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OCD and ERP treatment how we support you in Columbia MD
- Moe | Scarlet Plus
- Dec 1
- 7 min read
Living with obsessive compulsive disorder, often called OCD, can feel overwhelming. You may notice scary thoughts that do not match your values. You may feel pushed to repeat certain actions until they feel just right. Or you might simply feel stuck in fear and anxiety with no clear way out.
At Caritas Behavioral Health Services LLC in Columbia MD, we want you to know that OCD is a real and treatable mental health condition. Evidence based care such as exposure and response prevention, or ERP, can help you step out of the cycle of obsessions compulsions and anxiety. (National Institute of Mental Health)
In this guide, we explain what OCD is, how ERP works, what ERP sessions may feel like, and how our in person and telehealth services across Maryland can support you.
Understanding OCD and anxiety
OCD is a mental health condition where a person has
Intrusive and unwanted thoughts images or urges called obsessions
Repetitive actions or mental rituals called compulsions that are meant to reduce fear or stop something bad
These obsessions and compulsions are not habits or preferences. They are distressing and time consuming and they can get in the way of work school relationships and daily life. The National Institute of Mental Health describes OCD as a long lasting disorder with recurring thoughts and behaviors that feel very hard to control. (National Institute of Mental Health)
OCD is linked with anxiety. In fact, it is often grouped with anxiety and related disorders because the cycle is driven by fear and worry. Anxiety disorders in general are common and can interfere with work, school, and relationships when they go untreated. (National Institute of Mental Health)
Some common themes in OCD include
Fear of germs or contamination
Fear of causing harm to yourself or others
Disturbing or taboo thoughts that go against your values
A strong need for things to feel exact or in the right order
Repeated checking, counting, praying, or asking for reassurance
If you notice these patterns and they are affecting your life, you are not alone. OCD affects millions of adults in the United States. (ADAA)
How OCD creates a cycle of anxiety
OCD often follows a cycle
TriggerA thought image situation or feeling shows up. For example, touching a doorknob or having a quick image of harm.
ObsessionThe brain reacts with intense worry. You might think things like what if I get sick or what if this means I am a bad person.
AnxietyYour body and mind feel very tense. You may notice a racing heart, trouble focusing, or a feeling of dread.
CompulsionTo feel safe, you do something that seems to lower the anxiety. You might wash your hands, check a lock many times, repeat a phrase, avoid a place, or ask others to reassure you.
Short term reliefAnxiety drops for a moment, so the brain learns that the compulsion is the way to feel better. Next time the fear shows up, the urge to do the ritual is even stronger.
ERP therapy is designed to gently interrupt this cycle and teach your brain that you can handle anxiety without doing compulsions. Over time, this helps anxiety fade on its own.
What is ERP therapy for OCD
Exposure and response prevention, or ERP, is a form of cognitive behavioral therapy. Decades of research show that ERP is one of the most effective and first line psychological treatments for OCD in adults and children. (PMC)
ERP has two main parts
ExposureYou slowly and safely face the thoughts images objects or situations that bring up OCD fears.
Response preventionYou practice not doing the usual compulsion or ritual afterward, with the support of your therapist.
The goal is not to flood you with fear. The goal is to help your brain learn a new message I can feel anxiety and still be safe and I do not need my rituals. The International OCD Foundation describes ERP as guided practice in facing triggers while resisting compulsions so that you learn to manage symptoms in daily life. (International OCD Foundation)
How ERP works step by step
Every person with OCD is different. At Caritas Behavioral Health Services LLC in Columbia MD, ERP is tailored to your story, your culture, and your values. Here is what the process may look like.
1. Careful assessment and a clear plan
Your work with us begins with a detailed evaluation. During this visit we
Learn about your symptoms and daily life
Ask about your history with anxiety and mental health
Talk about your supports and stressors at home, work, or school
Screen for other concerns such as depression or panic
If OCD seems likely, your provider will discuss the diagnosis with you in clear language. Together, you decide whether ERP fits your goals. We also talk about medication options, since many people benefit from a mix of therapy and medication for OCD. (Mayo Clinic)
2. Building a fear ladder
Next, you and your therapist create a list of OCD triggers, from mild to intense. This is often called a fear ladder.
For example
Looking at a picture of something you see as dirty
Touching a doorknob once
Touching a trash can then waiting before washing
Using a public restroom and not washing right away
You rate how strong each trigger feels. Then you and your therapist pick starting points that feel challenging but doable. You stay in charge and you never have to face your hardest fear first.
3. Exposure practice with support
During ERP sessions, you practice facing a chosen trigger in a slow, respectful way. Your therapist guides you and checks in with you. You might
Talk through an anxious thought in detail
Look at words or images that normally scare you
Touch objects that usually feel off limits
Imagine a situation that brings up fear
As you do this, your therapist helps you stay with the feeling rather than escape it. Many people notice that anxiety rises at first then slowly falls on its own. This teaches your brain that the feared outcome is less likely than it feels and that you can handle discomfort. (Medical News Today)
4. Response prevention and new coping tools
The second half of ERP is response prevention. This means
Not washing hands right away
Not checking the stove or lock again
Not repeating a phrase or prayer in a ritual way
Not asking for reassurance from loved ones
Instead, you practice new coping tools such as slow breathing, grounding skills, or talking back to OCD thoughts in a kinder realistic way. Over time, urges to do compulsions get weaker and daily life starts to open up.
What ERP feels like in real life
Many people feel nervous before starting ERP, which is very understandable. Your fears are real and you have used rituals to cope for a long time.
In ERP, you are never forced into a situation without consent. You and your therapist
Move at a pace that respects your comfort and safety
Check in often on how you are feeling
Adjust your plan based on what you learn each week
Celebrate small wins such as touching a trigger once or delaying a compulsion for a short time
Research shows that people who stay with ERP, even when it feels hard, often see strong and lasting drops in OCD symptoms and anxiety. (PMC)
ERP, anxiety, and telehealth
ERP is helpful not only for OCD but also for related anxiety conditions, including panic and some forms of social anxiety. (MWR Counseling)
The good news is that ERP can be delivered in different formats
In person sessions in the office
Live video telehealth sessions
Homework practice between visits
Studies suggest that remote ERP with a therapist by phone or video can work as well as in person care for many people. (paloaltou.edu)
At Caritas Behavioral Health Services LLC
We provide in person treatment in Columbia MD for OCD anxiety and related conditions
We provide telehealth evaluation across Maryland for people who prefer to start from home or who live outside the Columbia area
During telehealth sessions you meet with your provider through a secure video platform. You and your therapist can still design and practice ERP steps using items and situations in your home and community.
How Caritas Behavioral Health supports you through ERP
Our team understands how lonely OCD and anxiety can feel. We also know that many people delay care because they worry they will be judged or misunderstood. At Caritas Behavioral Health Services LLC in Columbia MD, our approach is
Professional and evidence based
Warm, respectful, and culturally aware
Focused on your values and goals
When we use ERP for OCD, we also look at the whole person. That may include
Screening for depression, trauma, or other conditions
Reviewing current medications and overall health
Helping you build routines that support sleep, movement, and stress reduction
Including loved ones when helpful so they can support your progress
If you already receive care here for anxiety or panic, we can weave ERP into your existing treatment plan. You can learn more about our services for OCD and anxiety on our obsessive compulsive disorder page and anxiety and panic page on the Caritas website. (Caritas Health Services)
When to reach out for OCD and ERP treatment
Consider contacting us for an evaluation if
You feel stuck in repeated thoughts or rituals
Anxiety or OCD symptoms are getting in the way of work school or relationships
You spend a lot of time hiding or managing your symptoms
You are unsure whether what you feel is OCD, anxiety, or something else
You do not have to wait until things are severe. Early support can keep symptoms from growing and can protect your quality of life.
At Caritas Behavioral Health Services LLC we provide
In person OCD and anxiety treatment in Columbia MD
Telehealth evaluation for adults and adolescents across Maryland
If you are ready to explore OCD treatment with ERP, we invite you to contact our office in Columbia or schedule an appointment online. Together, we can build a clear plan to loosen the grip of OCD and anxiety and help you move toward a more peaceful and meaningful life.
