Overcoming Obsessive-Compulsive Disorder (OCD) With Exposure and Response Prevention (ERP) Therapy

Thrive • October 11, 2022

By Thrive Wellness Sacramento Director of Child & Adolescent Services Alexis Nicodemus, AMFT, APCC

A condition experienced by 1.2% of individuals in the U.S. , obsessive-compulsive disorder (OCD) can consume a person’s mind with troubling thoughts and drive them to engage in repetitive behaviors. Through therapy, however, an individual can face the fears at the root of their obsessive thoughts and develop healthy coping strategies to supplant their compulsive behaviors.

WHAT IS OCD?

OCD is a mental health condition characterized by intrusive ideas and recurrent behaviors intended to lessen the anxiety stemming from the unwanted thoughts. The obsessive thoughts and compulsive behaviors associated with OCD interfere with a person’s ability to perform daily activities. 

Symptoms of OCD include:
  • Preoccupation with distressing ideas
  • Ritualistic behaviors

Many misunderstand OCD as a choice. Because OCD is a fear-based disorder, using logic to mitigate the symptoms isn’t effective. Fixating and carrying out ritualistic behaviors are typically unenjoyable, and if a person could cease them, they generally would. 

TYPES OF OBSESSIVE-COMPULSIVE DISORDER (OCD)

OCD is an umbrella term with different themes and elements varying from person to person. Some common types of OCD include:

    • Contamination OCD: Characterized by a fear of being dirty, contamination OCD is generally associated with the compulsion to repeatedly wash oneself. 
    • Hoarding OCD: Those with hoarding OCD commonly collect items and avoid throwing things away for fear of negative consequences.
    • Symmetry OCD: Often involving a fixation with things being “just right,” symmetry OCD is frequently linked to ordering items in a specific manner or repeatedly checking that things are as they should be.
    • Taboo thoughts OCD: Individuals who struggle with this type of OCD may experience invasive thoughts about violence, sex, or religion characterized as forbidden.

CAUSES OF OCD

Researchers aren’t sure exactly what causes OCD, but some possible contributing factors include:

  • Family history: A person’s risk of OCD is increased if a family member also has OCD. 
  • Sickness: Strep throat and scarlet fever have been linked to the onset of OCD. This occurrence is known as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).
  • Stress : Stress from major life transitions can lead to OCD.

When treating OCD, the antecedents aren’t typically a focal point. Instead, clinicians typically address the disorder directly intending to resolve clients’ symptoms. 

OCD AND PERINATAL MENTAL HEALTH

Many parents tend to develop OCD during the perinatal period which accounts for pregnancy up until one year postpartum. The fluctuation in hormones, changes in family dynamics, and the responsibility of caring for a baby may act as stressors that can lead to anxiety, preoccupation, and compulsive behavior. Perinatal OCD may take the form of unwanted ideas of aggression towards the baby or excessive fear of the baby contracting a serious illness.

OCD AND EATING DISORDERS

The obsessive thinking and ritualistic eating behavior that often accompany eating disorders parallel the symptoms of OCD, which can make the conditions difficult to distinguish from one another. Those with eating disorders commonly have repetitive thoughts about eating and their body. They may also eat particular foods in specific ways and at certain times. A person struggling with an eating disorder may have co-occurring OCD with characteristics unrelated to the eating disorder, such fear of contamination along with compulsive hand-washing.

TREATMENT OF OCD THROUGH EXPOSURE AND RESPONSE PREVENTION (ERP) THERAPY

Through exposure and response prevention (ERP) therapy, the therapist systematically introduces individuals with OCD to the circumstances they fear, while also helping them implement coping strategies. By beginning with triggers that cause lower levels of distress and incrementally increasing to situations that induce more anxiety, a clinician guides the client in developing resilience to their fears. 

During clinician-led exposures to triggers, clients can expect to feel upset. The therapist will stay within the client’s window of tolerance, however, while also pushing the client towards the edge of their ability to endure the situation. 

Depending on the acuteness of the OCD and a person’s willingness to be uncomfortable through the treatment process, symptoms can resolve within six to eight weeks in an intensive outpatient program (IOP), and within three to four months in an outpatient program.

OCD TREATMENT AT THRIVE WELLNESS

Thrive Wellness’ mental and behavioral health experts specialize in treating individuals struggling with all types of OCD, including perinatal OCD and OCD that co-occurs with eating disorders . By guiding individuals in quieting their intrusive thoughts and overcoming their compulsions, our clinicians can help alleviate the debilitating nature of OCD. To learn more about our therapeutic services , reach out

About the Author
Thrive Wellness Sacramento Director of Child & Adolescent Services Alexis Nicodemus, AMFT, APCC

Alexis Nicodemus earned a bachelor’s degree in early childhood education with a minor in counseling as well as a master’s degree in counseling from Sacramento State University in California. Her clinical experience includes working in intensive outpatient programs as well as residential facilities for eating disorder recovery. As the director of child and adolescent services at Thrive Wellness Sacramento, Alexis helps to ensure that program curriculum is properly implemented, works to collect collateral contacts as needed to support treatment, and offers therapeutic services to clients experiencing eating disorders and co-existing conditions.

As a clinical therapist, Alexis employs modalities such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and mindfulness practices to support clients struggling with mental and behavioral health concerns. Her passion is to assist individuals in the ways they most need in order to find joy, hope, and purpose along the path to healing. Alexis wants clients to know that while life inevitably presents challenges, they are not alone in facing them and there is always light at the end of the tunnel. She strongly promotes the importance of mental health, emphasizes that each of us matters, and advocates for seeking assistance when one’s well-being depends on it.

While all Thrive Wellness locations offer interdisciplinary clinical teams who collaborate to treat eating disorders, perinatal mood and anxiety disorders (PMADs), and additional mental and behavioral health conditions, programs and services may vary by location.

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December 2, 2025
Like the fir tree, a symbol of endurance rooted in hope, our Family Inclusive Recovery (FIR) approach reflects the strength that grows when families face challenges together. At our new residential center “The Greenhouse”, FIR is more than a treatment model, it’s a philosophy of healing that places families at the heart of recovery for adolescents and young adults navigating eating disorders, anxiety disorders, and obsessive-compulsive disorder (OCD). We believe lasting healing doesn’t happen in isolation; it’s built with the support of families through perseverance, hope, and compassionate care. What Is Family Inclusive Recovery (FIR)? Family Intensive Recovery (FIR) is a specialized and immersive approach that actively engages caregivers as central agents in their child’s healing process. Rather than seeing families as contributors to a problem, we view them as essential partners in recovery. Drawing from two evidence-based frameworks, Supportive Parenting for Anxious Childhood Emotions (SPACE) and Family-Based Treatment (FBT), FIR helps families cultivate resilience, confidence, and connection throughout the journey to recovery. Grounded in SPACE and FBT Through the SPACE model, parents learn how to recognize and reduce well-intentioned but unhelpful behaviors known as accommodations that can reinforce anxiety and OCD symptoms. By shifting from rescuing to supporting and challenging, parents develop the confidence to guide their child through discomfort, helping them build distress tolerance and self-trust. Simultaneously, Family-Based Treatment (FBT) empowers families to take an active, compassionate role in their child’s nutritional and emotional recovery. Parents learn how to support weight and nutritional restoration, disrupt the eating disorder’s patterns, and reestablish boundaries that promote health and growing autonomy. Together, these approaches strengthen both the individual and family system, allowing recovery to take root within an environment of empathy and optimism. From Blame to Collaboration A cornerstone of the FIR model is removing blame. At Thrive, parents are not viewed as the cause of their child’s struggles, but rather as key partners in recovery. Treatment focuses on joining forces to create a safe, supportive environment where: Families learn to sit with their child's discomfort alongside them without rushing to fix or control it. Parents practice compassionate firmness, setting boundaries grounded in care and safety. Teens and caregivers rebuild trust through open, honest communication. This collaborative framework helps families reestablish a sense of connection and confidence, fostering long-term resilience and open communication that extends beyond the treatment setting. Why Family Matters in Recovery Recovery from eating disorders, OCD, or anxiety isn’t a one-person job, it requires integrated care including the family. When families learn to navigate challenges together, they can model emotional regulation, reinforce healthy boundaries, and create conditions for sustained recovery. Through FIR, we aim to strengthen attachment bonds, reshape family interactions, and empower every member of the family to grow. The result is not only symptom reduction but also a deeper sense of unity, hope, and shared endurance, just like the steadfast fir tree that stands resilient through every season. Moving Toward Hope Family Inclusive Recovery invites caregivers and loved ones to become active participants in change. It’s a journey of learning, letting go, and leaning into love and acceptance. Together, families and clinicians can cultivate the courage in clients to face uncertainty, and in doing so, help them discover that recovery is not just possible, but enduring. If you’d like to learn more about Family Intensive Recovery at The Greenhouse or how we support families in eating disorder and OCD treatment, reach out to our team today.
November 14, 2025
The Greenhouse at Thrive Wellness A New Chapter of Hope and Healing in Nevada On Friday, November 14 , we gathered with our partners at Molina Healthcare to share an important moment for our community. Together, we celebrated Molina’s generous $50,000 grant , an investment that is helping bring The Greenhouse to life. Their support is not only a financial contribution—it’s a statement of belief in the young people and families of Nevada who deserve access to compassionate, evidence-based mental healthcare close to home. This gathering marked the beginning of something we’ve dreamed about for years: a place designed specifically for adolescents and emerging adults to receive the care, connection, and support they need during some of the most vulnerable moments of their lives. Something New Is Growing In early 2026 , Thrive Wellness will open The Greenhouse , Nevada’s first residential treatment center devoted to adolescents and emerging adults navigating eating disorders, anxiety, and OCD . For too long, families have faced a heartbreaking dilemma—send their child far from home for treatment or go without the specialized care they need. The Greenhouse is our answer to that gap. It will be a place where young people can settle into an environment built for healing, where they are understood, supported, and surrounded by a team that believes in their capacity to recover. The Greenhouse represents a natural extension of our mission. It’s a living expression of our belief that recovery is possible—and that with the right support, families can find their footing again. 
November 11, 2025
Are you looking for a meaningful way to give back this holiday season? Thrive Wellness is excited to continue our 6th Annual Giving Tree Program in collaboration with Perenn Bakery this winter. This year, Thrive Wellness Reno and Perenn Bakery are proud to partner with Ronald McDonald House Charities® of Northern Nevada. The organization supports families with children receiving treatment at area hospitals, providing comfort, hope, and a home-away-from-home during challenging times. Ronald McDonald House Charities offers essential services, removes barriers, strengthens families, and promotes healing when children need healthcare the most. How It Works Simply take one (or a few) tags from the Giving Tree, each listing an item you can purchase and donate for residents of the Ronald McDonald House. Then, drop off your item(s) at one of our designated donation locations by Friday, December 19. Items Needed: Restaurant gift cards Walmart or Target gift cards Games, puzzles, and coloring books Toys (Barbie, Hot Wheels, Lego sets, craft sets, magnet blocks, baby dolls, action figures, journals, infant toys, etc.) Children's books (picture, chapter, and graphic novels) Toiletry sets (for adults) Lotion/self-care gift sets (for adults) Sweatshirts/hoodies (adults, XS-XXL) Scarves, gloves, fuzzy socks, pajamas (all sizes) Infant diapers, onesies, and baby bottles Bulk individually wrapped snacks (granola bars, chips, etc.) Please ensure all donations are new, in original packaging, and unwrapped. Donation Drop-Off Locations Please deliver donations by Friday, December 19, to one of the following sites: Thrive Wellness 201 W Liberty St., Suite 201, Reno, NV 89501 Perenn Grocery 7600 Rancharrah Pkwy, Suite 130, Reno, NV 89511 The first 50 people to return their donations will receive a complimentary ornament gift!  Why We Give Back Through our Giving Tree program, we’re honoring one of our core values at Thrive Wellness: staying rooted in community. This annual tradition allows us to give back to those who need support most during the holiday season. We invite you to join us by taking a tag at any Thrive or Perenn location and helping spread kindness throughout our community. There’s no better way to embrace the holiday spirit than by supporting local families with thoughtful, heartfelt donations. We are deeply grateful for your generosity and continued support. Thank you for helping us make a difference!
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