OCD THERAPY & EXPOSURE AND RESPONSE PREVENTION

OCD Therapy and ERP Support in Ontario

ERP with Hannah in London and online across Ontario. In-person counselling is also available in Burlington.

When intrusive thoughts, checking, reassurance, mental reviewing or rituals keep pulling you into the same loop, therapy can help you understand what is happening and practise a different response. Our approach is collaborative, practical and paced with you.

Hannah Steyaert, M.A., RP offers Exposure and Response Prevention (ERP). If you are in Burlington, a free consultation can help you compare in-person counselling with Hailey and online ERP with Hannah.

Book a Free 15-Minute Consultation See How ERP Works

Intrusive thoughts

Unwanted thoughts, images, urges or doubts

Compulsions

Behavioural or mental rituals used to seek relief or certainty

ERP

A first-line psychological treatment for OCD

Collaborative

Treatment planned collaboratively with you

What OCD Can Look Like

Obsessive-compulsive disorder (OCD) involves obsessions and compulsions. Obsessions can show up as unwanted thoughts, images, urges or doubts. Compulsions are repeated behaviours or mental acts used to reduce distress, feel certain, prevent something feared or make things feel “just right.”

The relief from a compulsion can feel real, but it is often brief. Over time, the urge to check, avoid, repeat, ask for reassurance or mentally review can become harder to step away from.

An intrusive thought is not the same as wanting it, agreeing with it or intending to act on it. OCD can attach distress and doubt to thoughts that feel especially important, disturbing or out of character.

Obsessions may involve

  • contamination, illness or fear of being responsible for harm
  • repeated doubts about safety, mistakes or whether something was done correctly
  • morality, religion or scrupulosity
  • sexual, aggressive or other intrusive content that feels upsetting or inconsistent with your values
  • relationships, identity or repeated “what if” questions
  • symmetry, exactness or a strong “just-right” feeling

Compulsions may include

  • checking, repeating, washing or cleaning
  • asking for reassurance, confessing or seeking certainty from other people
  • counting, arranging or repeating actions until they feel right
  • mental reviewing, neutralizing, praying or repeating phrases internally
  • researching the same question again and again
  • avoiding people, places, objects, thoughts or situations that trigger uncertainty

THE PATTERN ERP TARGETS

Understanding the OCD Cycle

The details differ from person to person, but OCD often becomes self-reinforcing. A compulsion or avoidance strategy may reduce distress for a moment, which can make that response feel more necessary the next time uncertainty appears.

01

Trigger or obsession

A thought, image, urge, sensation or situation catches your attention.

02

Distress and uncertainty

Your mind treats the uncertainty as something that must be solved or neutralized.

03

Compulsion or avoidance

You check, repeat, review, reassure, research, avoid or perform another ritual.

04

Short-term relief

Relief can reinforce the loop, making the same response more tempting next time.

EXPOSURE AND RESPONSE PREVENTION

How ERP Works for OCD

Exposure and Response Prevention (ERP) is a form of Cognitive Behavioural Therapy (CBT) widely used in the treatment of OCD. The exposure part means intentionally practising contact with a trigger, thought, image, urge, sensation or uncertainty. Response prevention means practising not doing the compulsion or avoidance that would usually follow.

The International OCD Foundation describes ERP as a first-line psychological treatment for OCD. NICE guidance also recommends CBT that includes ERP. At Steyaert Counselling, ERP is a confirmed part of Hannah Steyaert’s approach.

Learn About CBT Meet Hannah

01

Map the pattern

Notice the obsessions, compulsions, avoidance and reassurance that keep the cycle going.

02

Choose meaningful targets

Build a plan around situations that matter in your real life, rather than doing exposure for exposure’s sake.

03

Practise a different response

Approach uncertainty gradually while reducing the ritual, reassurance or avoidance that normally follows.

04

Review and adjust

Notice what you learn, refine the plan and make the next step realistic enough to practise.

Gradual and collaborative

ERP can be uncomfortable because it asks you to practise making room for uncertainty without immediately neutralizing it. That does not mean starting with your hardest fear. You and your therapist agree on the plan, build gradually and review what feels useful. You should not be forced or tricked into exposure.

What OCD-Focused Therapy May Involve at Steyaert

We start by understanding what is happening before deciding which tools are most useful. That includes the patterns that feel hardest to interrupt and what you would like to be different in daily life.

  • clarifying the obsessions, compulsions, avoidance and reassurance that are taking up the most space
  • setting practical goals that are meaningful to you
  • using ERP with Hannah when OCD-focused exposure and response prevention is an appropriate fit
  • using CBT strategies to examine beliefs, predictions and behavioural patterns that interact with OCD
  • drawing from ACT when values, willingness and making room for discomfort support the treatment plan
  • discussing relationship or family accommodation when reassurance and participation in rituals are part of the cycle
  • planning realistic between-session practice when it is useful

Where ACT and mindfulness fit

ACT and mindfulness skills can support OCD treatment by helping you notice thoughts without automatically responding, make room for discomfort and return attention to what matters. When ERP is an appropriate treatment option, we use these approaches to support the plan rather than present them as a replacement for ERP.

Medication and other levels of care

Steyaert Counselling does not prescribe medication. CAMH notes that OCD treatment commonly includes CBT and medication. If medication, diagnostic clarification or more intensive care may be relevant, you can discuss those questions with your physician or another appropriate regulated professional.

DECIDING WHETHER TO REACH OUT

It May Be Worth Asking About OCD-Focused Therapy If…

You do not need to score yourself or meet an online threshold before asking for help. These are simply examples of patterns that may be useful to bring into a consultation.

  • checking, cleaning, repeating or mental rituals are taking more time than you want
  • you keep asking for reassurance even when the answer only helps briefly
  • you are avoiding people, places, objects or decisions because uncertainty feels hard to tolerate
  • intrusive thoughts feel sticky, shameful or difficult to disengage from
  • you repeatedly research, review memories or confess in an effort to feel completely certain
  • previous therapy has helped you understand your feelings but has not directly addressed compulsions or avoidance

THERAPIST FIT

Who You May Work With

Therapist fit and location are related, but they are not the same decision. For OCD specifically, the treatment approach you are looking for matters too.

Hannah Steyaert, Registered Psychotherapist in London, Ontario

Hannah Steyaert, M.A., RP

London and online across Ontario

ERP IS A CONFIRMED PART OF HANNAH’S APPROACH

Hannah primarily works from a psychodynamic perspective and also offers ERP, CBT, ACT, DBT and attachment-based therapy. If you are looking specifically for OCD-focused ERP, a consultation can help you decide whether working with Hannah fits your goals and circumstances.

In person: 659 Central Ave, Suite 15, London · Free parking · 226-970-2861

Meet Hannah
Hailey Steyaert, Registered Psychotherapist in Burlington, Ontario

Hailey Steyaert, M.A., RP

Burlington and online across Ontario

BURLINGTON AND ONLINE ACROSS ONTARIO

Hailey’s confirmed approaches include ACT, trauma-focused and trauma-informed therapy, EFT and DBT-informed tools. If ERP is specifically what you are looking for, Hannah currently offers ERP in London and online across Ontario. A consultation can help you compare the options.

In person: 582 Guelph Line, Burlington · Free parking · 647-970-1790

Meet Hailey
Book a Free 15-Minute Consultation

London, Burlington and Online Options

You can meet with us in London or Burlington, or choose online therapy anywhere in Ontario. If you are specifically looking for ERP, Hannah offers it in London and online.

London

IN-PERSON WITH HANNAH

Meet with Hannah in person at 659 Central Ave, Suite 15. Free parking is available. Online therapy is also available across Ontario, and phone consultations are available.

Explore London therapy →

Burlington

IN-PERSON WITH HAILEY

Meet with Hailey in person at 582 Guelph Line. Free parking is available. Online therapy is also available across Ontario, and phone consultations are available.

Explore Burlington therapy →

Online across Ontario

VIRTUAL THERAPY ACROSS ONTARIO

Both Hannah and Hailey offer online therapy across Ontario and phone consultations. Hannah also offers ERP online when it is a suitable fit.

Explore online therapy →

COMMON QUESTIONS

Questions About OCD Therapy and ERP

You do not need to know the terminology before reaching out. These answers cover the practical questions that most affect treatment fit and next steps.

ERP stands for Exposure and Response Prevention. It is a form of CBT that pairs planned exposure to OCD triggers or uncertainty with practice reducing the compulsion, reassurance or avoidance that would normally follow. The International OCD Foundation and NICE both identify ERP-based CBT as a first-line psychological treatment for OCD.

No. ERP should be collaborative and planned. You and your therapist can build a hierarchy or sequence of practice steps, starting at a level that is challenging enough to learn from but realistic enough to attempt. The IOCDF specifically notes that people should not be forced or deceived into exposure.

No. You do not need to arrive with a diagnosis to book a consultation or explain the patterns that are concerning you. If diagnostic clarification, medication assessment or a different level of care becomes important, we can discuss what type of referral or professional may be appropriate.

ERP can address mental rituals as well as visible behaviours. NICE guidance specifically includes exposure to obsessive thoughts with response prevention for mental rituals and neutralizing strategies. The work starts by identifying what you do internally to seek certainty or reduce distress, not only what other people can see.

ACT, mindfulness and broader CBT skills can support OCD treatment. When ERP is an appropriate treatment option, these approaches can complement the plan rather than take its place. ERP is the main OCD-specific treatment discussed here because it is widely recommended as a first-line psychological treatment.

Yes, when it is useful and everyone involved is comfortable with it. Reassurance, participation in rituals or changes to routines can sometimes become part of the OCD cycle. Therapy can include discussion of how a partner or family member responds, but you do not need to bring someone else to begin individual therapy.

Start with the free 15-minute consultation or the contact form below. Hailey provides in-person counselling in Burlington, while ERP is a confirmed part of Hannah’s approach in London and online across Ontario. We can help you compare the location and treatment options before you decide what feels like the right fit.

There is no fixed session count at Steyaert Counselling. The length and frequency of therapy can depend on the patterns being addressed, your goals, how much OCD is interfering with daily life, the pace of ERP practice and whether other concerns need attention. We would rather review progress with you than promise a set timeline.

Yes, ERP can be used while someone is taking medication when the treatment team considers that appropriate. Steyaert Counselling does not prescribe medication, so medication questions should be discussed with a physician or other qualified prescriber. CAMH describes CBT and medication as established treatment options for OCD.

A SIMPLE NEXT STEP

Book a Free 15-Minute Consultation

You do not need to decide on a treatment plan before reaching out. A consultation gives you a chance to briefly explain what has been happening, ask about ERP or another approach, and talk through whether Hannah, Hailey, London, Burlington or online therapy seems like the best fit for what you are looking for.

Book a Free 15-Minute Consultation Ask a Question

Clinical Information and Further Reading

This page is written for people deciding whether to seek therapy, so we have kept the clinical detail focused. For more in-depth information about OCD and treatment, these are useful starting points:

You may also want to explore individual therapy or review therapy fees and insurance information.