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Obsessive Compulsive Disorder (OCD) Treatment in Brisbane
OCD can make even everyday moments feel exhausting and overwhelming. Our experienced Brisbane psychologists use evidence-based treatment to help you reclaim your life.
If you are living with OCD, you may feel trapped in a cycle of unwanted thoughts and repetitive behaviours that seem impossible to break. These experiences can be exhausting, isolating, and deeply distressing, but OCD is a well-understood condition, and with the right psychological treatment, people can manage symptoms, regain their time and engage more fully in life.
What is OCD?
Obsessive Compulsive Disorder (OCD) is a mental health condition that affects around 3% of Australians1. Symptoms typically first emerge in late childhood or early adolescence, although OCD can develop at any age. Diagnostically, OCD involves two core features: obsessions and compulsions.
Obsessions are unwanted, intrusive thoughts, images, or urges that enter the mind repeatedly and cause significant distress. They are not something the person chooses to think; they are often involuntary, intrusive, and difficult to dismiss.
Compulsions are repetitive behaviours or mental acts that a person feels driven to perform in response to an obsession, usually to reduce anxiety or prevent a feared outcome. While compulsions offer temporary relief, they ultimately maintain and strengthen the OCD cycle rather than resolving it.
On this page
It is important to understand that OCD is not simply being "neat" or "particular." A clinical diagnosis of OCD involves clinically significant obsessions and compulsions that are time-consuming, cause significant distress, and interfere meaningfully with daily functioning at work, in relationships, or in everyday routines.
What is the difference between OCD vs OCPD?
OCD is also distinct from Obsessive-Compulsive Personality Disorder (OCPD), which involves rigid patterns of perfectionism and need for control without the discrete obsessions and compulsions of OCD.
Signs and Symptoms of OCD
It is common for people with OCD to feel a sense of shame regarding their thoughts and try to conceal their symptoms. This shame can delay people seeking help; however, it is worth noting that symptoms of OCD are not a reflection of a person’s character or intentions, but rather the consequence of a complex interplay of genetic, neurological and environmental factors.
Obsessions
Common obsessional themes include:
- Fear of contamination from germs, dirt, chemicals, or bodily fluids.
- Fear of harming yourself or others, even though you do not want to.
- Intrusive violent, religious or other types of thoughts that are unwanted and not consistent with the person’s underlying beliefs.
- Fear of making mistakes or causing harm through carelessness (e.g. leaving a door unlocked or an appliance on).
- A need for things to feel "just right". Concern regarding a feeling of incompleteness or asymmetry.
- Excessive doubt about relationships, morality, or one's own identity
Compulsions
Common compulsive behaviours include:
- Excessive handwashing, cleaning, or disinfecting
- Repeated checking of locks, switches, taps, or appliances
- Counting, arranging, or ordering objects in a specific way
- Mental rituals such as repeating words, prayers, or phrases silently
What Causes and Maintains OCD
Obsessive-Compulsive Disorder (OCD) is a complex condition driven by a combination of biological, genetic, and environmental factors:
Brain Circuitry
Research suggests that impairments in certain brain circuitry can affect the brain's ability to filter out intrusive thoughts and suppress compulsive urges.
Neurochemistry
Imbalances in key neurotransmitters—specifically serotonin, dopamine, and glutamate—disrupt communication within these brain circuits.
Genetics
OCD has a strong hereditary link, with a heritability rate of 45% to 65% in children and 27% to 47% in adults. It is polygenic, meaning it involves multiple genes.
Environmental Triggers
Severe stress, childhood trauma, or early developmental exposures can activate genetic vulnerabilities.
Cognitive Cycles
Distortions like perfectionism, inflated responsibility, and an intolerance of uncertainty cause anxiety. Compulsive rituals are learned behaviors used to find temporary relief, which reinforces the cycle. See details of the OCD cycle below.
How is OCD Treated?
There are effective treatments available for OCD, with psychological therapy suggested as the go-to treatment in combination with or separate from medication. The most evidence-based approaches are:
Exposure and Response Prevention (ERP)
ERP is considered the gold standard psychological treatment for OCD which is a specialised form of Cognitive Behavioural Therapy (CBT). It involves gradually and systematically confronting feared situations, objects, or thoughts and resisting the urge to engage in the compulsive response.
Rather than eliminating anxiety immediately, ERP works by allowing the anxiety to peak and naturally subside without the compulsion, gradually weakening the OCD cycle. This process is always collaborative, structured, and paced to suit the individual. Your psychologist will work with you to develop a personalised hierarchy of exposures and will never ask you to face anything without preparation and support.
What to Expect in OCD ERP Treatment Sessions
Initial assessment
Your first appointment will involve a thorough discussion of your symptoms, how they developed, their impact on your daily life, and your history. Your psychologist may use questionnaires to assess symptom severity and establish a baseline for tracking progress.
Psychoeducation
Early sessions will include education about the nature of OCD. Understanding the obsession-compulsion cycle, the role of avoidance and reassurance-seeking in maintaining symptoms, and why standard anxiety management strategies often make OCD worse rather than better.
Building your ERP hierarchy
Together with your psychologist, you will develop a personalised list of feared situations, thoughts, and triggers, ranked by difficulty. ERP begins at manageable levels and progresses at a pace that is challenging but sustainable.
Active exposure work
Sessions will involve practising exposures with the support of your psychologist, both in-session and through between-session tasks. Your psychologist will help you process each exposure and refine the approach over time.
Relapse prevention
As treatment progresses, sessions focus on consolidating gains, identifying early warning signs, and building a long-term plan for maintaining progress independently.
Cognitive Behavioural Therapy (CBT)
CBT helps identify and challenge the distorted beliefs that maintain OCD. For example, the belief that having an intrusive thought is equivalent to wanting it to happen, or that anxiety means danger.
By developing a more accurate understanding of obsessional thoughts and the nature of anxiety, people can respond to intrusions with less fear and urgency over time.
CBT and ERP are typically delivered together, as the cognitive component helps people understand and engage more effectively with the exposure work.
Acceptance and Commitment Therapy (ACT)
ACT is increasingly used alongside ERP for OCD, helping people develop a different relationship with intrusive thoughts. Observing them without engaging in compulsions or avoidance, and making room for them.
ACT focuses on psychological flexibility and valued living, which is particularly helpful when OCD has significantly narrowed the areas of life a person is engaging in.
How long does OCD treatment take?
The number of sessions that are needed to create meaningful change can vary depending on the severity of symptoms. Improvements can be seen within 10–20 sessions of ERP-focused therapy. More complex or longstanding presentations may require longer treatment. Your psychologist will discuss an expected timeframe with you at assessment.
Medicare Rebates and Fees for OCD Treatments
Medicare rebates are available with a Mental Health Treatment Plan from your GP. Please see our fees page for full information on session costs and rebates.
OCD in Children and Adolescents
OCD commonly emerges in childhood and adolescence, and early intervention is associated with better long-term outcomes. Children and teenagers with OCD often feel deeply ashamed of their symptoms and may go to great lengths to conceal them from family members.
Signs of OCD in young people can include:
Repeated reassurance-seeking
A child may repeatedly seek reassurance such as “Is this clean?”, “Am I safe?”
Checking rituals
Parents might see repeated checking of doors, taps, homework, school bags, lights, appliances, body symptoms, or whether something “bad” happened.
Washing, cleaning, or contamination fears
This can look like excessive handwashing, long showers, avoiding toilets, avoiding touching bins, door handles, school items, pets, other children, or needing clothes washed repeatedly.
“Just right” behaviours
Not all OCD is about germs. Some children need things to feel exactly right. They may repeat actions, erase and rewrite, arrange objects, step in a certain way, touch things evenly, restart tasks, or become very distressed if interrupted.
Bedtime or morning routines that become excessive
Bedtime can stretch out because of repeated checking, asking questions, needing parents to say things “the right way,” arranging items, or repeating goodnight rituals.
Avoidance
Children may avoid school, bathrooms, certain rooms, bins, playgrounds, pets, siblings, homework, or situations linked to intrusive thoughts. Avoidance can be a hidden compulsion.
Mental rituals
These are easy to miss. A child might silently count, repeat phrases, review memories, cancel out “bad” thoughts, or mentally check whether they are a good person.
School problems
OCD can show up as slow work, perfectionism, repeated erasing, difficulty finishing tests, lateness, avoiding assignments, frequent toilet use, asking teachers repeated questions, or distress when routines change.
“Meltdowns” when rituals are blocked
Parents may see anger, crying, panic, or refusal when they try to stop a ritual. This does not mean the child is being “naughty”; it often means their anxiety has spiked.
Our team works with children from age 8 and adolescents for OCD treatment, using age-adapted treatment and involving parents as active collaborators in the therapy process where appropriate.
Our psychologists who treat OCD
Dr Sascha Hardwick
DIRECTOR - CLINICAL PSYCHOLOGIST & CLINICAL NEUROPSYCHOLOGIST
Dr Sarah Pollock
TEAM LEADER - CLINICAL PSYCHOLOGIST & CLINICAL NEUROPSYCHOLOGIST
Amber Dornbusch
PSYCHOLOGIST
Dr Casey Roberts
SENIOR CLINICAL PSYCHOLOGIST
Stuart Wilkinson
CLINICAL PSYCHOLOGIST
Madison Brennan
PSYCHOLOGIST
Alice Middleton
PSYCHOLOGIST
Caitlin Knight
SENIOR CLINICAL NEUROPSYCHOLOGIST / SUPERVISOR
Mikayla Hancock
PSYCHOLOGIST
Isabella Alberti
PSYCHOLOGIST
Jac Tichbon
SENIOR CLINICAL PSYCHOLOGIST
Kate Philp
CLINICAL PSYCHOLOGIST
Dr Mathilde Gargan
CLINICAL PSYCHOLOGIST & CLINICAL NEUROPSYCHOLOGIST
Dr Teagan King
CLINICAL PSYCHOLOGIST & CLINICAL NEUROPSYCHOLOGIST
Megan Samuel
CLINICAL PSYCHOLOGIST
Wonny Kim
CLINICAL PSYCHOLOGIST
Sophia Robson
CLINICAL PSYCHOLOGIST
Dr Janet Wright
CLINICAL PSYCHOLOGIST & CLINICAL NEUROPSYCHOLOGIST
FAQ's about OCD
Is OCD an anxiety disorder?
OCD is classified in the DSM-5-TR in its own category: Obsessive-Compulsive and Related Disorders. Anxiety is a central feature of OCD, and many evidence-based anxiety treatments form the foundation of OCD therapy.
Can OCD be cured?
Evidence-based treatments such as ERP can meaningfully improve symptoms for many people. Many people reach a point where OCD no longer interferes meaningfully with their daily functioning.
Is ERP therapy painful or distressing?
ERP involves deliberately confronting feared situations, which can feel uncomfortable but it is always conducted collaboratively, at a pace you agree on, and with full preparation. The confrontation with the avoided situation is the pathway to recovery.
Most people find that the discomfort during exposures is much more manageable than anticipated and that the sense of progress and freedom is highly motivating.
What is the difference between OCD and OCPD?
OCD involves intrusive, unwanted thoughts and compulsive rituals performed to reduce anxiety. People with OCD often recognise their thoughts as “irrational”, but not always. OCPD (Obsessive-Compulsive Personality Disorder) involves a personality style characterised by perfectionism, rigidity, and need for control but without the specific obsessions and compulsions of OCD.
You can find more information about perfectionism on this page.
Can I use telehealth for OCD treatment?
Yes. OCD treatment, including ERP, can be delivered via telehealth video sessions. This can be particularly helpful for people whose OCD may initially limit their ability to get to the therapy room.
Do I need a referral to see a psychologist for OCD?
No referral is needed to book an appointment. However, a GP referral and Mental Health Treatment Plan may allow you to access Medicare rebates for your sessions.
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