an eating disorder, I invite you to reach out. You don’t have to do it alone. Healing is possible, and you are deserving of it.

Let’s take that first step together.

To learn more about therapy for eating disorders or to schedule a virtual consultation, please contact me using the button below.

The Body Image Course is a wonderful self guided e-course to compliment therapy for people living with eating disorders and their support people. Through powerful video lessons, reflective journaling prompts, and unique guided meditations, you’ll explore the roots of body image struggles, uncover the toxic impact of diet culture, and learn practical tools to build body image resilience.