Frequently asked questions about OCD

Yes. The NHS describes obsessive compulsive disorder (OCD) as a mental health condition. A person with OCD has obsessive thoughts and compulsive behaviours. OCD-UK estimates that OCD affects around 1.2% of people. That is around three quarters of a million people in the UK.

The NHS says OCD is a health condition like any other, so there is nothing to feel ashamed or embarrassed about. Having OCD does not mean you are ‘mad’, and it is not your fault.

Read more about what OCD is and how it works.

Almost everyone has unwanted thoughts sometimes. The NHS says a thought may be an obsession if it keeps coming back and takes over your thinking. OCD often involves compulsions too. These are repeated actions or mental acts you feel you need to do to ease the anxiety or unease for a short time.

Mind says a common misconception is that OCD just means liking things tidy or washing your hands a lot. OCD-UK says brief quirks that rarely cause distress are not OCD. Current NICE guidance (CG31) says OCD symptoms can cause a lot of distress or make it hard to get on with daily life.

If obsessions and compulsions are affecting your daily life, speak to a GP. Or you can book our Assessment & Diagnosis with a registered clinical psychologist. You can also read about common signs of OCD.

Violent or sexual intrusive thoughts can feel frightening. But the NHS says obsessive thoughts like these are just thoughts. Having them does not mean you will act on them. The Royal College of Psychiatrists says a person with OCD is at no greater risk of causing harm than anyone else.

Unwanted intrusive thoughts are very common. OCD-UK cites research showing that up to 80% of people have them, often about the same things as OCD obsessions. In OCD, the thoughts are more intense, more frequent and harder to control.

If you ever feel you cannot go on, or you cannot keep yourself or someone else safe, get help straight away. Our urgent help page lists who to contact. To learn more, read our guide to intrusive thoughts in OCD.

The NHS says it is not clear what causes OCD. A number of things may play a part:

• Family history. You are more likely to develop OCD if a family member has it.
• Differences in the brain. Some people with OCD have unusually high activity in parts of the brain, or low levels of a chemical called serotonin.
• Life events. OCD may be more common in people who have been bullied, abused or neglected. It sometimes starts after a big life event, such as having a baby or a bereavement.
• Personality. People who are neat and meticulous with high standards may be more likely to develop OCD. So may people who tend to be anxious or feel very responsible for others.

OCD-UK says there is no evidence yet that stress or parenting styles cause OCD. But major stress may trigger it in someone who is already prone to it. Whatever the cause, OCD is not your fault. Read more about what OCD is.

The NHS says the main treatments for OCD are talking therapy and medicine. The therapy is usually cognitive behavioural therapy (CBT) with exposure and response prevention (ERP). The medicine is usually a type of antidepressant called an SSRI.

Current NICE guidance (CG31) matches treatment to how much OCD affects your life:

• Mild OCD (adults): a short, lower-intensity course of therapy that includes ERP.
• Moderate OCD (adults): a choice of an SSRI or more intensive CBT with ERP. These appear to work about as well as each other.
• Severe OCD (adults): an SSRI and CBT with ERP together.
• Children and young people with moderate or severe OCD: CBT with ERP that involves the family is the treatment of choice.

NICE is updating its OCD guidance, and the new version is due in 2027. Our treatment is built on CBT with ERP. Find out how OCD treatment works.

We cannot promise a cure. The NHS says OCD is unlikely to get better on its own. But treatment and support can help you manage your symptoms and have a better quality of life. NHS inform says most people improve after treatment.

The Royal College of Psychiatrists says about 3 in 4 people who complete ERP are helped a lot. It also says about 1 in 4 people decide not to try ERP or do not finish it. Of those who get better, about 1 in 5 have symptoms again later and need more treatment. Current NICE guidance (CG31) notes that OCD can come and go over time.

For adults, NICE says your therapist should explain how to use what you have learned if the same or new symptoms come back. This should happen towards the end of treatment. OCD-UK says a realistic aim is to leave therapy better than when you started. Read more about treatment for OCD.

It depends on how much OCD affects your life. For fairly mild OCD, the NHS says a course of about 8 to 20 sessions is usual, with practice at home in between. More severe OCD may need longer.

The Royal College of Psychiatrists says ERP sessions are usually weekly or fortnightly at first. The NHS says it can take several months before you notice the benefit.

With us, sessions last 50 minutes, twice weekly, weekly or fortnightly. We agree a personalised treatment plan with you at your Initial Consultation. See our fees and how to book.

Yes. The Royal College of Psychiatrists says ERP with a professional can take place face to face, by phone or by video link. For adults with mild OCD, current NICE guidance (CG31) lists brief CBT with ERP by telephone as one option.

NICE is updating its OCD guidance, and the new version is due in 2027. As part of this, it is looking at evidence on CBT with ERP delivered remotely as well as face to face.

We see everyone online by Zoom, so you can join from home. OCD Action says some exposure work should ideally take place where OCD affects you most, such as at home. Not sure online therapy will suit you? Talk it through at an Initial Consultation.

No. Dr Craig Govan is a clinical psychologist, not a medical doctor, so he does not prescribe medicine. Our treatment is talking therapy.

The NHS says medicine for OCD is usually an SSRI, a type of antidepressant. It says you may need it if talking therapy has not helped, or if your OCD is fairly severe.

For adults with moderate OCD, current NICE guidance (CG31) says you should be offered a choice of an SSRI or more intensive CBT with ERP. For severe OCD, it suggests both together. Speak to a GP if you would like to talk about medicine.

If you already take medicine for OCD, do not stop without speaking to your doctor first. The NHS says stopping an SSRI suddenly can cause unpleasant side effects. Read more about medicine and therapy for OCD.

Yes. Our clinical psychologist works with children and adults. The NHS says OCD can start as early as age 6, but it often begins around puberty and early adulthood.

Some children and young people have OCD that has a moderate or severe impact on their lives. For them, current NICE guidance (CG31) says CBT with ERP is the treatment of choice. It should involve the family and suit the child’s stage of development.

Alongside ERP, our approach can also include family and systemic work. This means working with the family as a whole, not only with the child.

Read our guide to OCD in children and young people, or see how to book an Initial Consultation to talk through your concerns.

Our current prices for each service are on our fees and services page.

We offer the Initial Consultation at a discounted rate. You can only use it once. If you go ahead with treatment, we deduct its fee from your next booking.

Treatment sessions last 50 minutes. You get a discount when you book four or more sessions in advance. You pay for block bookings in advance by bank transfer.

The Initial Consultation is a 30-minute online session with our clinical psychologist. You can talk about your concerns, get a clinical opinion and advice, and make a personalised treatment plan together.

We offer it at a discounted rate, and you can only use it once. If you go ahead with treatment, we deduct the fee from your next booking. Check the Initial Consultation price on our fees page.

No. You do not need a referral from a GP or anyone else. You can book an Initial Consultation online yourself. Find out how to get started, or email craig@ocdtreatment.co.uk.

If you would prefer NHS treatment, you can speak to a GP, who may be able to refer you. In England, the NHS says you can also refer yourself to an NHS talking therapies service. To do this, you need to be 18 or over (16 or 17 in some areas).

No. You can book an Initial Consultation or treatment with us without a diagnosis. Everyone is welcome.

If you would like a formal diagnosis, our Assessment & Diagnosis is an optional, one-off 90-minute online appointment. If you meet the criteria for OCD, you get an official letter from a registered clinical psychologist. If not, we give you recommendations and our view of what may be going on.

You can skip it if you already have a diagnosis or feel you do not need one. See what each service includes.

Yes, with a few limits. We keep what you tell us confidential. Our clinical psychologist is registered with the Health and Care Professions Council (HCPC). HCPC standards say we can only share confidential information:

• with your permission
• where the law allows
• when it is in your best interests
• in the public interest, for example to prevent harm

Many people with OCD feel ashamed and find their symptoms very hard to talk about, even with professionals. Current NICE guidance (CG31) says sexual, aggressive or death-related intrusive thoughts are common in OCD and are often wrongly taken as a sign of risk. You can talk about them openly with us.

Information about your mental health is a special category of personal data under UK data protection law, so it needs extra protection. Our privacy policy explains how we use your information.

In the UK, ‘clinical psychologist’ is a title protected by law. Anyone using it must be registered with the Health and Care Professions Council (HCPC). The word ‘psychologist’ on its own is not protected, and OCD-UK points out that anyone can call themselves a therapist.

The HCPC advises checking its online Register (opens in a new tab) if you are unsure. You can search by profession and surname, or by registration number.

Dr Craig Govan is a clinical psychologist registered with the HCPC. He is not a medical doctor. To find him on the Register, choose the profession ‘Practitioner psychologist’ and search for the surname ‘Govan’. Read more about Dr Govan and our clinic.

We are not an emergency service, and we cannot monitor emails for urgent help. If you need help right now, do not wait to hear from us. Call 999 or go to A&E now if someone’s life is at risk. Do the same if you do not feel you can keep yourself or someone else safe. The NHS says you will not be wasting anyone’s time.

For urgent help that is not an emergency:

• England: call 111 and choose the mental health option, or use 111 online (opens in a new tab)
• Wales: call 111 and press 2
• Scotland: call NHS 24 on 111 and choose the mental health option
• Northern Ireland: call Lifeline on 0808 808 8000

You can also call Samaritans free on 116 123, day or night, or text SHOUT to 85258.

If you are under 19, you can call Childline free on 0800 1111, any time. Our urgent help page has more options.