OCD Therapy in Denver | Specialized ERP Treatment
If you’re stuck in cycles of intrusive thoughts, constant doubt, mental reviewing, or compulsive behaviors meant to get relief, you’re not alone. I’m Josh Kaplan, LCSW, an OCD specialist providing evidence-based OCD therapy in Denver and throughout Colorado, helping teens and adults break these patterns and move forward with greater calm, clarity, and confidence.
Meet Josh Kaplan, LCSW
Denver OCD Therapist
Hi, I’m Josh Kaplan. I am a Licensed Clinical Social Worker specializing exclusively in anxiety disorders and OCD. My practice is focused on evidence-based treatment, not general counseling, with an emphasis on helping clients break out of fear-driven cycles and move forward with greater flexibility and confidence.
Training and Treatment Approach
My work is grounded in ERP, CBT, and Acceptance and Commitment Therapy, with over a decade of specialized experience treating OCD and anxiety disorders. Treatment is practical and direct, focusing on helping you make meaningful, lasting changes rather than simply managing symptoms or coping around them.
Over a decade of exclusive specialization in treating Obsessive-Compulsive Disorder (OCD)
Advanced expertise in Exposure and Response Prevention (ERP) for all OCD subtypes
Structured, clear, actionable, and collaborative treatment that helps clients understand the “why” behind each step of therapy
Contributing member of the International OCD Foundation (IOCDF)
The OCD Cycle That Keeps You Stuck
What OCD Really Is
Obsessive-compulsive disorder is not a personality trait or a lack of willpower. It is a fear-based condition driven by intrusive thoughts, images, urges, or sensations that feel urgent, threatening, or deeply distressing. These experiences show up automatically and are often the opposite of what you value or want.
When an intrusive thought appears, anxiety quickly follows. To reduce that anxiety, people feel a strong urge to engage in compulsions. These may be obvious external behaviors such as checking, washing, reassurance-seeking, repeating actions, or avoiding certain situations. Compulsions can also be internal and harder to notice, including mental reviewing, rumination, trying to replace “bad” thoughts with “good” ones, or attempting to figure out what a thought means. While compulsions provide temporary relief, that relief teaches the brain that the thought was important and dangerous, reinforcing the OCD cycle.
How Obsessions and Compulsions Reinforce Each Other
When a compulsion reduces anxiety, even briefly, the brain learns a powerful lesson. The relief that follows acts as negative reinforcement, meaning the behavior is strengthened because it removes discomfort. Over time, the brain begins to associate compulsions with safety and relief, even though the relief is temporary and misleading. This process teaches the brain that something bad would have happened if the compulsion had not been completed. The absence of immediate danger is falsely attributed to the compulsion itself, rather than to the fact that the feared outcome was unlikely to occur in the first place. As a result, future intrusive thoughts feel more urgent and more convincing, and the pressure to respond grows stronger.
At the same time, repeated reliance on compulsions lowers tolerance for anxiety and uncertainty. The nervous system becomes more sensitive, reacting more quickly and more intensely to distress. Over time, even minor thoughts, sensations, or situations can trigger significant anxiety. This creates a self-perpetuating cycle in which obsessions become more frequent, compulsions feel more necessary, and overall distress increases. Without intervention, the disorder feeds itself, leading to more symptoms, more avoidance, and a shrinking sense of freedom in daily life.
Why Talk Therapy Alone Isn't Enough for OCD
How Reassurance and Analysis Can Strengthen OCD
Traditional talk therapy often emphasizes emotional processing, reassurance, and understanding the meaning of thoughts. In OCD, these well-intentioned approaches can unintentionally become part of the problem. Reassurance-seeking and repeated analysis can function as compulsions, reinforcing fear rather than reducing it. Many clients come to me after spending months or even years in therapy that provided little lasting relief, and in some cases increased distress, because the underlying OCD cycle was never directly addressed.
Why Insight Does Not Equal Relief
Many people with OCD already understand that their fears are irrational or unlikely. Insight alone does not stop OCD because the disorder is maintained by learned fear responses, not logic. Effective treatment must target behavior and response patterns, not just awareness.
Exposure and Response Prevention (ERP): The Gold-Standard Treatment for OCD
What ERP Is and How It Works
Exposure and Response Prevention (ERP) is a highly specialized form of Cognitive Behavioral Therapy (CBT) designed specifically to treat OCD. ERP involves gradually facing intrusive thoughts, sensations, images, or situations while resisting compulsive responses. This allows the brain to relearn that anxiety is uncomfortable but not dangerous.
How ERP Breaks the OCD Cycle
By repeatedly responding differently to intrusive thoughts, the brain stops associating them with threat. Anxiety rises temporarily, then naturally falls without the use of compulsions. Over time, obsessions lose their intensity and frequency, and the urge to perform rituals weakens.
What You Learn Through ERP
ERP teaches you how to tolerate uncertainty, allow discomfort without reacting, and disengage from compulsions. The goal is not to eliminate intrusive thoughts, but to change your relationship with them so they no longer control your behavior or life. As this shift happens, anxiety becomes less intense and less persistent, intrusive thoughts occur less frequently and feel less threatening, and many people experience a greater overall sense of calm, confidence, and flexibility in daily life.
ERP Therapy for OCD in Denver
ERP therapy is the most effective, evidence-based treatment for OCD and is the primary approach I use with clients in Denver and throughout Colorado. Treatment focuses on breaking the obsession–compulsion cycle by helping you respond differently to intrusive thoughts, urges, and anxiety rather than trying to eliminate them.
Why Specialized ERP Matters
ERP Is a Specific Form of Cognitive Behavioral Therapy
While many therapists offer CBT, ERP is a highly specific intervention that requires additional training. General CBT often focuses on thought restructuring and coping strategies, whereas ERP directly addresses the fear-learning mechanisms at the core of OCD.
Why Not All CBT Therapists Are Trained in ERP
ERP requires careful identification of compulsions, including subtle mental rituals that are easy to miss. Without specialized training, therapy may unintentionally reinforce reassurance-seeking, avoidance, or mental reviewing.
How Improper Treatment Can Reinforce OCD
When OCD is treated with reassurance, over-analysis, or symptom management alone, progress often stalls. Specialized ERP ensures treatment is focused, effective, and aligned with what actually leads to long-term improvement.
The Benefits of Online ERP Therapy in Denver and Throughout Colorado
Practicing ERP Where OCD Actually Shows Up
Online ERP allows therapy to take place in the real-life settings where OCD is triggered. This might include your home, your car, work environments, social situations, or public places like grocery stores.
Applying ERP at Home, in the Car, at Work, or in Public
Because exposures are practiced in real-world environments, treatment can be more precise and effective. Skills learned in session are immediately applied to daily life, accelerating progress.
What to Expect From Online OCD Therapy
Online ERP sessions are structured, supportive, and collaborative. Treatment is offered throughout Colorado, and many clients begin to notice meaningful improvement within 8–12 sessions when ERP is applied consistently.
Who I Help
My passion is helping people recover from OCD, whether symptoms are mild, moderate, or severe. If you’re feeling overwhelmed or stuck, I encourage you to reach out and schedule a free online consultation. We can discuss your current symptoms and explore what ERP treatment would look like for your specific situation, tailored to your individual needs and goals.
Teens and Adults With OCD
I work with motivated teens and adults who are ready to take an active role in treatment and practice skills outside of session.
Common OCD Themes Treated
This includes harm OCD, contamination OCD, relationship OCD, health anxiety, moral scrupulosity, intrusive sexual thoughts, and other OCD subtypes.
When OCD Begins to Interfere With Daily Life
If OCD is consuming your time, draining your energy, or limiting your ability to live fully, specialized treatment can help interrupt the cycle and restore flexibility.
OCD Therapy in Denver and Across Colorado
My passion is helping people recover from OCD, whether symptoms are mild, moderate, or severe. If you’re feeling overwhelmed or stuck, I encourage you to reach out and schedule a free online consultation. We can discuss your current symptoms and explore what ERP treatment would look like for your specific situation, tailored to your individual needs and goals.
Online OCD Therapy Services
I work with motivated teens and adults who are ready to take an active role in treatment and practice skills outside of session.
Serving Denver and Surrounding Areas
This includes Denver, Aurora, Littleton, Centennial, Lakewood, Highlands Ranch, and other communities across the state.
Intensive Outpatient OCD Therapy (IOP)
This level of OCD therapy provides more frequent sessions, hands-on exposure work, and close support between sessions to help you break down long-standing patterns, reduce compulsions and avoidance, and gain confidence in managing anxiety and uncertainty. The OCD IOP is offered virtually throughout Colorado, and in some cases can include in-person home visits or additional in-person exposure practice (within the Denver Metro Area).
Structured, high-frequency ERP therapy sessions to target more severe OCD symptoms
Ideal for more severe symptoms or when weekly ERP therapy isn't enough
Available virtually throughout Colorado for flexible and convenient access to OCD treatment
Increased support and guided exposure practice to break entrenched patterns and build lasting confidence
What to Expect from OCD Therapy?
Starting Exposure and Response Prevention (ERP) therapy can feel intimidating, especially if you’ve spent years trying to avoid fear and discomfort at all costs. That makes sense. ERP does not ask you to stop having intrusive thoughts or anxiety. Instead, it teaches you how to respond differently when they show up. From the very beginning, our work is collaborative, structured, and paced to match your readiness. You are never forced into anything.
Learning How OCD Really Works
Early sessions focus on building a clear understanding of how OCD operates in your life and why your brain keeps sending false danger signals. You’ll learn how intrusive thoughts are misinterpreted as threats, why anxiety spikes so quickly, and how compulsions, reassurance seeking, mental reviewing, and avoidance provide only temporary relief while strengthening OCD over time. We spend time carefully mapping your personal OCD cycle so you can see exactly how your responses are keeping the disorder alive. From there, you’ll learn the rationale behind Exposure and Response Prevention and how ERP works to retrain the brain by reducing fear, increasing tolerance for uncertainty, and breaking the pattern that allows OCD to maintain control.
Gradual, Structured Exposure Practice
Exposures are carefully planned exercises designed to help you face the thoughts, images, urges, sensations, and situations that trigger OCD in a gradual and intentional way. This includes in-vivo exposures, where you confront real-life situations you’ve been avoiding, as well as imaginal exposures, which involve intentionally bringing to mind feared scenarios that cannot be practiced directly. During exposures, the goal is not to make anxiety go away, but to practice responding differently to your brain’s alarm system by resisting compulsions, reassurance seeking, mental reviewing, and avoidance. As you repeatedly allow anxiety and uncertainty to be present without trying to neutralize them, your brain learns that these internal alarms are false, and over time, they begin to lose their intensity and influence.
Managing Anxiety as It Rises and Falls
Learning to manage and tolerate anxiety as it naturally rises and falls during the early stages of exposure work is an important step in OCD recovery. Rather than trying to eliminate intrusive thoughts or prove they are untrue, you practice responding to them with openness, non-engagement, and willingness to tolerate uncertainty. Over time, this changes your relationship with both anxiety and doubt. With repeated practice, anxiety tends to peak at lower levels, fade more quickly, and show up less often, allowing you to move through daily life with greater comfort, confidence, and flexibility—even when uncertainty is present.
Building Lasting Change Through Practice
ERP is an active, skills-based therapy that goes beyond talking about symptoms and focuses on practicing new responses in real time. Treatment includes structured exercises and intentional practice between sessions so you can apply what you’re learning to everyday situations. Over time, as your brain learns that intrusive thoughts and anxiety do not require action, most clients experience meaningful relief from both obsessions and compulsions, increased tolerance for uncertainty, and a renewed sense of confidence in daily life.
Treatment for All OCD Themes and Subtypes
I treat all OCD themes and subtypes. While I’ve listed some of the more common themes below, OCD doesn’t always fit neatly into one category. You don’t need to have everything figured out before starting treatment; understanding your symptoms and identifying the patterns is part of my role. Whether your OCD fits a well-known theme or feels confusing, unique, or hard to explain, we can sort through it together.
Therapy for Contamination OCD
Contamination OCD involves intense fears of becoming contaminated or spreading some form of contamination. The feared “contaminants” can include germs, chemicals, emotions, or even other people. To feel safe, individuals may wash, clean, avoid contact, or seek reassurance. Exposure and Response Prevention (ERP) helps individuals gradually face contamination-related fears, reduce rituals and avoidance, and relearn that discomfort or uncertainty about feared contaminants does not equal actual danger.
Therapy for Intrusive Violent, Sexual, and Taboo Thoughts
Intrusive, violent, sexual, and taboo thoughts are unwanted, distressing mental images or urges that go against a person’s values and sense of self. These thoughts can feel alarming and lead to guilt, fear, and shame. To feel safe, individuals frequently attempt to suppress their thoughts and engage in compulsive efforts to “prove” they’d never act on them. Exposure and Response Prevention helps individuals face these disturbing, intrusive thoughts without trying to neutralize or suppress them, reduce mental and physical compulsions, and relearn that having a thought, no matter how taboo or alarming, does not mean you want it, will act on it, or that it reflects your character.
Therapy for Harm OCD
Harm OCD involves intrusive fears of accidentally or intentionally causing harm to oneself or others, often triggering guilt, panic, and compulsive checking or reassurance seeking. These thoughts are unwanted and distressing, not reflections of intent or desire. Exposure and Response Prevention (ERP) helps individuals face these fears, reduce compulsions, and relearn that thoughts of harm don’t equal danger or action.
Therapy for Relationship OCD (ROCD)
Relationship OCD (ROCD) involves intrusive doubts and fears about one’s partner, relationship, or feelings. Doubts such as “Do I really love them?” or “What if they’re not the right one?” These thoughts create anxiety and lead to compulsions like constant reassurance seeking, comparison, or overanalyzing feelings. Exposure and Response Prevention (ERP) helps individuals confront the doubts and “what ifs” that fuel Relationship OCD, reduce reassurance-seeking and mental checking, and relearn that uncertainty about relationships is normal and not a sign that something is wrong.
Therapy for Pedophilia OCD (POCD)
Pedophilia OCD (POCD) involves intrusive, unwanted sexual thoughts or fears of being sexually attracted to or harming children. These thoughts are unwanted and distressing, not reflections of intent or desire. Common compulsive behaviors include mental checking, avoidance, or reassurance seeking. Exposure and Response Prevention (ERP) helps individuals with POCD face these fears safely and learn that thoughts do not reflect intent, character, or risk of acting on them.
Therapy for Existential OCD
Existential OCD centers on intrusive, unanswerable questions about life, reality, death, or the meaning of existence. People with this form of OCD often get stuck in endless rumination, trying to find certainty about questions that have none. Exposure and Response Prevention (ERP) helps individuals learn to tolerate uncertainty and disengage from overanalyzing, allowing them to reconnect with the present moment and live more fully.
Therapy for Moral or Religious Scrupulosity OCD
Moral or Religious Scrupulosity OCD involves obsessive fears of being immoral, sinful, or offending one’s faith or values. Individuals may engage in excessive praying, confessing, reassurance seeking, or mental reviewing to feel “pure” or “good enough.” Exposure and Response Prevention (ERP) helps individuals face these fears while learning that uncertainty, imperfection, and doubt are normal parts of faith and morality, not signs of wrongdoing.
Therapy for Sexual Orientation OCD (SO-OCD)
Sexual Orientation OCD involves intrusive, unwanted thoughts about one’s sexual orientation, regardless of how a person identifies. Someone who has always identified as straight may suddenly start experiencing intrusive thoughts like “What if I’m actually gay?” while someone who identifies as gay may experience intrusive doubts that they are actually straight. These thoughts are not part of a natural or authentic exploration of identity; they are ego-dystonic, distressing, and create a sense of “what if I’m not who I’ve always thought I was?” In response, individuals may engage in compulsive behaviors like checking for certain feelings, analyzing physical reactions, reviewing past experiences, or seeking reassurance in an attempt to feel certain. Exposure and Response Prevention (ERP) helps individuals face intrusive doubts about their sexual orientation, reduce checking and reassurance-seeking, and relearn that uncertainty or unwanted thoughts about identity do not signal a real shift in orientation or require compulsive analysis.
Therapy for Checking OCD
Checking OCD involves repeated behaviors or mental reviews to prevent harm, mistakes, or accidents. Things like repeatedly verifying that doors are locked, appliances are off, or messages were written correctly. These checks provide temporary relief but reinforce doubt and anxiety over time. Exposure and Response Prevention (ERP) helps break this cycle by teaching you to face uncertainty and resist checking, allowing confidence and trust in your memory and actions to naturally return.
Therapy for Hyperawareness or Somatic OCD
Hyperawareness or Somatic OCD centers on an obsessive focus on automatic bodily sensations or processes, such as blinking, swallowing, breathing, or heartbeat, or on being overly aware of one’s own thoughts. This heightened self-focus can make once-automatic sensations feel unbearable or constant. Exposure and Response Prevention (ERP) helps retrain attention and reduce anxiety by teaching you to allow these sensations or thoughts to exist without trying to control or escape them, so they fade naturally from awareness.
Therapy for Magical Thinking OCD
Magical Thinking OCD involves the belief that certain thoughts, numbers, words, or actions can cause or prevent bad outcomes, even when there’s no logical connection. People with this form of OCD may feel intense responsibility to think or act “just right” to keep something terrible from happening. Exposure and Response Prevention (ERP) helps break this false link between thoughts and outcomes, teaching the brain that thoughts are not dangerous and that safety doesn’t depend on mental rituals or superstitions.
Start OCD Therapy in Denver
If OCD has been controlling more of your life than you want, help is available. With the right treatment, it is possible to break out of the OCD cycle and regain a sense of calm, clarity, and confidence.
I offer a free 20-minute online consultation to answer questions, discuss your symptoms, and help you determine whether my approach is the right fit.
CBT 4 Anxiety