Relentless what if thoughts, rituals that take over your day, urges to check or avoid until life starts shrinking. At Cura Mind and Wellness, patients across the Houston metro receive specialized, evidence based care for Obsessive-Compulsive Disorder. In person services are available in Richmond, TX, with secure telehealth for patients throughout Houston and Fort Bend County.
Care is directed by Vivian Emuobe, MSN, BSN, APRN, PMHNP-BC, a board certified psychiatric mental health nurse practitioner experienced in complex anxiety and mood disorders. Our program combines exposure and response prevention, ERP, targeted medication management, and practical coaching so you can reclaim time, energy, and confidence.
OCD 101, obsessions, compulsions, and the loop
Obsessions are intrusive thoughts, images, or urges that feel unwanted and alarming. Compulsions are mental or physical actions done to reduce the distress, for example, checking, washing, repeating, seeking reassurance, counting, or reviewing memories. Relief is brief, which teaches the brain to demand another ritual. ERP therapy breaks this loop by helping you face feared thoughts and situations, then not perform the compulsion, so anxiety rises, peaks, and falls naturally. With repetition, the brain relearns safety.
OCD is not just about cleanliness. We treat contamination concerns, harm and safety fears, religious or moral scrupulosity, sexual or relationship obsessions, perfectionism and just right feelings, symmetry and ordering, and intrusive what if thoughts about health or mistakes at work.
How OCD shows up in Houston life
- Avoiding freeways because of fear of hitting something, circling blocks to recheck,
- Long pre work rituals, washing, arranging, repeating steps until late,
- Reassurance loops with partners by text or in person,
- Rewriting emails at energy companies, hospitals, or tech firms until deadlines pass,
- Mental rituals during meetings, reviewing, neutralizing, or silently counting,
- Skipping gatherings in Sugar Land, Katy, or Missouri City due to fear of contamination or panic.
If OCD is stealing time from work, school, family, and sleep, there is a proven way to take that time back.
Our evaluation, clarity before action
Your first visit maps the OCD cycle precisely. We clarify themes, triggers, compulsions, avoidance patterns, safety behaviors, co existing concerns such as depression, panic, ADHD, or trauma, and medical factors like sleep or thyroid. We use validated symptom measures to set a starting point. Together we define goals that matter, driving to work without detours, sending emails once, sitting with family without rituals, sleeping through the night.
ERP is the gold standard, what it looks like here
We build a graded plan of exposures matched to your themes, then practice response prevention so the compulsion is delayed and gradually reduced. Examples include:
- Touch, do not wash, reduce sanitizing, sit with the urge and let it fade,
- Write feared sentences, read them aloud, stop mental neutralizing,
- Purposefully send a single pass email, live with uncertainty,
- Drive a planned route without circling back,
- Reduce reassurance questions, then stop them, while using coping scripts.
Sessions include skill building, coaching, and between session practice. ERP is challenging, but paced. You are never ambushed. You know the plan, and you guide the speed.
Medication that supports progress
Many patients benefit from medication that lowers baseline anxiety so ERP is easier to do. We use SSRIs and related options at therapeutic doses for OCD, titrated carefully and monitored for side effects. When history includes non response or sensitivity, pharmacogenomic gene testing at the Richmond office may help personalize selection and dosing. If depression co occurs, we integrate treatment for both conditions rather than treating them in isolation.
In select, treatment resistant cases, we discuss advanced options. TMS has FDA cleared protocols for OCD and can be considered when criteria are met, available in Richmond. Emerging evidence supports ketamine for OCD in specific scenarios. These conversations are individualized, conservative, and grounded in safety.
Family and partner involvement, reducing accommodation
Loved ones often get pulled into rituals, answering reassurance questions, helping with checking, avoiding triggers as a household. We provide guidance to reduce accommodation gently and consistently. Clear scripts and boundaries help families support recovery without feeding the OCD loop.
Telehealth ERP, built for consistency
ERP works well through secure video when structure is strong. Many exposures are done at home or work, which can be more realistic than clinic only practice. We create stepwise plans, shared exposure logs, and brief check ins between sessions to keep momentum. If an exposure requires clinic or community practice, we coordinate those visits through the Richmond site.
What improvement looks like
- Fewer hours lost to rituals and mental reviews,
- Lower distress when intrusive thoughts appear,
- Greater tolerance for uncertainty at work and in relationships,
- More time for sleep, exercise, and hobbies,
- Confidence returns as avoided activities become normal again.
Progress is measured weekly so wins are visible, and plans are adjusted quickly when a step is too easy or too hard.
A four week starter roadmap
- Week 1, assessment, education about OCD, build exposure hierarchy, choose first targets,
- Week 2, begin low to moderate exposures, introduce response prevention and coping scripts,
- Week 3, expand exposure variety, reduce reassurance, track time won back from rituals,
- Week 4, consolidate gains, plan higher level exposures, refine medication or skills as needed.
The goal is steady steps, not perfect days. Consistency beats intensity.
Frequently asked questions, OCD treatment in Houston and Richmond
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ERP is planned exposure to triggers with response prevention. You are never forced. We set goals together, move at a tolerable pace, and debrief every step.
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Yes. Many patients improve with ERP alone. Medication can help when symptoms are severe, when depression co occurs, or when ERP needs a bridge.
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For most themes, yes. Practicing where the triggers live can accelerate progress. We blend telehealth with in person visits when helpful.
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OCD involves intrusive, unwanted thoughts and ritual behaviors. OCPD is a personality style marked by perfectionism and control. We evaluate for both and tailor care accordingly.
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Some patients see relief within weeks as ritual time shrinks. Full recovery takes longer and includes relapse prevention plans for stressful seasons.
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Intrusive thoughts are a symptom, not intent. We assess safety carefully. ERP teaches you to allow thoughts without rituals or avoidance.
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We treat adolescents through adults. Treatment plans are developmentally appropriate and involve family when useful.
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Yes. We collaborate respectfully with personal beliefs, designing exposures that target OCD, not values.
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We evaluate related concerns, and when indicated, add habit reversal or refer to complementary specialists.
Why patients in Houston choose Cura Mind and Wellness for OCD
- Specialized approach, ERP centered care plus precise medication management,
- Experienced leadership, board certified clinician with hospital and outpatient background,
- Whole person planning, sleep, stress, fitness, and nutrition support recovery,
- Local access, in person care in Richmond, telehealth across Houston,
- Integrated options, gene testing, TMS, and coordinated therapy within one practice.
Take the next step
OCD convinces people they must buy certainty with rituals. You can learn another way. Cura Mind and Wellness provides ERP centered, compassionate treatment for OCD across Houston, with in person support in Richmond. Together we will map the cycle, build a paced plan, and help you take back the minutes and hours that OCD has been stealing.