What does therapy at Onward Healing look like?

At Onward Healing, we specialize in evidence-based treatments for OCD, anxiety, BFRBs, tics, and trauma. Sessions are typically 50 minutes long and conducted via secure telehealth video. Treatment is collaborative — we work together to understand what's keeping you stuck and build skills to help you move forward. Depending on your goals, we may use Exposure and Response Prevention (ERP), Habit Reversal Training (HRT), the ComB model, EMDR, or other structured approaches.

Do you accept insurance?

We are currently out-of-network with all insurance providers. This means we do not bill insurance directly. However, many clients are able to use out-of-network benefits to get partial reimbursement. We can provide a superbill (an itemized receipt) that you can submit to your insurance company. We recommend calling your insurance provider before starting to understand your out-of-network mental health benefits.

How does telehealth therapy work?

All sessions at Onward Healing are conducted via secure, HIPAA-compliant video platform. Once you're scheduled, you'll receive a link to join the session from wherever you are — your home, office, or anywhere private. Telehealth is just as effective as in-person therapy for the conditions we treat, and many clients find it more convenient and accessible.

What states do you serve?

We are currently licensed to provide therapy in Pennsylvania (PA), Vermont (VT), and Florida (FL). You must be physically located in one of these states at the time of your session.

How long will I need therapy?

This varies widely depending on your goals, the severity of your symptoms, and your engagement with treatment. Some clients see significant improvement in 12-16 sessions; others prefer ongoing support over a longer period. We'll discuss your goals at the outset and check in regularly on your progress.

What is ERP therapy, and is it right for me?

Exposure and Response Prevention (ERP) is the gold-standard treatment for OCD and certain anxiety disorders. It involves gradually facing feared situations or thoughts (exposure) while resisting compulsions or avoidance behaviors (response prevention). It sounds challenging — and it can be — but it's also highly effective. We move at a pace that feels manageable, and you're never pushed into anything you're not ready for.

What are BFRBs, and can therapy help?

Body-Focused Repetitive Behaviors (BFRBs) are repetitive, self-directed behaviors like hair pulling (trichotillomania), skin picking (excoriation disorder), nail biting, and cheek chewing. These behaviors are often automatic and can cause significant distress or physical harm. Evidence-based treatments like Habit Reversal Training (HRT) and the Comprehensive Behavioral (ComB) model have strong research support and can lead to meaningful reduction in urges and behaviors.

How do I get started?

The easiest first step is to schedule a free 15-minute consultation. This call gives us a chance to learn about what you're struggling with, answer any questions you have, and see if we're a good fit. There's no pressure and no commitment. You can book directly through our website or reach out by email.

Does having harm OCD mean I'm secretly dangerous?

No, the exact opposite. Research has shown that over 80% of the general population experiences intrusive thoughts of harm at some point. What differs in Harm OCD is the response to those thoughts (anxiety, shame, avoidance, compulsions), not the thoughts themselves. People who actually harm others are not distressed by harm-related thoughts. The fact that yours horrify you is the strongest possible evidence that you are safe.

Will telling a therapist about my harm thoughts get me reported or hospitalized?

No. Intrusive thoughts of harm in the context of OCD are not the same as plans or intent to harm, and trained OCD therapists understand this clearly. Mandated reporting in the US is for specific situations involving imminent danger or abuse. Ego-dystonic Harm OCD intrusive thoughts do not meet that threshold.

What's the difference between Harm OCD and actually being violent?

The presence or absence of distress. People who act violently are typically ego-syntonic, they feel justified, planful, or detached. Harm OCD is ego-dystonic, the thoughts feel foreign and disturbing, you would never act on them, and the entire experience is one of fear and shame. These are categorically different presentations.

Why do these intrusive harm thoughts feel so real?

OCD has a remarkable ability to attach to the things you care most about. Your brain produces a thought that feels alarming, you treat it as a warning that needs answering, and your nervous system responds with adrenaline, which makes the thought feel even more real. It's a feedback loop. ERP interrupts the loop.

Can I do ERP if my thoughts involve specific people I love?

Yes. The loved-one-specific Harm OCD pattern is one of the most common. ERP doesn't require harming anyone or doing anything dangerous, it works with the thoughts and images themselves, plus gradually reducing the avoidance and reassurance behaviors that feed OCD.

What about sexual harm intrusive thoughts (POCD)?

Pedophilia-themed OCD (POCD) is a Harm OCD variant where the intrusive content is sexual harm to children. It is one of the most distressing OCD presentations, and it is not the same as pedophilia. POCD is ego-dystonic, distressing, and unwanted. Treatment is the same, ERP works.

How long does Harm OCD treatment take?

Most Harm OCD clients see meaningful symptom reduction within 1220 ERP sessions. Some see noticeable change within the first few weeks, especially around the relief of finally having a therapist who recognizes Harm OCD. Treatment is structured and time-limited.

What if previous therapy made Harm OCD worse?

Many Harm OCD clients have done previous therapy that focused on analyzing where the thoughts come from or providing reassurance, both of which make Harm OCD worse. ERP works fundamentally differently. The free consultation is a good place to ask about what made previous therapy hard and how ERP differs.

Is Harm OCD treatment covered by insurance?

Onward Healing Therapy is private-pay. A superbill is provided after each session for out-of-network reimbursement (many PPO plans cover 4080%). Specialized Harm OCD treatment is hard to find on insurance panels, private-pay typically means faster access to a trained specialist.

What happens on the free Harm OCD consultation?

A no-pressure 15-minute video call. You share as much as feels comfortable, many Harm OCD clients say very little on the first call, and that's fine. You'll get a sense of whether working together feels right. There's no commitment, no judgment, and absolutely no shock at anything you share.

Harm OCD Therapy for Intrusive Thoughts of Harm

Onward Healing Therapy is a private-pay specialty telehealth practice serving adults in Pennsylvania, Vermont, and Florida. Founder Nina Eberly, PhD, LCSW. The content on this site is for educational purposes and does not constitute clinical advice or establish a therapist-client relationship. If you are in immediate distress, call or text 988 for the Suicide and Crisis Lifeline.

Harm OCD Therapy for Intrusive Thoughts of Harm

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