OCD therapy for the doubts that loop.
Online OCD therapy in California using ERP — the gold-standard, evidence-based protocol — for Pure-O, ROCD, Harm OCD, scrupulosity, and the intrusive thoughts you can't talk about.
Pure-O. ROCD. Harm OCD. Scrupulosity. The thoughts you can't say out loud without feeling ashamed, and the rituals you can't stop — even though they never quite make the fear go away.
The short version.
- Treatment — Exposure and Response Prevention (ERP), supported by ACT
- What we treat — Pure-O, ROCD, Harm OCD, scrupulosity, contamination, checking, symmetry
- Who leads it — Danielle Miller, AMFT (CA #144995), previously an OCD Exposure Coach at Psychological Care and Healing Center. Close to half her caseload is OCD
- Also treating OCD — Fidel Quintanilla, AMFT (CA #125756), previously Assistant Program Director for the treatment of OCD, Depression, Families and Couples at the same center
- Who else takes OCD cases — Fidel Quintanilla, AMFT (CA #125756) and Jasmeet Bhullar, LMFT (CA #117019), who leads the family work. Three clinicians in total; the rest of the practice refers OCD to them
- Languages — English, Spanish (Fidel), Hindi and Punjabi (Jasmeet)
- Format — entirely online, anywhere in California, weekly 50-minute sessions
- Timeline — most people see measurable change in 8–12 weeks
- Fee — $200 a session, out-of-network with monthly superbills, a few reduced-fee places
- Level of care — weekly outpatient ERP. We refer out for residential, PHP and IOP
What OCD actually is.
OCD is a loop. An intrusive thought arrives — disturbing, unwanted, and at odds with who you are. The anxiety it creates demands relief, so you perform a compulsion: a check, a ritual, a reassurance, a mental review. The relief is real but brief, and the loop tightens. The compulsion is what feeds it.
It's also frequently misunderstood, even by therapists. Most general anxiety techniques — reassurance, relaxation, talking it through — actually make OCD worse, because they function as compulsions. OCD needs a specific, evidence-based treatment: ERP.
How it shows up.
OCD is far broader than the stereotype of handwashing and tidiness. Some of the ways it shows up:
- Pure-O — intrusive thoughts with mostly invisible, mental compulsions
- ROCD — relationship doubts that loop and demand reassurance
- Harm OCD — intrusive thoughts about hurting someone, which terrify you precisely because they're against your nature
- Scrupulosity — religious or moral obsessions and compulsions
- Contamination, checking, symmetry — the more visible compulsions
- Reassurance-seeking and avoidance as the quiet, constant compulsions underneath
If the loop mostly finds you at night, Danielle wrote about that version of it in The 12 a.m. spiral.
Why ERP works.
ERP — Exposure and Response Prevention — is the gold-standard treatment because it targets the loop directly:
- Exposure — gradually, carefully approaching the thoughts or situations that trigger the anxiety
- Response prevention — building the tolerance to not perform the compulsion that usually follows
- The brain relearns — that the feared outcome doesn't come, and the anxiety fades on its own
- Gradually paced — always within your control, never flooding
- Measurable — most clients see meaningful change in 8–12 weeks
The questions you should be asking.
Most therapists who list OCD haven't been trained in ERP, and general talk therapy can make OCD measurably worse. The International OCD Foundation publishes a list of questions to ask any prospective OCD therapist. Here are ours, answered. Ask them of us on a consultation call — and ask them of everyone else you're considering.
What techniques do you use to treat OCD?
ERP, supported by ACT. ERP is what the APA's practice guideline recommends starting with, and it's where we start.
What's your training and background in treating OCD?
Danielle Miller, AMFT was an OCD Exposure Coach at Psychological Care and Healing Center — a Los Angeles treatment center providing partial hospitalization, intensive outpatient and residential care — where she did exposure work with OCD and severe intrusive anxiety. Fidel Quintanilla, AMFT was Assistant Program Director for the treatment of OCD, Depression, Families and Couples at the same center. Both practice under the supervision of Jasmeet Bhullar, LMFT.
How much of your practice is OCD?
Close to half of Danielle's caseload. The IOCDF suggests anything above 25% indicates a genuine specialty — this is roughly double that.
Are your therapists licensed, or pre-licensed?
Danielle and Fidel are associate therapists working under a licensed supervisor. The IOCDF specifically notes that a pre-licensed clinician working directly under a specialist's supervision is a legitimate route to good OCD care. What matters is the ERP training and the OCD hours — not the letters.
What's your attitude towards medication?
Positive. We don't prescribe, but medication helps many people with OCD, often alongside ERP. We'll coordinate with your psychiatrist or help you find one. We won't talk you out of considering it.
Will you leave the office to do exposure work?
There's no office to leave — and for ERP that's an advantage. Exposures happen where your OCD actually lives: your kitchen, your desk, your phone. We're there while you do them.
Do you include families in treatment?
Often, and deliberately. Family accommodation — the reassurance, the checking done on your behalf, the adjustments everyone quietly makes — is one of the most reliable things keeping OCD in place. Danielle, Fidel and Jasmeet all have extensive family therapy experience with OCD, and we'll bring partners or family in when it would help.
Do you have experience treating people who identify like me?
Often, yes — and we'll say so honestly when the answer is no. Our team includes South Asian, Asian American and Latino therapists, and we work extensively inside immigrant and bicultural family contexts. Fidel works in Spanish; Jasmeet works in Hindi and Punjabi. If someone else here is a better fit than the therapist you first speak to, we'll tell you and make the introduction.
How would you account for my cultural background in treatment?
Concretely. Scrupulosity looks different when religious observance is a family obligation rather than a personal choice. Contamination fears can be tangled up with cultural practice around food and cleanliness. And just set a boundary with your parents is not a treatment plan in a family where that isn't on offer. We build exposures that work inside your actual life, not a generic version of it.
How therapy helps.
We use ERP to break the cycle that other approaches accidentally reinforce — helping you face the thoughts and situations you've been avoiding while resisting the compulsions that keep the loop alive. It's not pleasant in the moment, and it's not magic. It's the actual research-supported way to retrain a stuck loop.
Danielle Miller, AMFT leads our OCD work, and close to half her caseload is OCD. She was previously an OCD Exposure Coach at Psychological Care and Healing Center, working with OCD and severe intrusive anxiety — the presentations most general practices refer out. She also has OCD herself, which is part of why she paces exposure the way she does: gently, with attention to the body, never faster than you can tolerate.
Fidel Quintanilla, AMFT (CA BBS #125756) also carries OCD cases. At Psychological Care and Healing Center he served as Assistant Program Director for the treatment of OCD, Depression, Families and Couples — a leadership role explicitly covering the condition — as well as group therapist and Program Director for the Transitional Living Program. Both practice under the supervision of Jasmeet Bhullar, LMFT.
For the neuroscience of why the brain's alarm loops the way it does — and how it relearns — see Why Therapy Works.
Who does this work at Align.
Three of us take OCD cases. Not everyone here does, and that's deliberate — OCD needs ERP specifically, and a therapist who treats it occasionally is not the same as one who treats it regularly.
Danielle Miller, AMFT (CA #144995) — leads this work, and close to half her caseload is OCD. Previously an OCD Exposure Coach at Psychological Care and Healing Center. She has OCD herself, which shapes how she paces exposure.
Fidel Quintanilla, AMFT (CA #125756) — previously Assistant Program Director for the treatment of OCD, Depression, Families and Couples at the same center. He works with OCD alongside high-achiever burnout and men's mental health.
Jasmeet Bhullar, LMFT (CA #117019) — Founder and Clinical Director, and supervisor to both. He brings the family piece: the accommodation, reassurance and quiet adjustments that families make around someone's OCD, which is often what holds the loop in place.
Which of us you work with depends on whether the OCD is best approached individually or with your family in the room. We'll sort that out on the consultation call.
Our approach at Align.
ERP is the core, supported by ACT to build tolerance for uncertainty and mindfulness to change your relationship to the thoughts themselves. We don't offer reassurance as treatment, because reassurance feeds OCD — we offer the skills to need it less.
Sessions are weekly, 50 minutes, online, with a California-licensed, ERP-trained therapist. $200 per session.
Who we work with.
Adults in their 20s and 30s with OCD in any of its forms — including the kinds that hide. The Pure-O sufferer whose compulsions are all internal. The person with intrusive thoughts too shameful to mention. Anyone who's been treated for “anxiety” and gotten worse because it was actually OCD.
What we don't do.
We provide weekly outpatient ERP. We're not the right fit if you need a higher level of care — residential treatment, a partial hospitalization program, or an intensive outpatient program. If that's where you are, we'll say so on the consultation call and point you toward it, rather than starting work we can't see through.
We also don't treat OCD in children or adolescents. Our practice is adults in their 20s and 30s.
OCD therapy — common questions.
What is ERP, and why is it different?
Exposure and Response Prevention gradually exposes you to what triggers your OCD while helping you resist the compulsion that usually follows. It's the gold-standard, evidence-based treatment — and it's clinically distinct from general anxiety therapy, which often makes OCD worse by providing reassurance.
My thoughts are disturbing and I'm afraid to say them. Is that normal in OCD?
Yes — deeply normal. Harm OCD, sexual intrusive thoughts, and taboo obsessions are common and treatable. The fact that the thoughts horrify you is itself a sign they're OCD, not desire. A trained therapist has heard them before and won't be alarmed.
How do I know if it's OCD or just anxiety?
The clearest tell is the loop. Anxiety worries; OCD demands. With OCD there's an intrusive thought you didn't choose, followed by a compulsion — visible or mental — that briefly relieves it and then strengthens it. If reassurance helps for an hour and then stops helping, that pattern points to OCD. It matters clinically, because the treatments differ and general anxiety therapy can make OCD worse.
Is ERP scary?
It's challenging, but never flooding. ERP is gradual and always within your control — you build a hierarchy and move at a pace you can tolerate. Most clients find it far more manageable than they feared, and the relief is real.
Can OCD be treated online?
Yes — often better. ERP frequently goes more smoothly online because the work happens in your actual environment, where the triggers and compulsions really live.
How long does OCD treatment take?
Most clients see measurable improvement in 8–12 weeks of consistent ERP. OCD is highly treatable when the right protocol is used.
Do you take insurance for OCD treatment?
We're an out-of-network provider. Sessions are $200, and we provide monthly superbills you can submit for out-of-network reimbursement. Many PPO plans reimburse a meaningful portion. We hold a limited number of reduced-fee places — ask on the consultation call.
What if my OCD is severe?
ERP works across severity levels, but weekly outpatient sessions aren't always enough. If you need daily contact or a structured program, we'll tell you on the free consultation and help you find an intensive outpatient program — rather than starting treatment that isn't matched to what you need.
More resources.
- How to find the right OCD therapist — the IOCDF's own guidance, and the source of the questions above
- The IOCDF Resource Directory — the best specialist search tool available; it verifies OCD-specific training in a way general directories don't
- The IOCDF screener — a starting point if you're not sure what you're dealing with
- Navigating insurance for OCD care — useful if cost is the obstacle
If you're in crisis, please don't use this page as your point of contact. Call or text 988 — the Suicide and Crisis Lifeline — or go to your nearest emergency room.
Related specialties.
- Anxiety & overthinking — the worry that drifts from one thing to the next
- Relationship anxiety — the what-if loop about the person you love
- People-pleasing — the yes you didn't quite get to choose
- Disordered eating — the rules, the rituals, the mental arithmetic around food
- All topics & patterns — the full list of what we work with