Therapy and O.C.D. in the time of coronavirus

Exposure and response prevention therapy is the most effective treatment, experts say. It systematically tests a patient’s worries that something will harm them by exposing them in a prolonged, repetitive and intensifying system to things that they fear.

When the exposure doesn’t cause significant illness or harm, the patients can begin to learn how to better cope.

But the unusual and urgent focus on sanitation to fight the spread of the virus is also creating concerns for health care professionals involved in the treatment of O.C.D., said Bradley Riemann, a psychologist and the chief clinical officer of Rogers Behavioral Health, which has mental health and addiction treatment centers around the country. (Dr. Riemann is also the clinical director of Rogers’s O.C.D. Center, in Oconomowoc, Wis.)

That’s why providing treatment for O.C.D. right now is especially complicated. “This is clearly a time when we have had to change the way we interact with one another and the way we interact with our environment — it’s a matter of public safety for all of us,” Dr. Riemann said. “But it really collides with the world of O.C.D., and in particular with patients with contamination O.C.D.”

Usually, Dr. Riemann and his staff work with patients by asking them to interact with germs, increasingly extending the amounts of time between washing their hands or otherwise sanitizing. In some situations, he said, patients are asked to touch toilet seats or bathroom floors, and then are given food to eat before washing their hands.

“As you can see, the world we live in today, that collides head on with that kind of treatment intervention,” he said. “It has been very challenging to try to achieve a balance where you are keeping your staff and patients as safe as we all can be, yet still providing effective treatment.”