OCD Treatment Specialist in Rochester, NY
Exposure and Response Prevention for Obsessive-Compulsive Disorder
Obsessive-compulsive disorder (OCD) can become exhausting, time-consuming, and isolating. You may find yourself caught in repetitive loops of intrusive thoughts, checking, reassurance-seeking, avoidance, mental review, or rituals that temporarily reduce anxiety but keep the cycle going.
Stephen Haramis, LCSW, PLLC provides OCD treatment in Rochester, NY, including Exposure and Response Prevention, often called ERP. ERP is a structured, evidence-based treatment that helps people gradually face feared thoughts, situations, sensations, or uncertainties while reducing the compulsive responses that maintain OCD.
Our approach is practical, collaborative, and clinically focused. Treatment is paced carefully, but it is also active: the goal is not simply to talk about OCD, but to help you build more freedom from compulsions, avoidance, and fear-driven decision-making.
Read below to find out more about OCD Treatment and related issues:
What can Exposure and Response Prevention (ERP) help with if I have OCD?
What ERP Helps With:
ERP can be useful for many OCD presentations, including:
Contamination fears
Checking compulsions
Harm-related intrusive thoughts
Relationship OCD
Sexual or religious intrusive thoughts
“Just right” OCD
Health-related/Medical obsessions
Reassurance-seeking and mental compulsions
Avoidance and rumination
What Treatment Looks Like
In the early phase of treatment, we work to understand your OCD cycle: the intrusive thoughts, feared outcomes, compulsions, avoidance patterns, and reassurance loops that keep symptoms going. From there, we develop a treatment plan that usually includes psychoeducation, exposure planning, response prevention, and between-session practice.
ERP does not mean being forced into overwhelming situations before you are ready. It means learning, step by step, how to relate differently to fear, uncertainty, and intrusive thoughts so OCD has less control over your life.
Beyond Symptom Reduction
Many people with OCD also want to understand the emotional and relational patterns around their symptoms: shame, responsibility, perfectionism, guilt, fear of harming others, or difficulty trusting themselves. When appropriate, treatment can integrate ERP with a deeper psychotherapeutic understanding of the person, not just the symptom pattern.
Start OCD Treatment
Stephen Haramis, LCSW, PLLC offers OCD treatment in Rochester, NY and telehealth therapy across New York State.
Schedule a consultation to discuss whether ERP or OCD-focused therapy may be a good fit.
OCD Treatment FAQ:
What is Exposure and Response Prevention?
Exposure and Response Prevention, or ERP, is a structured treatment for OCD. It involves gradually approaching feared thoughts, situations, sensations, or uncertainties while reducing the compulsions, avoidance, reassurance-seeking, or mental rituals that keep OCD going.
Is ERP the only treatment for OCD?
ERP is one of the best-supported treatments for OCD, but it is not the only approach that may be useful. Depending on the person and the clinical picture, treatment may also include approaches such as Inference-Based Cognitive Behavioral Therapy, or I-CBT, psychodynamic or analytic therapy, or clinical hypnotherapy as an adjunct. The goal is to use a thoughtful treatment plan that fits the person, not just the diagnosis.
Is ERP the same as just facing my fears?
No. ERP is planned and collaborative. The goal is not to overwhelm you, but to help you practice responding differently to OCD triggers in a way that builds flexibility, tolerance, and confidence over time.
What kinds of OCD can ERP help with?
ERP can be used for many OCD presentations, including contamination fears, checking, harm-related intrusive thoughts, relationship OCD, religious or moral obsessions, sexual intrusive thoughts, health-related fears, “just right” OCD, health anxiety, reassurance-seeking, rumination, and mental compulsions.
Can OCD involve mental compulsions, not just visible rituals?
Yes. Many compulsions are internal, sometimes referred to “Pure ‘O’ OCD”. These may include reviewing memories, analyzing whether a thought means something, seeking certainty, silently neutralizing thoughts, praying in a ritualized way, replaying conversations, or trying to “figure out” whether something is safe.
Do I have to do exposures I am not ready for?
No. Treatment should be paced carefully. ERP usually begins with understanding your OCD cycle, identifying compulsions and avoidance patterns, and creating a gradual plan. The work should be challenging enough to be useful, but not careless or coercive.
What about hair pulling and skin picking?
Hair pulling, also called trichotillomania, and skin picking, also called excoriation disorder, are related conditions sometimes referred to as body-focused repetitive behaviors. Treatment may include Habit Reversal Training, or HRT, as well as expanded HRT-based approaches. In some cases, clinical hypnotherapy may also be used as an adjunct.
Does your practice offer more than OCD therapy?
Yes. Stephen Haramis, LCSW, PLLC offers more than OCD treatment. The practice also provides depth-oriented psychotherapy, anxiety treatment, couples therapy, group therapy, and treatment for relational patterns, emotional difficulties, and longstanding concerns that may not fit neatly into one symptom category.
Can therapy address more than OCD symptoms?
Yes. ERP can help reduce the OCD cycle, but many people also want to understand shame, guilt, perfectionism, responsibility, relationship patterns, or difficulty trusting themselves. When appropriate, treatment can integrate OCD-focused work with deeper psychotherapeutic understanding.
How long does OCD treatment take?
The length of treatment depends on symptom severity, how long OCD has been present, the number of themes involved, co-occurring concerns, and how consistently skills are practiced between sessions. Some people benefit from shorter-term focused work, while others need longer treatment.
Do you offer OCD therapy online?
Stephen Haramis, LCSW, PLLC offers OCD treatment in Rochester, NY and telehealth therapy for clients located in New York State.
Who in this practice treats OCD?
Currently both Stephen Haramis, LCSW, BCD and Andrea Tomaino, MHC-LP treat OCD.
Is ERP covered by my insurance?
If your insurance is one of the insurances accepted by the practice (see Billing), then yes, ERP is covered in the same way any other form of talk therapy.
How do I get started?
Reach out today to set up an intake evaluation and consultation!