Frequently Asked Questions About OCD, BDD, BFRB & Anxiety Therapy

Costs, insurance, session length, teletherapy logistics, and how the work is structured. What people want to know before they reach out. If your specific question isn't here, the free 15-minute consultation is a good place to ask it.

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01 Costs, Insurance & Payment

Standard 50-minute sessions are $275. I also offer 75-minute sessions ($400) and 90-minute sessions ($475) for clients who benefit from a longer session format. Extended sessions are common in ERP-focused work because exposures often need more than 50 minutes to build meaningfully. All fees are due at the time of session.
Specialty ERP, CBT-focused, and ACT-informed treatment for OCD, BDD, BFRBs, and severe anxiety requires specific training and ongoing continuing education that generalist therapy doesn't. The rate reflects the specialization, not the therapy hour. For comparison, generalist therapy in NYC typically runs $200-$300 per session, and specialty OCD/BDD rates in the NYC metro area run $250-$500 per session.
No. I'm an out-of-network provider across all insurance plans, which means you pay at the time of session and I provide a monthly superbill you can submit to your insurance for potential reimbursement if you have out-of-network mental health benefits.
Insurance panels for mental health providers typically pay a fraction of the actual cost of specialized care, and they require diagnostic coding that reduces flexibility in how treatment is structured. Working as out-of-network means I can offer the level of specialized care OCD, BDD, and BFRB treatment requires, and clients with OON benefits still get partial reimbursement through their insurance.
A superbill is a detailed receipt from your therapist that lists your diagnosis, the services provided, the dates of service, and the fees paid. You submit the superbill to your insurance company, which then reimburses you a portion of the fee based on your out-of-network mental health benefits. I provide a superbill monthly, and you keep them for your records.
Call the number on the back of your insurance card and ask three specific questions: (1) "Do I have out-of-network mental health benefits?" (2) "What is my out-of-network reimbursement rate for a licensed clinical social worker (LCSW)?" (3) "What is my out-of-network deductible for mental health services, and how much of it have I met this year?" Many plans reimburse 50-80% of the session fee once the OON deductible is met.
Reimbursement varies significantly by plan even within the same insurance company, so plan-level details matter more than the insurance company name. That said, Aetna, Cigna, BCBS/Anthem, and United typically offer OON benefits with reasonable reimbursement rates for LCSWs. Medicare and Medicaid do not reimburse for out-of-network providers.
Sessions are still available at the standard rate as a private-pay client. Some clients choose to invest in specialized care because they've tried in-network options that didn't help, and specialized treatment produces better outcomes for OCD, BDD, and BFRB conditions than generalist therapy typically can.
At this time I do not offer sliding scale. If cost is a barrier, I'm happy to refer you to specialized OCD and BDD clinicians who offer more accessible rates or work with insurance.
Payment is due at the time of session. I accept credit cards, HSA/FSA cards, and other standard payment methods through a secure payment platform.
Sessions cancelled less than 24 hours in advance are billed at the full session rate. If you need to reschedule with more than 24 hours' notice, I'll do my best to find another time in the same week.

02 Session Structure, Length & Frequency

Standard sessions are 50 minutes. I also offer 75-minute and 90-minute sessions, which are common in ERP-focused work because exposures often need more than 50 minutes to build in a meaningful way. If our 50-minute sessions consistently feel rushed or the work needs more room to breathe, we can discuss moving to a longer session length together.
Weekly sessions for the first three to four months. This is clinical necessity for ERP-focused work, not a preference. Biweekly sessions don't build the momentum needed to interrupt the OCD, BDD, or BFRB cycle, and progress often stalls or reverses on that schedule. Once we've established meaningful traction and the underlying pattern has genuinely shifted, we can discuss moving to biweekly if that fits your goals.
ERP works through repeated, structured practice that builds evidence for the brain that discomfort is survivable and temporary. That evidence-building depends on frequency. Biweekly sessions leave enough time between exposures for the anxiety and doubt to reconsolidate, which means the cycle keeps regenerating. Research on ERP outcomes consistently shows weekly (or more frequent) sessions produce meaningfully better results than biweekly for OCD-spectrum conditions.
Yes. Once we've established meaningful traction (usually 3-4 months of consistent weekly work) and the pattern has genuinely shifted, we can discuss moving to biweekly or as-needed sessions. Some clients benefit from maintenance sessions well after the intensive work is complete.
Most clients begin noticing meaningful change within two to three months of consistent ERP work. A full course of treatment runs six to twelve months for most clients, depending on severity, subtypes present, and complexity. OCD, BDD, and BFRB conditions are all treatable, and sustained recovery is the expected outcome of good specialty treatment.
Missed sessions without proper cancellation notice are billed at the full rate. I'm generally understanding of genuine emergencies (illness, family crises, unavoidable work conflicts). Please give as much notice as possible.
I do my best to accommodate schedule changes. During heavy treatment phases (weekly sessions in the first few months), consistency matters most, and rescheduling should be a rare exception rather than a regular practice.

03 The Free 15-Minute Consultation

You describe what's been happening in whatever words you have for it. I ask a few questions to understand what you're dealing with. I give you an honest read on whether the work I do is the right fit for what you have, what the treatment would involve, and what's realistic to expect. If we're not the right fit, I'll tell you and refer you to a colleague who is.
No preparation needed. You don't need to have a diagnosis, describe your intrusive thoughts in detail, or explain your history. You can start by saying "something is going on and I don't know what to call it" and that's enough.
Yes. Fully free, no strings attached. There's no commitment to book a session afterward.
That's completely fine. Some people book consultation calls to get information they can act on later. Some people call, decide they need to do a few things first, and reach back out weeks or months later. There's no pressure.
Yes. Part of what I do in the consultation is help you figure out what you're actually dealing with. Many clients come in with a suspicion but no diagnosis; others come in with something else on their mind that turns out to be OCD-spectrum on closer look.
Use the "Book a Free 15-Minute Consult" button on any page of the site, or contact me directly through the contact page.

04 How Treatment Actually Works

ERP is the gold-standard treatment for OCD, BDD, and related conditions. It works by gradually facing the situations, thoughts, or sensations that trigger the compulsion, and practicing not performing the compulsion. Over time, the brain learns that the discomfort is survivable and temporary, and the cycle loses its grip. It's not about white-knuckling through fear. It's about building evidence, one small step at a time, that you can be in the situation without performing the compulsion.
Cognitive Behavioral Therapy (CBT) is a broader framework that identifies thought patterns and behaviors that sustain distress, and provides tools to change them. ERP is a specific behavioral technique within the broader CBT framework, developed for OCD-spectrum conditions. In practice, I use CBT to address the thought patterns and behaviors driving anxiety, and ERP for the response cycle itself.
Acceptance and Commitment Therapy (ACT) helps you change your relationship with difficult thoughts and feelings, so they have less power over what you actually do in your life. For OCD and anxiety, ACT complements ERP by helping you keep moving toward what matters even when the intrusive thoughts and worries don't disappear.
I'm a licensed clinical social worker and don't prescribe medication. Many clients benefit from combining ERP with SSRIs, and I coordinate with prescribing psychiatrists when medication is part of the treatment plan. If you're not currently on medication and want to consider it, I can refer you to psychiatrists who understand OCD, BDD, and BFRB conditions specifically.
This is one of the most common things new clients tell me. Most previous therapy for OCD, BDD, or BFRB conditions wasn't ERP-based or wasn't ERP done correctly. Talk therapy that relies on reassurance, insight, or open-ended processing tends to quietly feed OCD-spectrum cycles rather than break them. Specialized ERP is structured differently by design.
The first session focuses on getting a detailed picture of what you're actually dealing with: the specific thoughts, the specific compulsions (behavioral and mental), the specific patterns of avoidance, and what has been tried before. You don't need to describe intrusive thoughts in detail unless you want to. We build the treatment plan around what's actually running.
Change usually shows up in your week before it shows up in how you feel. You notice you did something OCD said you couldn't. You stop reorganizing your day around a compulsion. You find yourself in situations that would have derailed you before and you handle them. Formal measures also help. I use standardized assessments periodically to track symptom reduction over time.
Plateaus happen and they're not a sign of failure. When we hit one, we look at what's changed, what's stuck, and whether the treatment approach needs adjustment. Sometimes we intensify (add exposures, increase session frequency). Sometimes we address something underneath (co-occurring depression, life circumstances, medication changes). We adjust based on what's actually happening.

05 Teletherapy & Access

No. All sessions are conducted via secure teletherapy. This is intentional: for OCD, BDD, and BFRB work, teletherapy is often more effective than in-person sessions because ERP exposures happen in the environments where the compulsions actually occur (your home, your inbox, your bathroom mirror) rather than in a neutral office.
New York, California, Florida, Connecticut, and New Jersey. To work with me via teletherapy, you must be physically located in one of these states during the session.
Yes, and often more effective for these specific conditions. Research consistently shows teletherapy outcomes match in-person outcomes for OCD, BDD, and anxiety disorders. Beyond the research, ERP works by changing how you respond to real-life triggers, and real-life triggers happen in your real life. Doing the work from your own home means the treatment is happening where the patterns actually live.
I use a HIPAA-compliant, secure video platform designed for healthcare providers. You receive a link before each session.
A private space where you won't be interrupted or overheard, a device with a camera and microphone (laptop, tablet, or phone), and a stable internet connection. That's it.
We reconnect. If we can't reestablish the video connection, we can continue by phone for the remainder of the session, or reschedule.
Yes. As long as you're physically located in New York, California, Florida, Connecticut, or New Jersey during the session, you can be at home, at work, traveling, or anywhere else within that state.
Legally, I can only provide therapy to clients who are physically located in states where I'm licensed. If you'll be traveling to a state I don't cover for an extended period, we'll need to pause treatment during that time.

06 What I Treat

Obsessive-Compulsive Disorder (OCD) and all OCD subtypes, including Pure-O, Harm OCD, Sexual OCD, Relationship OCD (ROCD), Scrupulosity, Contamination OCD, and others. Body Dysmorphic Disorder (BDD). Body-Focused Repetitive Behaviors (BFRBs), including trichotillomania (hair pulling), excoriation (skin picking), and nail biting. Anxiety disorders, including Generalized Anxiety Disorder (GAD), panic disorder, and health anxiety. I also work with body image concerns and self-esteem issues that often accompany these conditions.
I primarily work with adults. If you're inquiring about a teenager or child, please reach out and I can either help determine if they're a fit or refer you to specialized child and adolescent OCD/BDD clinicians.
Both. Many clients have both OCD and generalized anxiety, or panic disorder, or health anxiety. Treatment addresses the specific cycles for each, using ERP, CBT, and ACT as appropriate.
Yes. OCD and BDD frequently co-occur, and treatment for one often supports treatment for the other because the underlying cycles are similar. Many of my clients have both, and treatment is integrated.
Trauma is often present alongside OCD, BDD, and anxiety, and I work with trauma when it's part of what's driving the condition. That said, I'm not a trauma-first specialist. If your primary presenting concern is PTSD or complex trauma, I can refer you to colleagues who specialize in trauma-focused treatment (EMDR, prolonged exposure for PTSD, etc.).
Depression frequently accompanies OCD, BDD, and BFRB conditions, and treatment addresses it as part of the broader picture. If depression is your primary concern rather than co-occurring, I can refer you to depression-focused specialists.

07 About Working With Robyn

I'm a Licensed Clinical Social Worker (LCSW) with specialized training in ERP, CBT, and ACT for OCD, BDD, BFRBs, and anxiety disorders. I've been in practice for over a decade specializing in these conditions. I'm an active member of the International OCD Foundation (IOCDF) and serve on the IOCDF's Conference Planning Committee for BDD. I've been featured on Good Morning America and consulted by the IOCDF on BDD-specific issues.
Yes, and this is a significant part of what shapes my clinical work. I have my own lived recovery with BDD specifically, which gives me a level of understanding of what these conditions actually feel like that isn't purely clinical. That combination — clinical training and personal experience — is unusual in this field and matters when you're working with something hard to put into words.
Most therapists who list OCD or BDD on their profile treat it as one of ten or fifteen things they see clients for. Very few have specific ERP training. Even fewer specialize in the OCD spectrum as their primary focus. My practice is built around OCD, BDD, BFRBs, and anxiety exclusively, which means the depth of specialization is different from a generalist who sometimes sees OCD clients.
The 15-minute consultation is designed to answer exactly this question. It's not a sales conversation, it's a fit assessment. If I'm not the right therapist for you, I'll tell you and help you find someone who is.
Trauma is often present alongside OCD, BDD, and anxiety, and I work with trauma when it's part of what's driving the condition. That said, I'm not a trauma-first specialist. If your primary presenting concern is PTSD or complex trauma, I can refer you to colleagues who specialize in trauma-focused treatment (EMDR, prolonged exposure for PTSD, etc.).
Everything you share is confidential and protected under HIPAA. The exceptions are limited and legally required: if you're in imminent danger to yourself or others, if child or elder abuse is disclosed, or if I'm subpoenaed by a court. I discuss confidentiality in detail in our first session.

08 For Specific Situations

The work I do is direct treatment with the person experiencing the condition. If you're a partner or family member of someone with OCD, BDD, or a BFRB, the most useful next step is usually for the person experiencing it to book their own consultation call. If they're not ready to do that, I can point you to family-focused resources through the IOCDF.
You don't need a formal diagnosis to work with me. Many of my clients have never been formally diagnosed. Part of the initial work is figuring out what's actually running.
No. Cosmetic procedures are one of the most common paths people with BDD try before finding specialized treatment. Trying them doesn't change how I work with you.
Yes. Postpartum OCD in particular has specific features that specialized treatment addresses. I work with clients throughout pregnancy and the postpartum period.
The specialist gap in the U.S. is real, especially for OCD, BDD, and BFRB conditions. Working with an out-of-network specialist via teletherapy often ends up being both faster to access and more effective than continuing to search for an in-network local specialist. If cost is a barrier, I can point you to lower-cost options through the IOCDF referral network.

Ready to book a consultation, or still have questions?

The free 15-minute consultation is where individual questions get answered. There's no pressure to commit and no obligation to continue.