About OCD
OCD (obsessive-compulsive disorder) involves intrusive thoughts that cause distress and repetitive behaviours or mental rituals to reduce it. Cognitive-behavioural therapy with exposure and response prevention is the first-line psychological treatment.
Psychologists assess and treat emotional, behavioural and relationship difficulties through psychological therapy. They do not prescribe medication. In many countries clinical practice requires a specific qualification and registration with a licensing body, which Therapy247 checks.
Getting mental health care in the United States
Public health system · No single public system (Medicaid, Medicare, community mental health centers)
There is no universal public mental health service. People with low incomes may be covered by Medicaid, older adults by Medicare, and publicly funded community mental health centers and treatment facilities can be located through the federal SAMHSA locator. More information
How to check that a professional is licensed
- State boards of psychology (umbrella body: ASPPB). Psychologists are licensed by each state board; check the board of the state where you live. Use of the title psychologist generally requires a state license.
Insurance and coverage
Federal parity law (MHPAEA) requires most group health plans that cover mental health to do so on terms no more restrictive than for physical health; deductibles, copays and in-network rules still apply.
Online therapy in the United States
The clinician must normally be licensed in the state where the patient is located. Psychologists in PSYPACT member states may practice telepsychology across those states.
Urgent help in the United States
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 911 · Emergency (911)
- 988 · 988 Suicide & Crisis Lifeline
Information reviewed in November 2026 · Sources: findtreatment.gov, docinfo.org
Signs to look out for
Many people have occasional intrusive thoughts or like things a certain way. OCD may be involved when unwanted thoughts, images or urges cause intense distress, and you feel driven to perform rituals, such as checking, washing, counting, seeking reassurance or mentally neutralising, to reduce the anxiety. These rituals take a lot of time, feel hard to resist and interfere with daily life.
What helps: treatments and professionals
Cognitive-behavioural therapy with exposure and response prevention (ERP) is the psychological treatment with the strongest evidence for OCD. It involves gradually facing feared thoughts or situations without performing rituals, at a pace agreed with the therapist. Clinical psychologists and psychologists trained in ERP usually lead treatment. A psychiatrist can assess whether medication may help, particularly when symptoms are severe.
When to seek urgent help
Having an intrusive thought about harm does not mean you want to act on it; this is common in OCD. However, if you feel hopeless, have thoughts of ending your life, or rituals prevent you from eating, drinking or caring for yourself, contact your local emergency services or go to the nearest emergency department. Sudden onset of OCD symptoms in a child should be checked by a doctor.
What you can do in the meantime
Learn from reliable sources how OCD works: trying to push thoughts away or seeking reassurance usually makes them stronger. Try to delay a ritual by a few minutes, or shorten it slightly, and notice that anxiety tends to fall on its own. Ask family members to support you without joining in rituals. Look after sleep and stress, which can intensify symptoms.
What does a psychologist do?
A psychologist spends most of the working day talking with people about what worries them and helping them change it. That includes assessing the difficulty, agreeing goals, and using structured psychological techniques in sessions with adults, teenagers, children, couples or families. Between sessions they prepare materials, write notes, and sometimes coordinate with doctors, schools or other professionals, always with your consent.
When to see a psychologist
It makes sense to see a psychologist when anxiety, low mood, stress, relationship problems, a loss or a difficult change start to affect your sleep, work or relationships, or when you simply want to understand yourself better. If symptoms are very severe, you may need medication, or there are signs of a medical cause, a psychiatrist or your doctor should be involved too.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in the United States cover psychological care?
There is no universal public mental health service. People with low incomes may be covered by Medicaid, older adults by Medicare, and publicly funded community mental health centers and treatment facilities can be located through the federal SAMHSA locator.
How do I check that a psychologist is licensed in the United States?
State boards of psychology (umbrella body: ASPPB): Psychologists are licensed by each state board; check the board of the state where you live. Use of the title psychologist generally requires a state license.
Can I have online therapy in the United States?
The clinician must normally be licensed in the state where the patient is located. Psychologists in PSYPACT member states may practice telepsychology across those states.