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OCD & BFRB Clinic

Archways Centre for CBT is an Institutional Member of the International OCD Foundation (IOCDF). We currently have clinicians with specialized training in the treatment of OCD and other conditions related to OCD. It can be difficult to find clinicians trained in evidence-based therapies for OCD and BFRBs, so we are happy to be able to offer our specialized services virtually across Ontario.

June 2024

OCD & BFRB Clinic Services

Obsessive Compulsive Disorder (OCD)

Body Focused Repetitive Behaviours (BFRBs)

Obsessive Compulsive Disorder (OCD)

Affecting approximately 1 or 2 out of 100 individuals (National Institute of Mental Health), OCD consists of obsessions (thoughts, images, impulses, ideas, doubts) and compulsions (actions or thoughts aimed at neutralizing the obsessions). Obsessions can be focused on any subject matter, but they are different from worries in that they are more excessive and tend to be inconsistent with the individual’s character or values. Compulsions are often behaviours (e.g. washing/cleaning, checking, ordering, repeating an action etc.) but can also be thoughts (e.g. mental checking, reviewing memories, reassurance seeking, distracting/blocking, counting etc.)

Use our OCD screening tool, designed as a guide to determine if you might have Obsessive Compulsive Disorder (OCD).

Click below to learn more about our services for OCD.

TYPES OF Treatment

  • Cognitive behaviour therapy (CBT)
  • Exposure and response prevention (ERP)
  • Acceptance and committment therapy (ACT)
  • Booster sessions

Areas of Specialty

  • Obsessive Compulsive Disorder (OCD)
  • Perfectionism
  • Scrupulosity
  • Violent/Sexual Obsessions
  • Body Dysmorphic Disorder
  • Hoarding Disorder
  • Skin Picking
  • Trichotillomania (Hair pulling disorder)
  • Treatment of Co-occurring Disorders

Treatment Planning Process

The initial appointment involves a general clinical assessment, followed by a more detailed OCD assessment using a behavioural formulation approach. Obsessions, compulsions (behavioural and mental), and avoidance strategies are explored. Based on a combination of the client's goals and the clinician's impressions, short-term and long-term treatment goals are developed. Pre and post measures are given, usually YBOCS and/or Obsessive Compulsive Inventory. Other measures are given depending on the themes of the obsessions. Psychoeducational materials are also provided to orientate the clients to the function of compulsions, as a basis of understanding how treatment works.

Core Treatment Components

Our psychologists are trained in providing exposure with response prevention (ERP). Woven into this may be components of other approaches. For example:

  • Cognitive therapy (to explore the meaning attached to the obsessions)
  • Comprehensive behavioural therapy ComB (for comorbid BFRBs)
  • Values assessment (acceptance and commitment therapy)
  • Behavioural activation (for comorbid depression)
  • Problem-solving (to manage other life issues)

If your psychologist or therapist thinks that you could benefit from medication in combination with ERP, they can arrange for a Psychiatry Consultation.

Treatment of Co-Morbid Disorders

Co-occurring disorders are common with OCD. We mostly see concurrent depression, generalized anxiety, sleeping problems and BFRBs. Our psychologists and therapists are trained to work with any co-morbid conditions, so long as studies have shown that CBT is the treatment of choice. If a client has a significant addiction problem, we would refer them to a suitable program if it was indicated.

Our OCD & BFRB Clinic primarly sees individuals with OCD and BFRBs. Body dysmorphic disorder (BDD) and hoarding disorder can also be treated at Archways.

Length of Stay

We are a private clinic where clients rely on self-funding or insurance benefits to cover the costs of treatment. Since these plans vary, a client might be able to only attend 3 sessions. Other more severe cases of OCD may require 50+ sessions. We do not cap the length of treatment as long as the client is progressing. If they are not progressing, we will consider doubling the dosage of therapy (i.e. increasing frequency of sessions) or referring them for a psychiatry consultation.

Body Focused Repetitive Behaviours (BFRBs)

BFRBs is a term that describes a group of conditions characterized by excessive and repetitive self-grooming behaviours, resulting in damage or physical injury.

Click below to learn more about BFRBs.

Hair Pulling (TrichotillomanIa)

Hair pulling disorder (also known as Trichotillomania) is characterized by excessive and repetitive pulling of one’s hair from one or more parts of the body. Trichotillomania is officially classed as an “Obsessive-Compulsive related disorder” (DSM-5), but it is more commonly known as a BFRB.

Use our free Hair Pulling Disorder Screening Tool.

Skin Picking

Skin picking disorder (also known as Excoriation or Dermatillomania) is characterized by excessive and repetitive picking of one’s skin from one or more parts of the body. Officially classed as an “Obsessive-Compulsive related disorder” (DSM-5), this type of self-grooming behaviour is also considered a Body Focused Repetitive Behaviour (BFRB). BFRBs are characterized by excessive and repetitive self-grooming behaviours, resulting in damage or physical injury.

Use our free Skin Picking Disorder Screening Tool.


Other examples of BFRBs include (but are not limited to) nail biting, cheek biting and lip biting. Some individuals experience more than one type of BFRB. When these behaviours cause noticeable hair loss or skin damage, or to the degree of impairment (including avoidance), it may be time to seek professional help.

OCD & BFRB Clinic Staff:

Think you might have OCD or a BFRB?