OCD Group Therapy for Young Adults: ERP, ACT & Lasting Relief

Living with Obsessive-Compulsive Disorder (OCD) can be both exhausting and confusing. Often referred to as “the doubting disorder,” the intrusive thoughts, urges, and repetitive behaviors it brings can be deeply debilitating and demoralizing. It’s not uncommon for individuals with OCD to withdraw from activities, or even relationships, that once brought them fulfillment and joy.

With proper treatment, however, there is hope. Group therapy that combines Exposure Response Prevention Therapy (ERP) and Acceptance and Commitment Therapy (ACT) can be a powerful opportunity for young people to learn coping skills, practice resisting their urges with clinical guidance, and build resilience and connection alongside their peers. 

Key Article Takeaways

At The Dorm, our research shows that clients who receive comprehensive care experience a 30% reduction in OCD symptoms, leading to fewer intrusive thoughts, reduced compulsions, and significantly diminished distress. 

To understand what contributes to this success, we spoke with OCD group facilitator, Anna Bergson, LICSW, to explore how our group therapy curriculum is designed to support meaningful symptom improvement, and the factors that make it such a powerful part of our treatment approach.

What is OCD Group Therapy Like?

Anna Berson, LICSW: Every group is different based on the treatment program and population that is being served. At The Dorm, where we exclusively treat young adults, our dedicated OCD group is guided by the evidence-based GOAL model developed by Jonathan Grayson, PhD. We blend evidence-based treatment modalities such as Exposure and Response Prevention (ERP), psychoeducation, and Acceptance and Commitment Therapy (ACT) to support functioning and processing. By blending ERP’s evidence-based strategies for reducing compulsions with ACT’s focus on mindfulness, values, and psychological flexibility, our clients can learn to live more fully and freely in their day-to-day lives. 

This integrated approach is particularly effective for young adults, who are often balancing school, work, and social activities. The added accountability of group check-ins and reviews helps ensure they stay consistent with ERP practice. Additionally, many young adults with OCD experience more covert, mental compulsions; psychoeducation and mindfulness strategies can provide greater clarity and awareness, supporting meaningful progress during treatment. 

What does this look like in practice? 

• Each week, our clients set a goal to challenge their OCD, discuss their expectations and anxiety, and then debrief on their progress. There is also a weekly focus on psychoeducation where a different aspect of OCD is explored including the obsessive-compulsive cycle, overt vs. covert compulsions, cognitive defusion strategies, etc.
• Goals will differ for every client and may involve resisting urges or assigning social exposures. For someone with contamination OCD, for example, the goal might be to eat an item out of the fridge. For someone who is struggling with social settings, it might be going up to an employee at their local grocery store to ask a  question.
• The aim of our group is to help reduce distress caused by obsessions and compulsive behaviors while our clinical team is there to walk clients through processing their emotions and ask thoughtful questions about their experiences.
• Each session is 90 minutes in length to allow for 60 minutes of psychoeducation material and conversation around the experience and treatment of OCD, followed by 30 minutes of processing time. 
• When clients struggle to meet their goals, which is an inevitable part of the process, the power of the peer group is that they can provide a supportive, non-judgmental space for reflection, encouragement and growth. 

Why is ERP and ACT such an important part of the OCD Group Therapy Curriculum? 

It’s important to follow evidence-based treatment modalities to effectively address OCD and maximize outcomes. 

Exposure and response prevention therapy is the gold standard treatment for this diagnosis, with reports showing that up to 63-83% of patients can benefit from treatment. It works by offering a controlled, gradual hierarchy of exposures where clients learn to confront their stimulus (objects or thoughts that prompt distress) and stay in those situations, without engaging in any response behavior or mental ritual, until the anxiety decreases.

With time, frequency, and habituation, exposure can help clients build a tolerance to the anxiety they feel, and eventually, start to experience it decrease.

Working in complement with ERP, it’s helpful to integrate Acceptance and Commitment Therapy (ACT) which supports a person’s psychological flexibility. Because OCD is so often coined the “doubting disorder”, ACT offers a grounding counterbalance, reminding individuals to focus on their values and what it means to lead a values-guided life. 

Many of our clients in this stage of young adulthood are especially responsive to exploring their values and what feels most meaningful to them, making this treatment approach particularly resonant.

Can Any Therapist or Clinician Run an OCD Therapy Group?

It’s important that providers leading an OCD group, regardless of the age of the cohort, are skilled at working with individuals with OCD and, at minimum, are trained in ERP.

It is very easy for OCD symptoms to go unnoticed or under-diagnosed and some standard therapeutic approaches such as classic Cognitive Behavior Therapy (CBT) can do more harm than good. Clinicians trained in OCD treatment understand the critical distinction between when to refrain from reinforcing compulsions and when to redirect or engage with rumination. This is a nuanced skill that takes years of dedicated practice to develop.

Do Individuals Really Need Group Therapy for OCD? 

While many individuals can see improvement in OCD symptoms with stand-alone therapy, there is something very powerful about being part of a community milieu and peer group that can offer perspective, camaraderie and support. 

Every day, I see our clients learn from one another and begin to feel less alone in their experience. OCD is ego-dystonic in nature, meaning the thoughts and urges it brings often conflict with a person’s true beliefs, values, and intentions. This can lead to deep feelings of shame.

When clients come together and name what they’re experiencing, the symptoms begin to lose their power. The act of sharing normalizes the struggle and the power of that normalization is magnified tenfold in a group setting. 

What is the Result of Effective OCD Group Therapy?

The good news is that treatment for OCD offers some of the best outcomes of any mental health condition. Measurable relief is not only possible, it’s common with the right support and can happen in as little as 12-16 weeks with a targeted treatment plan. 

At The Dorm, 100% of clients who participate in OCD group therapy report that it has helped:

• Reduce feelings of shame, self-doubt and guilt and enhanced their ability to build a sense of self beyond their OCD diagnosis.
• Promote skills that allow them to be more emotionally available, connected in their relationships and present for life’s special occasions.
• Gained them back time and quality of life by helping them reduce repetitive behaviors. 
• Feel more comfortable with uncertainty, even when life feels unpredictable or inconsistent.
• Feel less isolated and alone in their experience. 

Is OCD Group Therapy Enough for Treatment? 

OCD treatment works best when it’s fully integrative and combined with other evidence-based treatment approaches. At The Dorm, for example, treatment often involves:

• In-depth psychoeducation to learn more about how OCD works including examples of cognitive errors i.e. the fact that one’s compulsions may have become more elaborate in order to maintain the same decrease in anxiety, but the anxiety continues to come back regardless.
• 1:1 individual therapy and clinical coaching to address underlying issues that may be fueling or perpetuating OCD symptoms. This may include focused ERP work that involves weekly homework assignments to work through resisting urges, exposures and habituation.
• Weekly OCD group therapy paired with  alternative weekly groups that promote complementary skill-building, processing and connection with peers. It’s truly beneficial for clients to engage in community with others who do not share their diagnosis, as this helps broaden perspective and supports the development of healthy relationships beyond their identity as someone managing OCD. For OCD clients, I tend to recommend The Dorm’s social group, dedicated ACT group, as well as sessions on mindfulness and yoga or general movement.  

Thank you, Anna for taking the time to walk us through our OCD group curriculum.

Know someone who needs support? 

Learn more about OCD Treatment for Young Adults at The Dorm in Washington, D.C. and New York City and Exposure Response Prevention Therapy (ERP