At Steadfast Psychiatry, Daniel Georges, MSN, PMHNP-BC, offers individualized psychiatric assessment and medication management through telehealth for eligible adults in New York. Your concerns, history, and preferences shape the care plan, with clear conversations about options and follow-up.
Understanding OCD
Obsessive-compulsive disorder can involve intrusive, unwanted thoughts, images, or urges and repetitive behaviors or mental rituals performed to reduce distress or prevent feared outcomes. Themes may include contamination, harm, checking, symmetry, relationships, or other concerns. OCD is not simply a preference for neatness.
What an evaluation looks like
We explore obsessions, compulsions, avoidance, distress, time spent on rituals, and how symptoms affect daily functioning. It is also important to distinguish OCD from generalized worry, trauma-related symptoms, psychosis, and other conditions. Patients can discuss difficult or embarrassing thoughts without judgment.
Evidence-based approaches
Exposure and response prevention (ERP), a specialized form of cognitive behavioral therapy, is a first-line treatment for OCD. Certain medications, often serotonin reuptake inhibitors, can also be appropriate. When needed, psychiatric medication management can complement work with an ERP-trained therapist. Improvement is usually gradual and monitored over time.
Obsessions and compulsions can be hidden
Compulsions are not limited to visible checking or washing. Some people repeatedly review conversations, seek reassurance, mentally neutralize intrusive thoughts, or avoid triggers. A sensitive assessment identifies the time spent on obsessions or rituals and the degree of impairment without reinforcing compulsions. The goal is to understand the repetitive cycle of distress and short-term relief, not to judge the content of intrusive thoughts.
What evidence-based treatment emphasizes
Exposure and response prevention (ERP) is a specialized cognitive behavioral approach that helps a person face triggers while reducing rituals and avoidance. Some people also benefit from an SSRI, either alone or together with ERP depending on severity and preference. OCD treatment response can take longer than patients expect and should be assessed over an adequate trial, including functional improvement. If specialized ERP is not offered within the practice, care coordination or referral may help patients access it.
Frequently asked questions
Is OCD only about cleaning or checking?
No. Obsessions and compulsions can take many forms, including largely mental rituals.
Do you provide ERP therapy?
Medication evaluation and care coordination can be discussed; if specialized ERP is needed, referral to an ERP-trained therapist may be recommended.
Does having an intrusive thought mean I want to act on it?
Intrusive thoughts alone do not establish intent. A personalized assessment can help clarify symptoms and any relevant safety concerns.
Next steps
If these concerns sound familiar, a consultation can help clarify your options. Appointments are designed for collaborative, evidence-informed planning rather than a predetermined diagnosis or prescription.
View appointment availabilityInformation on this page is educational and is not a diagnosis or a substitute for individualized evaluation. Content prepared for Steadfast Psychiatry; clinical content should be reviewed periodically by Daniel Georges, PMHNP-BC.
Clinical reference materials
These resources inform general evidence-based care; treatment recommendations are individualized.
Editorial content updated October 21, 2026. Formal clinician review is pending; this information does not replace individual assessment.