Anxiety and OCD Therapy

Treatment begins with understanding the situations, thoughts, and responses that contribute to ongoing distress. Cognitive behavioral therapy (CBT) helps clients recognize these patterns and practice new ways of responding. Treatment is tailored to each person’s age, needs, and goals, including activities and experiences they would like to approach with greater comfort and confidence.

When separation anxiety disrupts daily routines, therapy may involve the child and caregivers. We consider the child’s developmental needs, the situations that trigger distress, and the responses that may maintain anxiety. Evidence-based treatments, including cognitive behavioral therapy (CBT) and gradual exposure to separation-related situations, help children build coping skills and increase confidence with age-appropriate independence. Caregivers are supported in responding consistently to anxiety and reinforcing progress toward everyday activities.

Selective mutism is an anxiety disorder characterized by difficulty speaking in certain settings despite speaking in others. Treatment uses gradual, structured practice to help children become more comfortable communicating in situations that trigger anxiety. This may include starting with nonverbal communication, gradually introducing sounds and words, and expanding speaking to additional people and settings as the child becomes more comfortable. Clinicians may collaborate with caregivers and, with permission, school staff to support progress across environments while following the child’s developmental needs and pace.

Obsessive-compulsive disorder (OCD) involves unwanted, intrusive thoughts, images, or urges (obsessions) and repetitive behaviors or mental acts (compulsions) intended to reduce distress or prevent a feared outcome. OCD does not always look the way it is portrayed in the media. It may involve visible rituals, but it can also include mental reviewing, repeated checking for certainty, reassurance seeking, avoidance, or persistent doubts that interfere with relationships, school, work, faith, and daily life. Even when compulsions are not apparent to others, OCD can cause significant distress and consume considerable time and energy.

Exposure and response prevention (ERP) is an evidence-based treatment for OCD that helps individuals gradually face situations, thoughts, images, or uncertainties that trigger obsessive fears while practicing not engaging in compulsions. With guidance from a trained clinician, treatment is collaborative and tailored to the person’s specific symptoms, developmental needs, and goals.

ERP does not require individuals to prove that their fears are unfounded or eliminate intrusive thoughts. Instead, it helps them learn to tolerate uncertainty and distress without relying on compulsions for relief. For someone experiencing scrupulosity, this might involve allowing a question about a moral decision to remain unanswered rather than repeatedly reviewing it, seeking reassurance, or repeating a prayer until it feels exactly right. Treatment is designed to help individuals live more freely in alignment with their values, rather than allowing OCD to dictate their choices.

Anxiety and OCD can affect family routines and relationships, not just the individual experiencing symptoms. Caregiver sessions, parent education, and group support can help families understand the treatment approach and respond consistently between appointments. To learn about available parent workshops and support groups, visit current events or contact Therapy SoCal to ask which options are currently offered.