OCD treatment in Miami Florida
Santana Mental Health Services provides comprehensive OCD evaluations and individualized treatment plans for adolescents and adults. Our providers use evidence-based psychotherapy and medication management, the two approaches with the strongest clinical support, to help patients reduce obsessive-compulsive symptoms, regain functioning, and improve quality of life. Care is available both in-office and through secure telehealth services.
Understanding Obsessive-Compulsive Disorder
Obsessive-compulsive disorder (OCD) is a chronic condition characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a person feels driven to perform. OCD has a lifetime prevalence of approximately 2–3% and affects men and women at roughly equal rates. The age of onset is bimodal, with peaks in late childhood or early adolescence and again in early adulthood (ages 20–29). If left untreated, OCD typically follows a chronic course with waxing and waning symptoms, and remission rates without treatment are low — approximately 20% even after 40 years. OCD frequently co-occurs with depression, anxiety disorders, tic disorders, and substance use.
Contamination obsessions and cleaning compulsions
Intense fear of germs, dirt, chemicals, or bodily fluids that leads to excessive hand washing, showering, cleaning, or avoidance of perceived contaminated objects or environments. This is one of the most commonly recognized symptom dimensions of OCD.
Harm obsessions and checking compulsions
Intrusive, unwanted thoughts about causing harm to oneself or others — such as fears of accidentally starting a fire, hitting someone with a car, or leaving a door unlocked — that lead to repeated checking behaviors. Patients often recognize these fears are irrational but feel unable to stop checking.
OCD with co-occurring conditions
Most people with OCD have at least one co-occurring mental health condition, commonly depression, anxiety disorders, especially social anxiety, and tic disorders. About 20–30% have current or past tics, and substance use disorders are also more common than in the general population.
Symmetry obsessions and ordering compulsions
A strong need for things to feel "just right," even, or symmetrical. This may involve arranging objects in a precise order, repeating actions a certain number of times, or counting. Distress arises when things feel out of order or incomplete.
Forbidden or taboo thought obsessions
Intrusive, distressing thoughts of a sexual, religious, or violent nature that are deeply inconsistent with the person's values. These obsessions often cause intense shame and guilt, which can make patients reluctant to disclose them. Compulsions may include mental rituals such as praying, reviewing, or seeking reassurance.
When to Seek an Evaluation
Consider scheduling an evaluation if you are experiencing intrusive thoughts or repetitive behaviors that are time-consuming, distressing, or interfering with your ability to function at work, in relationships, or in daily activities. OCD is frequently underrecognized — the average delay from symptom onset to first treatment is nearly 8 years. Common signs include:
• Recurring, unwanted thoughts, images, or urges that cause anxiety or distress
• Feeling driven to perform repetitive behaviors or mental rituals (such as checking, counting, washing, or repeating)
• Spending more than one hour per day on obsessions or compulsions
• Avoiding certain places, people, or situations because they trigger obsessive thoughts
• Difficulty completing daily tasks because of the need to perform rituals
• Recognizing that the thoughts or behaviors are excessive or irrational but feeling unable to stop
• Significant distress, shame, or secrecy about the thoughts or behaviors
How OCD is Treated
Effective OCD treatment is built on two pillars: specialized psychotherapy and medication management. Treatment is personalized based on symptom severity, patient preferences, co-occurring conditions, and prior treatment history. With appropriate treatment, the majority of patients experience meaningful symptom improvement, though full remission may require ongoing management.
Therapy for OCD
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Exposure and response prevention (ERP) is the most effective psychotherapy for OCD and is considered the gold standard treatment. ERP is a specialized form of cognitive behavioral therapy that involves two key components:
• Exposure — controlled, repeated, and gradual confrontation with situations, thoughts, or images that trigger obsessions and anxiety
• Response prevention — learning to resist performing the compulsive behavior or mental ritual that usually follows
Through repeated practice, patients learn that anxiety decreases on its own without performing compulsions, and that feared outcomes do not occur. This process helps break the cycle between obsessions and compulsions.
A typical course of ERP involves 12 to 20 weekly sessions (or daily sessions over 3 weeks in intensive formats), plus daily practice assignments between sessions. In clinical studies, 60–85% of patients experience significant symptom reduction with ERP, and improvements can be maintained for years after treatment ends.
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Traditional CBT for OCD focuses on identifying and challenging the distorted beliefs that drive compulsive behavior — such as inflated responsibility, overestimation of threat, or the belief that having a thought is the same as acting on it. CBT techniques may be used alongside ERP or as an alternative for patients who have difficulty tolerating direct exposure exercises.
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Acceptance and commitment therapy (ACT) helps patients change their relationship with intrusive thoughts rather than trying to eliminate them. ACT focuses on building psychological flexibility, accepting uncomfortable internal experiences, and taking action guided by personal values rather than by OCD. Research supports ACT as an effective treatment for OCD, either as a standalone therapy or as a complement to ERP, and it may be particularly helpful for patients who struggle with traditional exposure-based approaches.
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For many patients, the best results come from combining ERP and medication.
ERP helps patients develop long-term skills for managing obsessions and resisting compulsions, while medication can reduce the intensity of symptoms and make it easier to engage in therapy. Research suggests that ERP alone or in combination with an SSRI produces the best outcomes, and that ERP is likely more effective than medication alone.
Your provider will work with you to choose a treatment plan that fits your symptoms, goals, and preferences.
Medication for OCD
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Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for OCD. The FDA has approved the following SSRIs specifically for OCD:
• Fluoxetine
• Fluvoxamine
• Paroxetine
• Sertraline
Citalopram and escitalopram are also commonly used, though they are not FDA-approved specifically for OCD.
Clomipramine, a tricyclic antidepressant with strong serotonergic properties, is also FDA-approved for OCD and remains highly effective. However, SSRIs are generally preferred as first-line treatment because of their more favorable side effect profile.
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OCD medication management differs from treatment of depression or anxiety in two important ways:
• Higher doses are often needed — OCD typically requires doses at the higher end of the recommended range
• Longer time to response — improvement may take 8 to 12 weeks at an adequate dose, compared with 2 to 4 weeks for depression. Some patients may continue to improve for up to 28 weeks
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Some people experience early side effects, such as:
• Nausea
• Headache
• Sleep changes
• Jitteriness
These side effects often improve within the first one to two weeks. Providers typically start with a lower dose and increase gradually to the maximum tolerated dose within FDA guidelines.
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For patients who respond well, continuing medication for at least 1 to 2 years is generally recommended. Stopping medication too early carries a significant risk of relapse — more than half of patients who discontinue an SSRI after responding may experience symptom return within 6 months. Any medication changes should be made gradually and in close collaboration with your provider.
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Approximately 40–60% of patients continue to have significant symptoms after an initial trial of an SSRI or ERP. For these patients, options include:
• Switching to a different SSRI or to clomipramine
• Adding ERP to medication (or vice versa) — CBT is highly effective even in patients who have not responded to medication alone
• Augmentation with a low-dose atypical antipsychotic (such as aripiprazole or risperidone) added to the SSRI, which has been shown to help approximately 30% of treatment-resistant patients
Your provider will work with you to find the most effective combination.
Telehealth for OCD Treatment
OCD evaluations and follow-up appointments are available through secure telehealth. Research shows that remotely delivered CBT and ERP for OCD are as effective as in-person treatment, with no significant differences in OCD symptom reduction, depression, anxiety, or quality of life outcomes. A randomized clinical trial in children and adolescents also demonstrated that internet-delivered CBT was noninferior to in-person CBT for OCD. Telehealth can help overcome common barriers to OCD treatment, including limited access to ERP-trained therapists, stigma, and the time demands of frequent sessions.
Preliminary evidence suggests that individuals with very severe OCD may benefit more from face-to-face treatment, so your provider will recommend the most appropriate format based on your clinical needs.
Take the next step toward breaking free from OCD. Book a secure telehealth appointment today and get support from the comfort of home, on a schedule that works for you.
Frequently asked questions
Didn’t find what you were looking for?
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Yes. OCD is a well-established medical condition recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under Obsessive-Compulsive and Related Disorders. It involves dysregulation of brain circuits, particularly the cortico-striato-thalamo-cortical loop, and is among the most treatable mental health conditions when evidence-based care is provided.
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No. While some people with OCD have symptoms related to symmetry or ordering, OCD is a serious condition that involves distressing, intrusive thoughts and time-consuming compulsive behaviors across many different themes — including fears of contamination, harm, and taboo thoughts. OCD can be severely disabling and is not the same as a preference for neatness or organization.
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Yes. ERP is the most effective treatment for OCD and can produce significant improvement on its own. Medication is recommended when symptoms are moderate to severe, when therapy alone has not been sufficient, or based on patient preference. For many patients, the combination of ERP and medication produces the best results. Treatment decisions are always individualized.
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Yes. Without treatment, OCD typically follows a chronic course with low rates of spontaneous remission. A meta-analysis of untreated patients found that only about 4% experienced remission over an average follow-up period, and the DSM-5 reports that without treatment, only about 20% of adults achieve remission even after 40 years. Untreated OCD is associated with worsening functional impairment, higher rates of depression, and reduced quality of life. Earlier treatment is associated with better long-term outcomes.
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This varies by individual. ERP typically involves 12 to 20 weekly sessions, with many patients noticing improvement within the first several weeks. Intensive formats (daily sessions over 3 weeks) are also available. Medication generally requires 8 to 12 weeks at an adequate dose to determine effectiveness, and some patients continue to improve for several months. For patients who respond well, continuing medication for at least 1 to 2 years is recommended to reduce the risk of relapse.
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The neurobiology of OCD differs from that of depression. OCD appears to involve dysfunction in specific brain circuits (the cortico-striato-thalamo-cortical loop) that require higher levels of serotonin modulation to respond. This is why SSRIs are typically prescribed at the maximum tolerated dose for OCD and why a full trial of 8 to 12 weeks is needed before determining whether a medication is effective.
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Yes. Both initial evaluations and ongoing follow-up appointments are available through secure video telehealth. Clinical research, including randomized controlled trials and meta-analyses, supports that remotely delivered CBT and ERP are as effective as in-person treatment for OCD.
Important Notice
This page is for educational purposes only and should not be used to self-diagnose or self-treat any mental health condition. If you are experiencing symptoms or concerns, a professional evaluation can help clarify what you may be experiencing and what treatment options may be appropriate. Santana Mental Health Services is here to offer compassionate care, guidance, and support.
Medically reviewed by: Mailyn Santana, MD, DABPN
Clinical review: Child, Adolescent, Adult & Addiction Psychiatry
Last reviewed: April 4th, 2026
Written by: Santana Mental Health Services Editorial Team
Sources: The Lancet, JAMA, American Psychiatric Association, American Family Physician, Pediatrics, Journal of Anxiety Disorders, Journal of Clinical Psychology, Psychiatric Clinics of North America, New England Journal of Medicine, Current Medicinal Chemistry, Journal of Clinical Psychopharmacology, Journal of Affective Disorders, Psychiatry Research, Journal of Affective Disorders, JAMA, JAMA Network Open, Acta Psychiatrica Scandinavica, Archives of General Psychiatry
Disclaimer: Educational only; not a substitute for professional evaluation.