OCD and intrusive thoughts
OCD counseling for adults
You already know the thought is unlikely. Knowing has never been enough.
An OCD therapist works on the loop itself: the thought that will not let go, the checking, the asking, and the re-running in your head that buys a minute of relief and costs the rest of the day. Weekly counseling, in person in the Houston area or online anywhere in Texas.
The tide is not keeping it.
- Select insurance plans accepted
- Self-pay $100–$150 per session
- For adults in Houston-Willowbrook, The Woodlands, and Katy
- Online across Texas
In crisis or thinking about suicide? Call or text 988, the Suicide & Crisis Lifeline, any time.
If someone is in immediate danger, call 911. Counseling here is not an emergency service.
Who you might work with
Licensed counselors, matched to what you need
Tell us that OCD is what you want to work on, and whether the thoughts or the rituals are the harder part, and we will take both into account when we match you.
AJ Huynh
Director · LPC
Works with ACT, CBT and mindfulness-based approaches, with a focus on what matters to you rather than symptoms alone.
Brenda Resendez
Clinical Director · LPC
Blends ACT, CBT and motivational interviewing, adapting the approach to where you are rather than a fixed program.
Ricardo Alvarez
LPC
Draws on mindfulness, IFS and ACT, and offers EMDR at The Woodlands. A gentle, flexible approach that meets you where you are.
Cost and coverage
Know the cost before you begin.
For insured sessions, we verify your benefits and share an estimated out-of-pocket cost before the first session. That estimate is separate from the self-pay rates below.
Self-pay, per session
- Fully licensed clinician
- $150
- Associate clinician
- $100
Matching may include an associate clinician. Tell us if cost is a concern so we can discuss the options available to you.
Plans we currently work with
Coverage, cost, and availability depend on your plan, your eligibility at the time of service, and the clinician you see.
- Aetna
- Blue Cross & Blue Shield of Texas
- UnitedHealthcare
- Cigna
- Oscar
- Oxford
- Horizon BCBS
- BCBS of Massachusetts
- Original Medicare
- UHC Medicare Advantage
- Quest Behavioral Health
- Carelon Behavioral Health
Do not see your plan? Ask our team: consultations are free, and a limited number of sliding-scale openings may be available.
Daily life
A minute of relief. Then the whole day, again.
The stove, checked, and checked from the car. The question you have asked your partner four times today, in four different wordings, so it does not sound like asking.
The thought about the knife, or the child, or the thing you might have done, that you would never act on and cannot prove you would never act on. Doing it again until it feels right, and it never quite does.
None of that is a character flaw, and none of it means the thought is true. It is a loop, and loops can be interrupted.
That is most of the work.
- The fourth check What happens in the ten seconds between the urge and the hand.
- Asking one more time How reassurance feeds the doubt it is meant to settle, and what to do instead.
- A thought is not a plan Why the worst thought lands on the person least likely to act on it.
- Good enough, on purpose Leaving it not-quite-right, at a size you choose.
Understanding OCD
What OCD is, in plain terms
Obsessive-compulsive disorder is a loop with two halves: a thought, image or doubt that arrives uninvited and will not settle, and something you do, with your hands or in your head, to make it settle. The relief is real and short, and it teaches the thought to come back.
These are a starting point for a conversation, not a test.
01
The thought that arrives
It turns up unasked, and it is close to the last thing you would ever want to think. That is exactly why it sticks: a mind flags hardest what it cares most about protecting.
In counseling you practise letting it arrive without treating its arrival as evidence of anything.
02
The doubt that will not close
You can get to almost certain. You cannot get to certain, and almost is not where the feeling settles, so the search carries on for a proof that was never available.
The work is learning to move while the question is still open.
03
The thing you do about it
Something with your hands that makes the feeling drop: going back, doing it again, putting it right. It works, briefly, which is the trap, because the relief teaches the doubt that it was right to ask.
We look at what each one costs you and shrink it at a pace you set.
04
The thing you do in your head
Reviewing the conversation. Counting.
Praying it back. Replaying it until it runs clean, or cancelling one thought with another.
Nobody can see any of it, so nobody has ever suggested it might be a ritual. Naming it is usually the first relief.
05
Asking, and asking again
One more time, in different words, so it does not sound like the same question: of a partner, a parent, a forum, a search bar at two in the morning. We work on what to do with the urge to ask, and on what the people around you can say that helps instead.
06
The life that got smaller
The knives in a drawer you no longer open. The road you stopped driving.
The people you do not hold in case. Getting those back, one at a time and in the order you choose, is what the counseling is actually for.
What can contribute
- Family history
- A nervous system that treats doubt like danger
- A stretch of high stress, illness, or a new baby
- Perfectionism, or a lifelong difficulty with uncertainty
- Being told, kindly and often, that everything is fine
Having a horrible thought is universal; OCD is what happens when the thought sticks. If you want to read more first, see the OCD cycle, the different ways OCD shows up and Pure O OCD.
How we work
How OCD counseling works here
This is weekly individual counseling with one therapist. Three things do most of the work, mindfulness runs through all of them, and nobody is asked to touch, skip or say anything on day one that they are not ready to.
-
Naming the loop
Early on you and your counselor map your own sequence: thought, alarm, ritual, relief, and then a thought that comes back stronger. Mapping it is ordinary CBT, and it does one thing immediately: the loop stops feeling like a personality and starts looking like a mechanism, and a mechanism is a thing that can be changed.
-
Acceptance and commitment therapy
ACT has solid evidence for OCD and is the approach every counselor here works from. It does not argue with the thought or try to prove it wrong; it changes your relationship to it, so a thought can be present without being obeyed, and puts the time you get back into what you actually value.
-
Letting the ritual wait
Exposure and response prevention, or ERP, is the best-studied treatment for OCD and you will see it advertised everywhere. We do not run an ERP program, and no counselor here advertises ERP training.
ERP is not the only approach that works: ACT has its own trials for OCD, and when the two were combined and compared with ERP alone, the results were the same. What we do, inside ACT and CBT, is help you delay and shrink a ritual at a pace you set.
That is not ERP. ERP is a graded exposure protocol delivered by an ERP-trained clinician, and we do not deliver that.
If a formal course of ERP with an ERP-trained clinician is what you want, tell us when you ask to be matched and we will say so plainly before you book.
Getting started
Nobody will ask you to touch anything on day one.
Matching starts with what matters to you. You have a say in your goals and in whether the therapist feels like a fit.
-
Tell us what you need
Use the matching form to share what brings you here and whether you prefer an office or online sessions.
-
Explore your match
We suggest a counselor based on what you shared, who is available, and whether you want an office or online. You can ask about their approach before you decide.
-
Start where you are
In your first session, talk about what feels hard. Nobody will ask you to do anything you have been avoiding on day one.
Before your first session
If it helps, you might jot down:
- What the thought is about, one word is enough, and you do not have to say it out loud
- What you do to make it settle, and roughly how long that takes
- What you have stopped doing because of it
These notes are optional. You do not need a log, a count, or a tidy history: bring whatever you can say that day.
The Reset Guarantee
If the fit is wrong, your first session with a new counselor is free.
Near you, or online
Choose where you meet
Meet in person at one of our three Houston-area offices, or choose telehealth anywhere in Texas.
Houston-Willowbrook
12807 Haynes Rd, Building C1
Houston, TX 77066
The Woodlands
2219 Sawdust Rd, Suite 1204
The Woodlands, TX 77380
Online across Texas
Prefer to meet from home? Explore telehealth counseling in Texas.
Online sessions run the same way as an office visit, with the same counselors. If leaving the house is part of what OCD has made hard, starting on video is a reasonable first step, and you can move to an office later.
A few questions
Before you start
If the one you are carrying is not here, ask us when you get in touch.
Do I need an OCD diagnosis to see a therapist for OCD?
No, many people arrive with a word a doctor, a partner or the internet used, and no paperwork behind it. Working out what is going on is part of the first few sessions, not a gate you have to clear before you are allowed in.
Do you offer ERP (exposure and response prevention)?
Not as a program: we work from ACT and CBT, which includes helping you delay and shrink rituals at your own pace, and when ACT with exposure was set against ERP on its own, both groups improved and neither did better. ERP is the best-studied treatment for OCD, and if a formal ERP course is what you want, say so when you ask to be matched and we will tell you plainly before you book.
Will I have to say the thought out loud?
Not until you want to, and you may never need to say all of it. The content is not the problem: your counselor has heard worse, and knows an intrusive thought is not a plan.
Will you make me stop the rituals straight away?
No, nothing is taken away from you on day one. You choose which ritual to start with, how much smaller it gets, and when, and if a step turns out to be too big, the step gets smaller rather than you being told to push through it.
Is it OCD, or is it anxiety, or am I just particular?
OCD is the loop: a thought, then something you do about it, then a short relief, while generalised worry moves from topic to topic with no ritual at the end (if that is closer, anxiety counseling is the better starting point). Being exacting by temperament is a third thing: when your standards feel right to you and set the terms for everyone around you, that is closer to OCPD.
Do I need medication as well?
Some people take an SSRI alongside counseling, often at higher doses for OCD than for depressed mood, but talk therapy is a recommended first treatment in its own right. Our counselors do not prescribe; if you see a prescriber, the two run side by side.
Can I meet with a counselor online?
Yes, secure video sessions are available across Texas, with the same counselors you would see at one of our offices. Telehealth counseling in Texas has the details.
What if my therapist is not the right fit?
If the fit is wrong, tell us and we will match you with a different counselor. Your first session with them is free.
Your next step
The thought will come back. That is not the part that has to change.
Tell us what keeps looping, and we will help you find a counselor.
In crisis? Call or text 988 any time.
Counseling here is not an emergency service.
We provide diagnosis, assessment and therapy. Our clinicians are licensed in Texas as professional counselors, clinical social workers or marriage and family therapists, and none of them prescribe medication; if you see a prescriber, counseling runs alongside that.
We do not run a residential or intensive day program; this is weekly outpatient counseling.
