Contamination and washing
Fear of germs, illness, chemicals, or feeling dirty in a way that does not lift with one wash. Cleaning, hand-washing, showering, and avoiding "contaminated" objects or places can take over large parts of the day.
Services · OCD therapy
OCD therapy that works with the loop, not against you.
Online psychotherapy for adults across Ontario, built around Exposure and Response Prevention (ERP), the front-line approach for OCD. The work is structured and collaborative, and you set the pace.
- Fee
- $160 to $180 · 50-minute individual session
- Free consultation
- 15 minutes, no charge
- Format
- Secure online video via Jane
- Modalities
- ERP, ACT, CBT
- Clinicians
- Katelyn Matias (RP, CRPO #10340), Daniella Simas Medeiros (RP Qualifying, CRPO #19387)
- Receipts
- Provided for extended-health reimbursement · HST-exempt
About OCD therapy at Anchor & Bloom.
OCD therapy at Anchor & Bloom is virtual psychotherapy for adults across Ontario who are living with obsessions and compulsions, intrusive thoughts, and the exhausting cycle of doing something to make an unwanted thought or feeling go away. Sessions are offered by Registered Psychotherapists who use Exposure and Response Prevention (ERP), the front-line approach for OCD, often combined with Acceptance and Commitment Therapy and Cognitive Behavioural Therapy.
The work is collaborative and paced. ERP is structured, but it is never about flooding you. We build the steps together, and you stay in control of how fast we move.
What OCD can feel like
The shapes OCD takes.
A thought arrives that you do not want, and it feels urgent and wrong. To make the discomfort stop, you do something: wash, check, count, pray, re-read, ask for reassurance, or run the worry through your mind one more time. The relief is real, and it is brief. Then the cycle starts again.
OCD is not about being tidy or liking things organized. It is a loop between intrusive thoughts (obsessions) and the behaviours or mental acts used to neutralize them (compulsions). The compulsion works in the short term, which is exactly why it is so hard to stop.
Common patterns clients describe in early sessions:
- Intrusive thoughts that feel disturbing, repugnant, or out of character, and the fear of what they might mean
- Checking locks, appliances, messages, or your own body, often more than once
- Contamination fears and washing or cleaning that takes far longer than it should
- A need for things to feel "just right" before you can move on
- Reassurance-seeking from people, searches, or your own memory
- Rumination and mental review that can consume hours without anyone noticing
Checking
Repeatedly checking locks, the stove, the door, emails, or your own actions to make sure nothing bad happened or will happen. The doubt returns soon after the check, which is what keeps the loop going.
Harm and intrusive thoughts
Unwanted thoughts about hurting yourself or others, or thoughts that feel violent, sexual, or blasphemous. These thoughts are distressing precisely because they clash with your values. Having them does not mean you want to act on them.
Symmetry and "just right"
A pull toward order, evenness, or symmetry, or a feeling that something is not quite complete. Arranging, repeating, or redoing actions until they feel right, sometimes with no specific feared outcome attached.
Pure-O and mental rituals
OCD that looks invisible from the outside because the compulsions are mental: reviewing, analyzing, silently reassuring, praying, or arguing with the thought. People with Pure-O often spend years not realizing it is OCD.
Relationship and responsibility themes
Obsessions about whether a relationship is right, whether you are a good person, or whether you are responsible for something going wrong. The compulsion is often endless analysis and reassurance-seeking rather than a visible behaviour.
Rumination
Hours lost to mentally chewing on a question that never resolves. Rumination can feel like problem-solving, but in OCD it functions as a compulsion: a way to chase certainty that the brain cannot actually deliver.
The arc of the work
How sessions are structured.
Most clients move through a rough arc, though no two courses of therapy look exactly the same. The phase boundaries below are illustrative, a way to picture how ERP tends to unfold, not a fixed sequence. Some people stay longer in one phase. Some return to an earlier one. Pace is set collaboratively, and revisited often.
Mapping the loop.
The first few sessions are about understanding your specific OCD: which obsessions show up, which compulsions follow, and what you avoid. We explain how the loop works and how ERP interrupts it, so the approach makes sense before we start. Nothing is rushed, and you are never asked to commit to an exposure you do not understand.
ERP in practice.
The core of the work. Together we build a hierarchy of feared situations and start with steps that feel challenging but doable. You practise approaching the trigger while not performing the compulsion or reassurance, in session and between sessions. ACT and CBT skills support the process, helping you make room for discomfort and uncertainty rather than fighting them.
Maintaining gains.
Consolidating what you have learned and planning for the long run. We work on relapse prevention, how to respond when OCD tries a new theme, and how to keep practising response prevention on your own. We also name what signs would be worth returning for, so you leave with a plan rather than just a feeling.
The core method
Exposure and Response Prevention: what that actually means.
ERP is the most studied and most effective psychotherapy for OCD. It was developed specifically for the OCD loop, and it is what we use as the foundation of the work. We are honest about what it asks of you, because ERP works through doing, not only talking.
The simple version: OCD survives on a deal. An obsession creates distress, a compulsion relieves it, and the brain learns that the compulsion is necessary. ERP breaks that deal. You deliberately approach the trigger (the exposure) and choose not to perform the usual compulsion or reassurance (the response prevention). The distress rises, and then, given time and repetition, it settles on its own. The brain learns that you can tolerate the uncertainty, and that the feared outcome is less likely or less catastrophic than it felt.
ERP is graded and collaborative. We build a hierarchy together and start where you can succeed, then move up as your tolerance grows. It is not about flooding you, tricking you, or forcing anything. You agree to each step, and you set the pace. ACT helps you make room for discomfort and act on what matters, while CBT helps loosen the beliefs that keep the loop tight.
ERP can be hard, and it asks for practice between sessions. It is also one of the clearest examples in mental health of a treatment that targets the actual mechanism of the problem. We will be straight with you about the effort involved, and we will not overstate what any single approach can promise.
Fit matters
Who this fits, who it doesn't.
A good fit for
- Adults with mild to moderate OCD who can engage in weekly outpatient ERP
- Contamination, checking, symmetry, and harm or intrusive-thought themes
- Pure-O patterns built around mental rituals and rumination
- OCD layered with anxiety, see also anxiety therapy
- People who want a structured, skills-based approach with practice between sessions
- OCD alongside a need for nervous-system support, see also nervous system regulation
Not the right primary fit for
- Acute crisis, please use the crisis resources listed on our contact page
- Active suicidal ideation requiring stabilization or psychiatric care
- Severe OCD that needs intensive or daily ERP, a higher level of care, or is significantly impairing day-to-day functioning, which is often better served by a specialized OCD program. If that is the case, we will say so and help you find an appropriate referral.
- Conditions that require medication management or psychiatric assessment as the main intervention
If you are unsure whether outpatient OCD therapy is the right next step, the free 15-minute consultation is a good place to ask, and to talk through other options if it is not.
How therapy helps
Less about removing the thoughts, more about changing your response.
Map the loop
We name your specific obsessions, the compulsions that follow, and what you avoid. Seeing the loop clearly is the first step to interrupting it.
Practise response prevention
Through graded ERP, you learn to approach what you fear and resist the compulsion, in session and between sessions, so the brain can learn something new.
Make room for uncertainty
ACT and CBT skills help you tolerate discomfort and doubt rather than chasing certainty, so OCD has less to feed on.
A typical course
What sessions look like.
- First session. An hour to map your OCD, talk about what you would like therapy to help with, and explain how ERP works. You ask questions; we share our approach.
- Following sessions. A mix of building your hierarchy, practising exposures with response prevention, and agreed-upon practice between sessions. Pace is yours to set.
- Modalities used. ERP as the foundation, supported by ACT and CBT, blended around your needs.
- Frequency. Weekly is common, especially through the active ERP phase. Many clients move to biweekly as gains hold. Some need less, some need more.
- Format. Online video sessions through Jane, a PHIPA-compliant Canadian platform.
- Length. 50 to 60 minutes.
Signs the work is taking
What changes when therapy is working.
Progress in OCD work is rarely the disappearance of intrusive thoughts. It looks more like the thoughts losing their grip, and the compulsions losing their pull. Some of the shifts clients tend to notice, in their own words:
- An intrusive thought arrives, and you notice you do not have to do anything about it.
- The urge to check or wash still shows up, but you can let it pass without acting on it.
- Time spent on rituals and rumination shrinks, and the hours come back to you.
- You ask for reassurance less, and tolerate not knowing for sure.
- You re-enter situations or places you had been avoiding.
- When OCD tries a new theme, you recognize it as the same old loop rather than a new emergency.
Therapy does not aim to guarantee that the thoughts never return. The aim is a different relationship with them, one where an intrusive thought is just a thought rather than a command.
What we draw from
Modalities we use.
ERP is the foundation of OCD work, and it is well supported by other evidence-based approaches. Below are the frames that most often come into play with OCD specifically.
Exposure and Response Prevention (ERP)
The front-line approach for OCD. Graded exposure to feared situations or thoughts, paired with choosing not to perform the compulsion or reassurance, so the brain learns it can tolerate the uncertainty.
Acceptance and Commitment Therapy (ACT)
Less about arguing with intrusive thoughts, more about making room for discomfort and acting on what matters. ACT pairs naturally with ERP, supporting willingness to sit with uncertainty.
Cognitive Behavioural Therapy (CBT)
Working with the beliefs that keep OCD tight, an inflated sense of responsibility, overestimating threat, and the need for certainty. CBT helps loosen the appraisals that give intrusive thoughts their weight.
Mindfulness-based skills
Practices for noticing thoughts without immediately reacting to them. Helpful for recognizing an intrusive thought as a passing mental event rather than a fact that demands a response.
Relapse prevention
Building a plan for the long run: how to keep practising response prevention, how to spot OCD when it switches themes, and what to do early so a flare does not become a full return.
Nervous-system-informed pacing
Attention to what the body is doing as exposures raise distress, so the work stays within a range you can tolerate. Pacing keeps ERP challenging without tipping into overwhelm.
For OCD that overlaps significantly with anxiety, see anxiety therapy. For support settling a reactive nervous system alongside ERP, see nervous system regulation.
Who offers this
Clinicians who work with OCD.
Katelyn Matias, RP
Registered Psychotherapist, CRPO #10340
Founder of Anchor & Bloom. Structured, collaborative OCD work for adults using ERP, supported by ACT and CBT, with attention to pacing and the nervous system.
About KatelynDaniella Simas Medeiros, RP (Qualifying)
Registered Psychotherapist (Qualifying), CRPO #19387, supervised under Katelyn Matias
Affirming OCD work for adults, neurodivergent clients, and people in high-pressure roles. Uses ERP, ACT, CBT, and mindfulness, with practice between sessions.
About DaniellaCommon questions about OCD therapy.
What kind of OCD does therapy at Anchor & Bloom help with?
We work with common presentations of OCD, including contamination fears, checking, symmetry and "just right" feelings, intrusive thoughts about harm, and Pure-O patterns built around mental rituals and rumination. We do not diagnose, and we do not provide intensive or higher levels of care. Severe, significantly impairing OCD may be better served by a specialized program, and we will say so.
What is Exposure and Response Prevention (ERP)?
ERP is the front-line, evidence-based approach for OCD. In ERP, you gradually and deliberately approach the situations or thoughts that trigger obsessions, while practising not performing the compulsion or reassurance that usually follows. Over time, the brain learns that the feared outcome is less likely, less catastrophic, or more tolerable than it seemed. ERP is structured, collaborative, and paced, and it is never about flooding you or forcing anything.
Do you offer medication for OCD?
No. Registered Psychotherapists in Ontario do not prescribe medication. Many people with OCD work with both a psychotherapist and a physician or psychiatrist. If medication is part of the conversation, we collaborate with your prescriber while we focus on the psychotherapy side.
Is online therapy effective for OCD?
Research from organizations such as the Centre for Addiction and Mental Health supports psychotherapy for OCD, and ERP can be delivered effectively over secure video for many adults. Online work also lets us practise exposures in the real environments where OCD shows up, such as your own kitchen, bathroom, or front door.
Will ERP make me face my worst fears all at once?
No. ERP is graded. We build a hierarchy together and start with steps that feel challenging but doable, then move up as your tolerance grows. You stay in control of the pace, and nothing happens without your agreement.
How much do sessions cost and is OCD therapy covered by insurance?
Individual sessions are $160 to $180. Most extended health benefit plans through Canadian employers cover Registered Psychotherapist services. Confirm with your insurer before booking. Psychotherapy is exempt from GST/HST as of June 2024.
For plan-by-plan coverage details, direct billing notes, and how to submit a claim, see Fees & Insurance.
Further reading
Trusted Canadian resources.
For general information on OCD and its treatment, the Centre for Addiction and Mental Health and the Canadian Mental Health Association are good starting points.
For information on the regulation of psychotherapists in Ontario, see the College of Registered Psychotherapists of Ontario.
Start with a free conversation.
A 15-minute consultation is a low-stakes way to ask questions and see if the fit feels right.
Online therapy across Ontario
Sessions are virtual province-wide, with local support for:
Toronto · Mississauga · Oakville · Burlington · Hamilton