Does NOCD Work?
NOCD is an online platform through which people can receive live exposure and response prevention (ERP) teletherapy from a licensed therapist. This platform has become increasingly popular and a number of patients have asked about my opinion on it. While I cannot give firm conclusions about this program’s delivery of treatment, I can provide my impressions based on conversations with clients who have undergone NOCD treatment and clinicians who have been a part of their training program as well as results published by NOCD.
How effective is NOCD?
Results published by NOCD suggest that its treatment is as effective as traditional ERP. In both NOCD and traditional ERP, an average of 70% of patients experienced a significant effect from treatment (at least a 35% reduction in OCD symptoms). Furthermore the study on NOCD reports that these results were reached in “less than half of the total therapist time compared to traditional outpatient ERP (Fuesner et al., 2020)”
The content within NOCD treatment seems to be very similar to traditional ERP as well. Clients that I’ve treated who previously tried NOCD report that they were guided through traditional ERP processes such as making a hierarchy and doing exposures in an attempt to habituate to their OCD themes. Therefore, if you haven't tried therapy before, NOCD has potential to be a useful option.
“NOCD Didn’t Work”
Is NOCD not working? While offering traditional ERP can be a strength of NOCD, it can also be a weakness. Traditional ERP is garnering more and more evidence that it has several shortcomings, including a high relapse rate and failing to be effective for a significant amount of people with OCD. Therefore, if you already tried traditional ERP treatment and did not get the results you were looking for, I would not be confident that NOCD would be any different. Instead, you may benefit from what I would consider to be the more up to date and effective treatment approach: the Inhibitory Learning model of ERP. To learn more about the differences between this model and the traditional model of ERP, read more here.