OCD & ERP Case Consultation for Therapists
Practical, individualized case consultation for mental health clinicians treating OCD and complex ERP presentations.
I'm Dr. Jen Viscusi, a licensed clinical psychologist specializing in obsessive-compulsive disorder (OCD) and Exposure and Response Prevention (ERP).
I provide individual professional consultation to therapists seeking support with OCD case conceptualization, mental compulsions, reassurance dynamics, and complex or stalled ERP treatment.
Who Consultation is For:
I work with psychologists, clinical social workers, mental health counselors, LPCs, LMHCs, and other clinicians who treat individuals with OCD.
Consultation may be particularly useful if you:
Have foundational ERP knowledge but encounter challenges applying it to complex cases
Regularly treat OCD and want another specialist's perspective
Find that reassurance, avoidance, or mental rituals are interfering with progress
Are uncertain how to conceptualize a particular presentation
Want to strengthen your clinical decision-making around ERP
Consultation is case-focused and collaborative. It is not a substitute for foundational ERP training or required clinical supervision.
Common Reasons Clinicians Seek Consultation
When treatment seems stuck
A client understands the rationale for ERP and completes exposures, but continues spending significant time ruminating, reviewing, or seeking reassurance. You want to understand what may be maintaining the cycle.
When compulsions are difficult to identify
A client presents with relationship doubts, disturbing sexual or violent intrusive thoughts, scrupulosity, or "just right" concerns. Much of the compulsive behavior occurs internally, making response prevention difficult to define.
When ERP is difficult to implement
You have developed an exposure hierarchy, but the client avoids assignments, performs subtle rituals during exposures, or begins using ERP itself as a way to obtain certainty or relief.
When the therapist becomes part of the OCD cycle
Sessions repeatedly return to reassurance seeking, diagnostic certainty, or requests for confirmation. You want to respond therapeutically without inadvertently accommodating OCD.
When the clinical picture is unclear
You are considering differential diagnosis, overlapping symptoms, or whether the current treatment approach adequately addresses the processes maintaining the client's difficulties.
What We Can Work On
OCD Case Conceptualization Clarifying obsessions, behavioral and mental compulsions, avoidance, safety behaviors, reassurance seeking, and the processes maintaining symptoms.
Reassurance and Therapist Accommodation
Identifying how reassurance, excessive processing, repeated clarification, or therapist responses may unintentionally reinforce compulsive patterns.
ERP Strategy and Response Prevention
Developing or refining exposure hierarchies, identifying meaningful response-prevention targets, addressing treatment-interfering avoidance, and troubleshooting exposures that are not producing useful learning.
Complex OCD Presentations
Working through clinical challenges involving relationship OCD, sexual or violent obsessions, harm OCD, scrupulosity, perfectionism-related symptoms, and "just right" experiences.
Mental Compulsions and Rumination
Recognizing covert rituals, including mental reviewing, checking feelings, analyzing intentions, reconstructing memories, and attempts to obtain internal certainty.
Diagnostic and Treatment Questions
Considering differential diagnosis, co-occurring conditions, stalled progress, and when a case formulation or treatment strategy may need reconsideration.
My Approach to OCD Case Consultation
My approach is direct, collaborative, and clinically grounded.
I focus on helping clinicians understand what is happening within a case and translate that understanding into practical treatment decisions. We may examine subtle compulsions, reconsider exposure targets, identify ways reassurance has entered treatment, or refine how ERP is being implemented.
The goal is not to provide a rigid protocol for every presentation. It is to strengthen your ability to conceptualize OCD and make thoughtful, effective clinical decisions.
About Dr. Jen Viscusi
I am a licensed clinical psychologist with more than a decade of clinical experience and specialized training in OCD and Exposure and Response Prevention.
My clinical work includes complex OCD presentations involving taboo intrusive thoughts, relationship OCD, scrupulosity, mental compulsions, and difficult ERP implementation.
Alongside my work with patients, I provide professional case consultation to clinicians seeking a focused, practical perspective on OCD assessment, conceptualization, and treatment.
Consultation Format
Consultation is offered individually via secure telehealth in 60-minute sessions.
One-time consultations are welcome, and ongoing consultation is available for clinicians who would benefit from continued case discussion and support.
Each meeting is tailored to your clinical questions, whether you're seeking input on a specific case, troubleshooting ERP implementation, or working through ongoing treatment challenges.
Therapists and mental health clinicians throughout the United States are welcome to inquire about professional consultation.
Consultation vs. Supervision
Professional case consultation is distinct from clinical supervision.
Consultation provides collaborative input on assessment, case conceptualization, ERP implementation, and treatment decisions. It does not establish a supervisory relationship or fulfill supervision requirements for licensure, employment, or training.
The treating clinician retains responsibility for diagnosis, clinical decision-making, documentation, risk management, and the care provided to their clients.
Consultation is not psychotherapy or emergency clinical support.
Frequently Asked Questions
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Consultation is intended for psychologists, social workers, counselors, LPCs, LMHCs, and other mental health clinicians who treat OCD and want individualized support with case conceptualization or ERP implementation.
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Consultation may address relationship OCD, taboo intrusive thoughts, harm-related obsessions, scrupulosity, perfectionism-related OCD, "just right" symptoms, and other presentations involving complex compulsions, avoidance, or diagnostic questions.
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Yes. Mental compulsions, rumination, covert checking, and mental reviewing are frequent consultation topics. We can examine how to recognize these processes and develop clinically appropriate response-prevention strategies.
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Yes. Consultation can focus on identifying reassurance dynamics, including situations in which a therapist may inadvertently participate in compulsions, and developing more therapeutically useful responses.
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Yes. One-time consultation is welcome. You do not need to commit to an ongoing consultation arrangement.
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Yes. Ongoing consultation is available for clinicians who want continued support with complex cases, ERP implementation, or developing clinical reasoning in OCD treatment.
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No. This is professional case consultation, not formal clinical supervision. The treating clinician remains responsible for their clinical work.
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Therapists and mental health clinicians throughout the United States are welcome to inquire about professional consultation, subject to applicable professional and licensing requirements.
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Yes. Stalled or difficult-to-progress ERP cases are an important focus of consultation. We can review the case conceptualization, exposure targets, mental compulsions, reassurance, avoidance, and other processes that may be interfering with progress.
Request a Professional OCD Consultation
If you're treating OCD and would benefit from a focused discussion of a complex case or ERP implementation challenge, I invite you to get in touch.