As I'm writing this, it occurs to me that choosing the right behavior therapist a bit like choosing the right suit. There are so many important things that are similar (and all important), that it's worth spending a little time discussing them. And, although I write this with a bit a humor to make it easier to read, I'm every bit as serious about everything I say as you are about getting treatment for your OCD.

First, when suit shopping, you want to find a good quality suit.
Likewise, the person with whom you are going to work one your most difficult issues should be a competent therapist. That means, in all U.S. states and in most countries, having both at least a Master's Degree as well as a license to practice therapy. Anyone can call themselves a counselor (even lawyers!), but a therapist is a legal term, with specific requirements. They should be able to tell you about their education, their training and the legal board overseeing their license. They should have several years of experience doing therapy, and should be able to tell you where and when they practiced. They should even be able to give you the names of their previous supervisors, since most therapy training is done with supervision. A competent therapist may be a psychiatrist, psychologist, a nurse, a Licensed Clinical Social Worker, a Marriage and Family Therapist, or any other recognized licensed member of the helping professions. However, just because one has a "higher degree" like an M.D. or a Ph.D. doesn't mean that they're necessarily better therapists or better trained than their counterparts with "lower degrees;" it only means they are more educated (this is NOT the same as more experienced!). Just as many different suits may be of good quality, they may come from different places or be of different designs.

Second, a suit has to do what you need it to do.
For instance, a business suit would not do for a "black-tie affair," and a summer suit may not do in the Fall and Winter. A good therapist may not know much about behavior therapy unless they studied it specifically. Most therapists here in the States are "generalists" by training, and may have heard about behavior therapy but never practiced it. Or, they may believe that behavior therapy involves relaxation training and nothing more. Nothing could be further from the truth. This is a bit like saying "you've seen one tree, you've seen them all." In fact there are many different types of behavior therapy, used for very different purposes. For OCD, you'll be looking for a behavioral therapist that uses Exposure and Ritual (or Response) Prevention (E&RP), the ONLY kind of behavior therapy with proven effectiveness on OCD symptoms. If you have a related Spectrum Disorder (like an Impulse Control Disorder or tic disorder then you'll be wanting to make sure the behavior therapist knows Habit Reversal Training as well). But don't just ask the therapist if they know the technique; that would be like calling a clothing store and asking if they had nice suits. Ask the therapist to describe how they do exposures, how they do ritual preventions, how they structure assignments (they should be able to tell you that you'll need to reinforce behavioral work daily in between therapy visits), and they should be able to discuss the hierarchy of symptoms with you. They should be familiar with at least as many of the different symptoms of OCD as you are, and should be able to discuss the Yale-Brown Obsessive Compulsive Scale with you, at least in terms of discovering the extent of your OCD. Also, a good behavior therapist should be willing to leave their office to do certain exposures with you. If the therapist tells you that they NEVER leave their office for the sake of an "on-site" exposure, that's a clue that it's time for YOU to leave their office.

Third, a good suit needs to be tailored to you, at least for alterations.
The good behavior therapist needs to be able to tell you what they can offer in terms of individual, family or group treatment, support groups, interactions with other professionals (especially your physician if the therapist is not one). They should be willing to tell you how long they've been doing therapy, how long they've been working with OCD patients, whether they specialize in working with adults or children, and how many OCD patients they've seen in that time. As importantly, they should be able to tell you what they CAN'T offer. No one can offer everything, and you deserve the honesty that this answer provides.

Finally, a good suit has to fit you well. Many good behavior therapists may know OCD, may be competent with E&RP and may be recommended by a friend or other professional. However, if you don't "click" as a working pair, you won't be able to do the work as effectively. You might be able to get this feeling about the therapist from your first meeting, or from hearing them at a public lecture. But most of the time, it takes a few sessions before you know if you'll be comfortable working together. Make sure the therapist is willing to re-evaluate with you your working relationship after 4-6 sessions. But also remember, you might end up with someone that you trust and respect, but don't necessarily like well enough to want them to inherit the family estate. The important thing is, can you form a trusting relationship with this person, and can they help you learn and practice the skills you need to effectively manage your OCD symptoms? Hopefully, the answer will be yes.

All of this assumes that you already know how to get to the clothing store, or at least know how to look up their address and phone number. Where do you start? The Yellow Pages may be fine for suits, but not for behavior therapists specializing in OCD treatment. One of the best places to find referrals to behavior therapists is by recommendations from members of OCD support groups in your area. If there aren't ones that you're aware of, then contacting the OC and Spectrum Disorders Association (who screen their recommended providers) in Los Angeles, the OC Foundation in Connecticut, the OCD Information Center in Madison, the Association for the Advancement of Behavioral Therapists or the Anxiety Disorders Association of America may be more practical. Most importantly to remember is that you're the consumer of therapy services, and you have every right to be satisfied with your service. After all, you're employing them to help you, aren't you? Be a pro-active consumer, and don't settle for suits that don't suit you if you have a choice.

OCD Resources

OC & Spectrum Disorders Assn.

The OC Foundation, Inc.

OCD Information Center

Obsessive-Compulsive Anonymous

Association for Advancement of

The Anxiety Disorders Association of America

The Trichotillomania Learning Center (TLC)