OCD Therapy
OCD Therapy Online across Ontario to address intrusive thoughts, compulsions, and phobias.
Are intrusive thoughts or repetitive behaviours taking over your life?
Obsessive-compulsive disorder (OCD) can feel like your mind is stuck in a loop, where worries, fears, or urges control your actions. Research shows that OCD affects about 1% of Canadians (approximately 400,000 people), and without treatment symptoms can persist and significantly impact daily life, relationships, and well-being.
- Do you fear causing serious harm to yourself or others if you don’t do "X"?
- Do you repeat words or phrases when you think of something uncomfortable?
- Are you tired of checking if you locked the door properly?
- Do you worry about contamination and wash your hands repetitively?
- Do you have a particular phobia that causes you distress?
Work with a therapist and learn to reduce intrusive thoughts, fears, compulsive behaviour, and regain more control in your life.
OCD Therapy | Toronto, ON
Common Symptoms of OCD
OCD can show up as unwanted, repetitive thoughts, images, or urges – what we call obsessions – and the routines or rituals you might do to try to ease the worry or discomfort they bring, called compulsions. Even when you know these thoughts or behaviours don’t fully make sense, it can feel almost impossible not to follow through, because doing so brings temporary relief or helps prevent something you fear.
- Persistent unwanted thoughts
- Rituals and routines to feel safe
- Fear of harming self or others
- Repetitive uncontrolled behaviours
- Anxiety about germs & contamination
- Phobias causing distress or avoidance
- Aggressive intrusive images
- Avoidance of places & people
- Perfectionism
- Need for order and symmetry
- Excessive doubt or checking
- Anxiety disorders
In OCD therapy, your therapist will guide you in a structured and compassionate way to help you reduce your distress and reduce the behaviours that keep compulsions, phobias or anxiety going.
horizon therapy | Toronto, ontario
Meet Tom Walpole
Work with Tom, who provides OCD therapy online across Ontario integrating Exposure and Response Prevention (ERP) to help you better manage OCD Compulsions, Phobias and General Anxiety.
Tom Walpole, MSW, RSW
Registered Social Worker
- Accepting New Clients
- OCD
- ADHD
- Anxiety
- Phobias
- Relationships
- Neurodiversity
OCD Therapy | Toronto, ON
Understanding OCD, Anxiety & ADHD
Living with OCD can feel overwhelming, and when anxiety or ADHD are also part of the picture, everyday life can feel like a constant uphill climb. Understanding how these conditions interact is the first step toward finding relief and regaining control.
OCD and Anxiety
Anxiety is a big part of how OCD works, but it isn’t the root cause. Think of anxiety as the fuel that keeps OCD going. OCD develops from a mix of factors like brain chemistry, genetics, learning, and how someone relates to uncertainty. When an intrusive thought shows up, anxiety is the reaction that follows.
The OCD cycle usually looks like this: an unwanted thought pops into your mind, anxiety spikes, and you do something to feel better, like checking, avoiding, or mentally reviewing. The relief feels real, but it’s short-lived. Your brain learns that the compulsion helped, so it asks you to do it again next time. Over time, the thoughts feel louder and more urgent.
The tricky part is that compulsions don’t actually solve the problem. They teach the brain that the thought was dangerous and needed fixing, which keeps the cycle alive.
OCD and ADHD
OCD and ADHD can affect some of the same brain systems, especially those involved in attention, impulse control, emotional regulation, and executive functioning. When someone has both, the conditions can amplify each other. ADHD-related distractibility can make it harder to resist compulsions or stick with exposure-based treatment. At the same time, OCD-related anxiety and mental rituals can overwhelm an already taxed attention system, leading to burnout, frustration, and shame.
The two conditions can mask each other. For example, ADHD-related impulsivity might be mistaken for “poor insight” in OCD, while OCD-related avoidance or mental checking can look like inattention. This is one reason people with both conditions are sometimes misdiagnosed or diagnosed later in life.
Because ADHD can affect how OCD shows up, treatment can be paced and adapted to support focus, emotional regulation, and motivation while still addressing the OCD cycle directly.
OCD treatment isn’t about eliminating thoughts, but changing how you respond to them. As you learn to relate differently to anxiety, the brain slowly settles, and the OCD cycle begins to loosen its hold. And if you have ADHD, therapy can be tailored to how your brain actually works so that you are better able to manage your emotions, fears, and daily life.
OCD subtypes we support | Toronto, ON
OCD Subtypes
Obsessive compulsive disorder entails obsessions and compulsions that are time consuming, taking more than one hour of your day, or significantly disrupting your daily life. OCD doesn’t always appear visibly – it can take a silent grip in the form of panic, excessive self doubting and mental rituals. Our OCD program can support you with:
Contamination OCD
Focus on fears of germs, illness, or contamination that lead to excessive cleaning, washing, or avoidance.
Relationship OCD
ROCD involves persistent doubts and intrusive thoughts about one’s relationship or partner, despite genuine care or commitment.
Checking OCD
Involves repeated checking of doors, locks, appliances, or bodily sensations driven by fear of danger or responsibility.
Harm OCD
Includes unwanted thoughts or images about causing harm to oneself or others, despite having no desire to act on them.
Ordering & Symmetry OCD
Focuses on intense discomfort when things feel uneven, misaligned, or not “just right.”
Religious OCD (Scrupolosity)
Centres on intrusive fears about morality, sin, or being a bad person, often linked to religious or ethical beliefs.
Pure O - Intrusive Thoughts
Characterized by mostly mental obsessions and internal compulsions such as rumination, reassurance seeking, or mental reviewing.
Emetophobia
A fear of vomiting or seeing others vomit that can lead to avoidance of foods, places, or bodily sensations.
Pregnancy OCD
Involves intrusive fears related to pregnancy, childbirth, or the baby’s safety that feel distressing and unwanted.
Phobias
We help with a variety of feared situations, referred to as triggers, such as spiders, heights, needles, or elevators etcetera
OCD Treatment | Toronto, ON
What’s Possible Through
OCD Therapy
- Strengthen confidence in managing OCD triggers.
- Face feared thoughts and images safely with guided exposure.
- Reframe thoughts and learn to see obsessions as "false alarms" from the brain.
- Challenge intrusive thoughts and respond differently.
- Resist compulsions and watch anxiety naturally drop.
- Tolerate uncertainty without seeking reassurance.
- Build coping skills for distress tolerance without rituals.
- Reduce OCD symptoms and improve daily life!
OCD Treatment | Toronto, ON
Approaches We Use for OCD Treatment
Whether your OCD symptoms are mild or severe, we use evidence-based trauma informed approaches to support you, taking into account your symptoms, readiness, and goals. Our approach is collaborative and compassionate and we will go at your pace, supporting you as you grow.
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) helps you identify and challenge the negative thought patterns that fuel cycles of anxiety, fear, and self-doubt.
Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP) therapy is a specialized form of cognitive behavioural therapy (CBT) most commonly used to treat Obsessive-Compulsive Disorder (OCD), though it can also be helpful for other anxiety-related concerns. ERP works by gently and gradually helping individuals face situations, thoughts, or images that trigger anxiety or intrusive thoughts (the “exposure” part), while learning to resist engaging in compulsive behaviours or avoidance strategies (the “response prevention” part). Over time, this process helps the brain learn that anxiety naturally decreases on its own without needing to rely on compulsions, leading to reduced distress and greater freedom in daily life. Exposure therapy safely helps you face your fears and anxiety without relying on compulsions and rituals.
Acceptance & Commitment Therapy
ACT teaches you how to accept difficult thoughts without letting them run your life and to learn to stay focused on your values and what’s most important to you.
Mindfulness Therapy
Mindfulness therapy supports you to become more aware of your thoughts and feelings, and learn to tolerate discomfort, and move through distress.
Psycho-education and Home Practice
We will help you better understand OCD and happening in your brain and body which help reduce fear and shame. We’ll offer you clear, compassionate information about OCD and tools like worksheets and take-home practices to support your learning and growth between sessions.
What About Medication for OCD?
Medication can be an important part of OCD treatment for some people, often alongside therapy. Before medication is prescribed, a qualified healthcare professional such as a family doctor or psychiatrist will complete a careful assessment to understand symptoms and confirm a diagnosis of OCD. If medication is recommended, the most commonly used options today are selective serotonin reuptake inhibitors (SSRIs). Research shows that about 40–60 percent of people with OCD experience a meaningful reduction in symptoms with SSRIs, especially when the dose is carefully adjusted and monitored over time.
It is important to stress that there is no single “right” choice when it comes to taking medication. Treatment decisions should always be collaborative and based on your goals, comfort level, and overall wellbeing. If you do take medication, it is often most effective when combined with Exposure and Response Prevention (ERP) therapy, the gold standard psychological treatment for OCD.
OCD Therapy in Toronto & Across Ontario
Questions About OCD Therapy
What causes obsessive compulsive disorder (OCD)?
OCD is influenced by biology and genetics, meaning some people have a higher likelihood of developing it. However, not everyone with this genetic tendency will experience OCD. Experts think that the condition often appears when a genetic vulnerability combines with triggers such as significant stress, traumatic experiences, or certain infections.
What is ERP?
Does ERP mean forcing myself into scary situations?
No. ERP is done slowly, collaboratively, and at a pace that feels manageable. You and your therapist work together to create a plan that builds confidence over time. The goal is not to overwhelm you, but to help you feel more in control.
Is OCD an anxiety disorder?
OCD used to be grouped with anxiety disorders, but it is now considered its own condition. Anxiety plays a big role in how OCD shows up, but OCD is really about how the brain responds to uncertainty, discomfort, and perceived threat.
Will ERP make my anxiety worse?
ERP can feel uncomfortable at first, because it involves not doing compulsions. However, research consistently shows that anxiety decreases over time as the brain learns it does not need to stay on high alert. Many people find ERP empowering once they see it working.
What is the difference between obsessions and compulsions?
Obsessions are the thoughts, images, or urges that trigger anxiety. Compulsions are the actions you take to reduce that anxiety, like checking, washing, avoiding, or mentally reviewing. The relief from compulsions is usually temporary, which is why the cycle keeps repeating.
Do I need an OCD diagnosis to be in your program?
No, you don’t require an official diagnosis to register for our OCD treatment program. If you would like to explore a diagnosis however, we are happy to refer you to a mental health professional who offers assessments for OCD.
How is OCD diagnosed?
OCD is diagnosed by a trained mental health professional through a thorough assessment. This usually involves discussing your symptoms, their intensity, how much they interfere with daily life, and your personal and family history. Sometimes, questionnaires or structured interviews are used to support the diagnosis. We can refer you to a professional if you’d like to pursue an assessment.
How does OCD look different from person to person?
OCD can focus on many themes, including contamination, harm, relationships, religion, morality, health, or responsibility. Some compulsions are visible, while others are mental and easy to miss. Two people can have OCD and experience it very differently.
Can ERP help with anxiety or phobias?
ERP is a highly effective, evidence-based therapy for many forms of anxiety disorders, especially phobias (dogs, flying, medical appointments, bridges etc) and obsessive-compulsive patterns. ERP works by gently and gradually helping individuals face feared thoughts, situations, or sensations while learning to respond differently, rather than avoiding or engaging in anxiety-driven behaviours. Over time, this reduces anxiety and builds confidence and resilience.
Can OCD actually get better?
Yes. OCD is very treatable, especially with evidence-based approaches like ERP. Treatment focuses on changing how you respond to thoughts, not getting rid of them. With practice and support, many people experience less distress, fewer compulsions, and a stronger sense of confidence in daily life.
Books on OCD
The OCD Workbook:(Hyman & Pedrick)
Brain Lock: (Schwartz)
Sources
- Cognitive‑Behavioral Therapy and OCD Treatment Outcomes. Abramowitz, J. S. (1997). Cognitive‑Behavioral Therapy for Obsessive‑Compulsive Disorder.
- Anxiety and Depression Comorbidity in OCD van Oppen, P., et al. (2003). The comorbidity of anxiety and depression symptoms in obsessive‑compulsive disorder: A network analysis.
- ERP Combined with Medication Improves OCD and Related Symptoms
Mao, L., Hu, M., Wu, Y., & Zou, J. (2022). The effectiveness of exposure and response prevention combined with pharmacotherapy for obsessive‑compulsive disorder: A systematic review and meta‑analysis. Frontiers in Psychiatry, 13, 973838.
Horizon Therapy | Toronto, ON
How To Get Started
Book Online To Get Started
You can book an appointment or a free consultation anytime using our online booking platform or by connecting with us by completing our contact form.
You don’t have to have it all figured out to begin. If you’re feeling ready, you can book an appointment directly, using our online booking platform, or complete the form below and we’ll help connect you with a therapist who feels like the right fit.
Send us a message through our contact form, email us or give us a call! We’re here to listen, answer your questions and help you find the support that feels right for you.