OCD Treatment in New Braunfels
OCD can be a loop. A thought shows up in your mind that feels wrong and urgent. Germs on your hands. A door left unlocked. A question you need to ask one more time. You do something to make the feeling stop. It works for a minute. Then the thought comes back even stronger.
Treatment works on the ritual, not just the thought. We offer OCD treatment in New Braunfels at our office on North Walnut Avenue, and by secure video anywhere in Texas. Call (830) 515-8480 to get set up.
OCD or Everyday Worry?
Everyone gets unwanted thoughts sometimes. The National Institute of Mental Health describes OCD as thoughts you can’t control, repeated behaviors, or both. The difference shows up in what the thought makes you do.
Everyday Worry
- A worry about something real, like a bill or a test
- It brings nerves or unease
- You think it through or make a plan
- It settles once life settles
- It passes, and your day goes on
OCD
- An unwanted thought, image, or urge keeps coming back
- It brings fear, doubt, disgust, or a sense that something isn't "just right"
- You feel driven to check, wash, ask, or repeat until it stops
- The relief fades fast, and the thought returns
- It eats up time and gets in the way of your day
The question isn’t how anxious you feel. It’s what you do next.
Some rituals happen only in your head. Replaying a conversation. Googling at 2 AM for one more answer. Nobody sees these, but they keep the loop going the same way.
Perfectionism gets mixed up with OCD, too. A perfectionist redoes the work to make it better. Someone with OCD redoes it because a bad feeling won’t lift until they do. Often they can’t even say what “right” would feel like.
The International OCD Foundation draws a clear line. The loop takes more than an hour a day, causes real distress, or gets in the way of things you care about.
OCD and anxiety often show up together. If worry is the bigger problem, anxiety counseling may fit you better. We’d rather tell you that in the first session than start the wrong treatment.
Common Types of OCD
OCD can latch onto almost any theme. These are the most common, drawn from the International OCD Foundation’s list of OCD subtypes.
Contamination
Fear of germs, illness, chemicals, or dirt. Then washing, cleaning, or avoiding.
Harm Thoughts
Unwanted thoughts of hurting yourself or someone else. They scare you because they go against who you are.
Checking and Responsibility
Fear that something bad will happen because you weren’t careful enough. A fire, a break-in, a wreck.
"Just Right"
A need for things to feel even, exact, or complete before you can move on.
Sexual Intrusive Thoughts
Unwanted sexual thoughts or images that feel wrong to you and won’t let go.
Faith and Morals
Fear of sinning, offending God, or doing something wrong, no matter how often you pray or confess.
Relationship
Constant doubt about whether your partner is “the one,” or fixating on their flaws.
Identity
Urgent, nagging doubts about your sexual orientation or gender identity. The problem is the doubt, not who you are.
Real Event
Replaying something from your past, over and over, to decide if you did something wrong.
The theme is different for everyone. The loop stays the same, and ERP works on the loop.
How ERP Works Here
The idea is pretty straightforward: confront your fears directly and resist the urge to perform any rituals you might typically rely on. That approach is called exposure and response prevention, or ERP. It’s a type of cognitive behavioral therapy (CBT), and the first-line therapy for OCD.
Nobody starts with the hard stuff. Here’s how it goes:
- We sort the thoughts from the rituals
- We list what you avoid: the road you don't drive, the room you skip
- We rank it all from mildest to worst, together, in your words
- You practice one step in session, with your therapist right there
- You repeat that step at home, and move up only when it stops stinging
You pick the starting point. Every time. If a step feels like too much, we back up and pick an easier one.
The urge to check, wash, or ask gets louder at first. You will sit with it anyway. Your brain learns something it can’t learn by arguing: the alarm goes off, nothing terrible happens, and the feeling comes down on its own.
Sessions run 45 to 60 minutes. Most of the change happens between them, in your own kitchen or car. The hour with us is the coaching. The week is where the work happens.
Why Talk Therapy Alone Can Stall
Plenty of people try a year of talk therapy for OCD and feel stuck. They talked about the thoughts every week. But talking through a fear, over and over, can turn into reassurance. And reassurance is a ritual. So the hour feeds the loop instead of starving it.
That’s not a bad therapist. It’s a therapist trained for something else. The International OCD Foundation says talk therapy helps with some problems, but no research shows it works for OCD. ERP is one of the treatments they recommend trying first.
Who Does This Work Here
At RiverBend Counseling, not every clinician does ERP, and we’ll tell you that straight when you call. These five do:
Our owner. A graduate of the IOCDF’s Behavior Therapy Training Institute (BTTI), he holds the CART credential and presents on OCD internationally.
Listed with the International OCD Foundation for OCD and ERP. Karly is private pay only.
Treats OCD alongside anxiety, anger, grief, and trauma.
Supervised by Jay Jeter, LPC-S. Julie uses ERP when OCD is a treatment focus, and also works with anxiety, trauma, and grief.
Supervised by Jay Jeter, LPC-S. Kat works with OCD, autism, and neurodivergence.
Each clinician here has their own focus. Not sure who fits? Call (830) 515-8480 and we’ll match you.
In Person or Online
Our office is at 1099 North Walnut Avenue, Suite A, in New Braunfels, and serves families across Comal County. Some people want a closed door and a set time away from home. For some ERP work, being in the same room matters.
But a lot of OCD lives at home. The lock. The shower. The light switch at bedtime. Online sessions let you practice right where the rituals happen.
- In person fits if you want to leave the house, or home is too busy to talk freely
- Online fits if your rituals are tied to your own kitchen, bathroom, or front door
- Online fits if a long drive would become the reason you quit
Online sessions are open to anyone in Texas, from San Marcos and Seguin to the far corners of the state. Texas only, since that’s where our clinicians are licensed. You can start one way and switch later, or mix both.
Insurance and Cost
Coverage depends on which clinician you see, so here it is plainly.
- Jay Jeter and Michael Wong: Aetna, BCBS/Anthem, Christus, Cigna, Meritain, Optum, and United
- Julie Ross and Kat Kaatz: Cigna and United
- Karly Kothmann: private pay only
Jay also accepts Alliance Work Partners, our only EAP.
We check your benefits before your first session, so you know what to expect before you sit down. We bill your insurance directly, and superbills are available on request. Full rates, including reduced fee openings, are on our Rates and Insurance page.
Frequently Asked Questions
How do I know if it's OCD or just worry?
OCD follows a pattern regular worry doesn’t: an unwanted thought, a rush of dread, then a ritual to make it stop. Worry moves around and eases when life eases. Checking the lock once is normal. Checking it five times and still feeling unsure is worth a conversation.
What is ERP?
ERP, or exposure and response prevention, means facing a fear on purpose and then skipping the ritual that usually follows. You and your therapist build a list together, from mild to hard, and you choose where to start. The urge gets loud at first, then fades on its own.
Does talk therapy work for OCD?
Talk therapy alone has no research showing it works for OCD. Talking through a fear over and over can turn into reassurance, which feeds the loop. ERP works on the ritual, not just the thought.
Do you offer OCD treatment online?
Yes, in person in New Braunfels and online anywhere in Texas. Online works well for OCD, since you can practice ERP right where your rituals happen.
Is it embarrassing to say my thoughts out loud?
It can feel that way, but nothing you say will surprise us. Harm thoughts, sexual thoughts, and religious fears are common in OCD. Most people find that saying the thought once makes it feel smaller.
Do I need a diagnosis before I call?
No. You can call with just a hunch. We’ll ask what’s going on and match you with a clinician who does this work.
What should I ask an OCD therapist before booking?
Start with where they trained in ERP and what the first month of treatment looks like. Then ask how they handle intrusive thoughts about harm, sex, or religion, and how they know when a session has turned into reassurance. If the answers are vague, keep looking.
How can family help without feeding OCD?
The biggest help is slowly stepping back from the rituals you do for them. Checking the stove for them. Answering “Am I a bad person?” for the fourth time at bedtime. That’s not a parenting failure. It’s what loving people do. Your clinician can help you choose what to say instead, and which habit to drop first.
Can my child or teen get OCD treatment here?
Yes. Call and ask who on our team is the right fit for your child’s age. When the whole household is caught in the loop, family counseling can run alongside individual sessions.
Ready When You Are
Call (830) 515-8480 and we’ll match you with a clinician who does this work. Meet in person at our New Braunfels office on North Walnut Avenue, or online anywhere in Texas.
Resources
International OCD Foundation: What is OCD?
https://iocdf.org/about-ocd/
How obsessions and compulsions work, the common types of OCD, and how to tell OCD apart from everyday intrusive thoughts.
International OCD Foundation: Exposure and Response Prevention (ERP)
https://iocdf.org/about-ocd/treatment/erp/
What ERP is, what to expect when you start, and how it differs from traditional talk therapy.
International OCD Foundation: Families and OCD
https://iocdf.org/families/
Guidance for parents, partners, and loved ones on how OCD affects a household and how to respond without feeding the loop.
National Institute of Mental Health: Obsessive-Compulsive Disorder
https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd
A plain overview of OCD from the federal government’s lead mental health research agency, including how it often shows up alongside anxiety.