FAQs

Do I really have OCD?

It's common for almost everyone to experience some level of checking or compulsive tendencies in their lives. Intrusive and unwanted thoughts can also occur occasionally for most individuals. In fact, research shows that the content of these thoughts is not significantly different between individuals with diagnosed OCD and those without.

A clinical diagnosis of OCD is typically given when these obsessions and compulsions cause significant distress or impairment. One key distinguishing factor between individuals with a clinical diagnosis and those with mere tendencies is the amount of time spent struggling with these thoughts and behaviors. Typically, those who qualify for a clinical diagnosis of OCD spend more than an hour per day on these activities.

If you find yourself exhibiting OCD tendencies, it's important to note that exposure and response prevention techniques can be effective even if you don't meet the clinical threshold for a diagnosis. However, your motivation and the need for treatment may vary based on the severity of your symptoms.

Do I need to start / stop / change my medication while I go through treatment?

If you're considering starting, stopping, or altering your medication during OCD treatment, it's important to understand its role in symptom management. Medications alone are unlikely to lead to significant improvement in OCD symptoms. However, combining therapy with appropriate medications has shown to offer the best outcomes, particularly when anxiety or depression symptoms are present.

Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed medications for OCD. Specifically, Clomipramine, Fluoxetine (Prozac), Fluvoxamine, and Sertraline (Zoloft) are FDA-approved for adults and adolescents with OCD, while Paroxetine (Paxil) is approved for adults only. It's worth noting that the effective dosage for OCD is often higher than the typical dosage for managing depression symptoms.

When considering medication, it is crucial to consult with a prescribing clinician experienced in treating individuals with OCD symptoms. They should be willing to work closely with you to determine the right medication and dosage for your specific needs. Gradually increasing or decreasing the dosage is important to minimize potential negative side effects. It's common to experience odd feelings or dizziness when initiating or adjusting medication, but these sensations usually subside after several days. It may take several weeks to reach therapeutic dosages and several more weeks before experiencing relief from OCD symptoms.

During the initial stages of starting antidepressants, it's essential to closely monitor any potential increase in suicidal thoughts or behaviors. While these symptoms typically decrease over time, it's crucial to have a safety plan in place that remains effective during this period.

As a clinical psychologist, I am unable to prescribe, alter, or discontinue medications. My general recommendation is to begin treatment without modifying your current medication regimen. If your symptoms suggest a need for changes, I will encourage you to reach out to your prescribing clinician to discuss the possibility of adjustments.

Do you take insurance?

To help make treatment more affordable, I am currently in-network with certain providers. If you live in Tennessee, I am in-network for most policies through BCBS, United Healthcare (UHC, UMR, Optum) and Aetna. If you are in Florida, I am in-network for most policies through United Healthcare (UHC, UMR, Optum) and Aetna (but not BCBS). Unfortunately, I am not in-network for these companies in any other state (self-pay only).

Medicare: I am a Medicare provider (Traditional Medicare Only) for any state listed on my home page. I am in-network for UHC Medicare Advantage members in the Tennessee.

If I am not in-network for you, I am afraid I cannot bill any insurance plans for you. I am happy to provide what is called a “super bill” to you that you can submit to your insurance company for possible reimbursement, although being that I am out-of-network, it is unlikely they will end up paying a significant amount due to high deductibles and co-pays. If I diagnose you with OCD, this treatment is an eligible treatment for using your health savings account or medical flexible spending account. If you have a credit card for one of these accounts, you should be able to pay me directly with those funds. If not, you should be able to submit a super bill from me to get reimbursed from your HSA/FSA.

Can you offer me a discount or sliding scale rate?

I can only work with a limited number of clients per week using this intensive treatment model, so I cannot offer you a lower rate. There are certainly cheaper options available to you both in-person and online. I highly recommend that you use the “Find Help” option on the iocdf.org website to find options. You may also find someone in the Psychology Today listings, but look for a provider that specifically uses ERP techniques. A great self-help book is Getting Over OCD, Second Edition by Jonathan Abramowitz. A great free website training program is available called ocdchallenge.com.

Can we meet in person?

Sure! I can see clients in person in my office in Cleveland, TN. However, this treatment is designed specifically for telehealth. While you are welcome to come by my office for the occasional appointment, everything has been designed to work online. All of the technologies that we will be using are encrypted and HIPAA compliant (with the exception of e-mail - please do not share confidential information via e-mail).

How long will treatment last?

My program has been designed to last for about 12 weeks with weekly sessions and frequently electronic check-ins, but the length can vary based on your individual situation. I do not use a workbook approach where everyone follows the same treatment. The program is customized to your particular needs. Adjustments are frequently made based on your progress. However, there is no obligation on your part - you can discontinue treatment at anytime, although if you do decide to stop I do request that we have a final brief session at no charge so I can make recommendations.

Will my OCD symptoms improve?

It would be both unethical and inaccurate for any therapist to guarantee treatment success. I use a combination of exposure and response prevention (ERP), cognitive-behavioral therapy, ACT, and strength-focused approaches. In general, most people participating in these types of treatments experience significant improvement in functionality. Typically about 25% of clients drop out of ERP treatment. This is the biggest challenge for both of us; to keep you active and engaged in a challenging therapy for you to see treatment gain.

Is this the right treatment approach for me?

While teletherapy has some significant advantages regarding accessibility, it is not the right treatment for everyone. If you are actively suicidal, you should be seeking in-person help (if you have not found help yet, please call the National Suicide Prevention Lifeline - 988). This program also is specifically for your OCD symptoms, although we will also be discussing other symptoms that often accompany OCD such as depression and anxiety. However, if you have another significant mental health concern outside of OCD, you will need to consult another therapist for work on those problems.