NOCD Online Therapy Review

The onset of the COVID-19 pandemic spurred a rapid rise in the demand for telehealth services, including for behavioral healthcare. While online talk therapy services existed before the pandemic, their popularity has skyrocketed in the past two and half years—and NOCD is one of the newcomers trying to meet the demand. However, unlike its online therapy competitors, NOCD distinguishes itself by focusing entirely on treating patients diagnosed with obsessive-compulsive disorder, or OCD, a mental health disorder characterized by obsessions and compulsions that interfere with daily life. 

OCD is a relatively common condition that affects between 2% and 3% of the general population. The obsessions and compulsions that accompany the disorder can often be distressing to deal with and may contribute to or increase feelings of anxiety or depression. Symptoms may even reach a level that can be disabling to the person with the condition and can significantly strain their personal and professional relationships. That’s why an online platform dedicated to this treatment specifically immediately caught our eye. 

To evaluate how well NOCD is able to help people with OCD, we evaluated the company by surveying 105 users that had used the platform and speaking with subject matter experts. I also signed up for therapy myself—here’s how the platform fared. 

What Is NOCD?

NOCD is an online therapy company dedicated exclusively to helping people with OCD better manage their symptoms. 

It was founded in 2017 by entrepreneur Stephen Smith, who himself was diagnosed with OCD while he was an undergraduate at college. Over the span of six months, his symptoms became severe enough that he became housebound—and it was only through treatment that he was able to get relief. So he wanted to pay it forward and help others with his new company. 

Without a doubt, NOCD’s focus on treating one mental health condition is unique in the world of teletherapy—and that gives it the potential to be able to help a lot of people, because OCD requires specialized care.

“Therapists who specifically treat OCD may be more effective than someone with more generalized knowledge,” says Amy Marschall, PsyD, psychotherapist and one of the subject matter experts we worked with on this project. “Many online therapy companies cast a wide net to get as many clients as they can, so it feels like a good sign to me that NOCD specializes.”

What Services Does NOCD Offer?

NOCD specializes in offering a form of cognitive behavioral therapy (CBT) known as exposure response and prevention, or ERP. As its name suggests, ERP usually consists of exposing patients to uncomfortable ideas or situations that often trigger symptoms, but in relatively small or controlled amounts. By doing this, the goal is to gradually adapt to and eventually decrease the discomfort the trigger usually produces. Additionally, the patient may work on delaying engaging in compulsions or rituals that certain thoughts or feelings would trigger. For example, someone afraid of enclosed spaces might practice riding the elevator, and be coached to avoid compulsions related to assuaging that fear, essentially learning that bad things don’t happen in that situation and that their compulsive response is not necessary to prevent bad things from happening.

ERP has proven to be beneficial for many people with OCD, with the National Institute of Mental Health citing it as effective in reducing compulsive behaviors in OCD.

In addition to one-on-one therapy, NOCD also offers support groups throughout the day seven days a week. They range in theme and objectives. Some are tailored to attendees with a particular sub-type of OCD, while others are for those interested in certain aspects of care. For example, some of the groups offer opportunities to create art or discuss different coping strategies. You can attend as many groups as you want—I personally attended one of these support groups. 

NOCD also has a message board where members can communicate with each other about living with OCD by bringing up different topics for discussion, similar to Reddit.  

About 20% of our survey participants found the additional resources offered by NOCD to be excellent, while 16% and 21% thought they were very good or good, respectively. However, 20% of respondents thought the additional services were just average.

Who Is NOCD For?

NOCD offers one-on-one individual therapy sessions for adults, teenagers, and children with suspected or confirmed OCD. It is available to anyone in the United States with access to the internet and Zoom. 

Someone interested in pursuing NOCD’s services can arrange for a free consultation by phone where the representative will offer a breakdown of logistics, such as how the services work, scheduling, insurance, and pricing, as well as answer questions the prospective client may have. A diagnostic assessment is also performed, determining whether NOCD’s services are right for you or your child.

How Much Does NOCD Cost?

NOCD is not a subscription therapy service, unlike many of the other companies we reviewed. 

Instead, you are billed $170 per individual session with your NOCD therapist. This amount is charged to a credit card at the completion of each session. 

Does NOCD Take Health Insurance? 

Yes, NOCD accepts many health insurance plans, including UnitedHealthcare, Aetna, Cigna, Humana, and Blue Cross Blue Shield. You can find a comprehensive list of the insurance providers it works with in each state directly on its website. 

From our analysis of this list, it seems NOCD mainly works with employer-sponsored plans, though it also accepts some Medicare health plans as well. 

NOCD generally does not take Medicaid-sponsored plans, with the exception of Anthem Blue Cross in California.  This is disappointing as it potentially excludes many people who do not have insurance through an employer and cannot afford out-of-pocket expenses. 

Does NOCD Offer Discounts? 

When I first spoke with a NOCD representative over the phone, I was offered a special introductory discount rate of $100 per session that I was told was valid for the month of October.  Yet when I tried to book an appointment online with the therapist I was matched with, it kept defaulting to the $170-per-session rate. 

I called NOCD at their customer service number and they took my credit card information and booked the first session at the discounted rate. The representative also assured me the discounted rate ($100 per session) would be effective for the first eight sessions before reverting back to the usual $170 per session rate if I wished to continue therapy with NOCD after that. 

It is unclear if NOCD offers similar promotional discounts during other months, but asking customer services about available promotions and discounts could be beneficial for those on a budget looking to try the service.

Navigating the NOCD Website

The NOCD homepage is bright, inviting, and fairly easy to navigate. It has a plain white background with black print, with headlines highlighted in deep blues and greens. The top of the landing page features the tagline, “Regain your life from OCD,” next to an image of a therapist consulting with her patient on Zoom. Featured immediately under the tagline is a button to schedule a free call with a NOCD representative. Its messaging explains that ERP is “the gold standard treatment for OCD.” 

The NOCD website also features detailed descriptions of different types of OCD. As someone who was diagnosed with OCD as a young teenager several decades ago when less was publicly known about OCD, I appreciated this educational portion of the site. 

The website also contains a directory of all of NOCD’s staff therapists and their credentials. 

The website did not offer any accessibility features or options that I could find. This presented a barrier for me in using the website as I have some visual impairments. This lack of attention to accessibility was a bit off-putting, especially considering this service is operating in the healthcare space and many of its clients may identify as disabled and have accessibility needs that should be addressed. 

While most survey respondents found the website easy to navigate—22% found it very easy and 40% found it easy—a little over a third of the respondents (34%) found navigating the website neither difficult or easy, which was my impression as well. 

Does NOCD Have an App? 

Yes, NOCD has an app that you can download onto your phone and/or your computer, and it’s available at the bottom of the site’s homepage. The app offers access to an internal member portal. 

How Do You Sign Up for Therapy at NOCD?

You can sign up for a therapy session after downloading the app and registering on the member portal. There is no option to sign up on the website—you can either log in on the site if you already have an account or you can click the numerous links to schedule a free 15-minute call that explains how NOCD services work. 

Once you’ve signed up through the app, the registration process asks for basic information like name, birthdate, and address. It will also ask other questions about family and personal history and your preferences regarding your therapist, such as their gender identity, sexual orientation, race or ethnicity, and religion, in an attempt to successfully match you with a NOCD therapist.

This process was fairly simple and straightforward, and our users agreed. Of the survey participants, 23% found it very easy to sign up for NOCD’s services, while 37% found it easy. Another 27% of respondents found it neither easy or difficult, which again resonates with my own experience. 

Matching With a Therapist

Within a day or two of registering, I received an email from NOCD matching me with a therapist. The therapist the online system matched me with was a female licensed mental health counselor (LMHC). I felt fine about the match because other than wanting a woman therapist, I didn’t outline any other particular preferences.

When I logged into the member portal to check her schedule and book a session, the therapist had many more openings for the month than the representative offered on the phone for the promotional discount. I had to call the NOCD customer service line to get access to those other appointments listed on the member portal. My first appointment was scheduled for two days later.  

How Do Therapy Sessions Work at NOCD?

My therapist was warm, friendly, and relatively easy to communicate with. While I did get the impression some of her comments were scripted, as NOCD’s intention is to apply a very specific treatment protocol, it did not come across as overly impersonal. That being said, the sessions did begin to seem more scripted as she advanced more into the ERP portion of the regimen, which didn’t appeal to me. 

NOCD recommends attending two one hour-sessions twice weekly for the first four weeks, all of which take place over Zoom, which does offer a HIPAA-compliant platform. Often from there the patient can decide if they want to continue with sessions. 

Individual Sessions

I attended four sessions over two weeks for this review. At the beginning of each session, the therapist verified my location (because therapists can only practice in the states in which they are licensed) and did a brief check-in on how I was feeling. For the very first session I also had to show my identification to make sure I was who said I was. This is for liability purposes—for example, if a company only treats adults ages 18 and above, it needs to check identification to ensure that it is not accidentally treating a minor.

My initial two sessions focused on reviewing my mental health background and family history, both in general and specific to my OCD diagnosis. I was offered homework after those sessions in the form of filling out online assessments further detailing my history and current sense of well-being. My therapist then booked me for sessions for the next several weeks. 

For the latter two sessions, I began formulating goals with my therapist by pinpointing specific symptoms of my OCD and working on some low level ERP exercises. These consisted of imagining some scenarios that are usual triggers for my OCD and sitting with the discomfort they cause until the feeling lessens and eventually dissipates. It was somewhat uncomfortable but not overwhelming. 

Switching Therapists 

Because I only tried the service for a month, I didn’t have the opportunity (nor did I want to) switch therapists. However, switching is generally discouraged at NOCD. The customer service agent said this was because the company wants patients to have consistency. They also noted NOCD has a limited selection of therapists to choose from. This is likely why I could not find an option or information for switching therapists on the portal.

When I spoke to an NOCD customer service agent about switching therapists and what the process would entail, I was informed she could email me a link that would allow me to look through available therapists in my service area and see if I could find one compatible with my schedule and needs. If I found a suitable therapist, I could submit a transfer request. The agent called this “self–transfer” and noted it’s usually a “last-case scenario.” NOCD prefers that you try to remain with your therapist in the beginning. Additionally, she explained my options for switching therapists may be limited by their availability.    

This aligns with the survey data, where only 4% of the participants believed that it was easier or faster to switch therapists at NOCD compared to their other online competitors. This is among the one of the lowest scores NOCD received in the category of things they did better than other online therapy companies.

However, it does look like switching therapists is still entirely feasible at NOCD.  During the NOCD support group I attended, more than one of the attendees mentioned being between therapists and that they were trying to find the right fit. Our user survey confirms it can be done: nearly a quarter (23%) of survey participants have switched therapists at least once, and more than a quarter (27%) have done it two to three times. Of those who switched therapists, the majority—63%—picked one from a limited selection they searched through online. Only 7% had their replacement therapist assigned to them. 

What Happens If I Miss a Session at NOCD? 

To cancel or reschedule a session with your NOCD therapist, you have to message them at least 48 hours in advance on the member portal. Failure to cancel by 48 hours usually incurs a fee in the form of the full charge for the session ($170). 

How Do I Cancel Therapy at NOCD?

To cancel a session, I had to message my therapist through the online member portal to notify her I would not be attending. 

Canceling my sessions was easy enough, though I did receive some mixed messaging at first about whether I would incur a fee for canceling more than one time (I ultimately was not charged). From there, I simply did not schedule any further sessions.  

A nice bonus is that it seems like even if you are no longer attending therapy sessions, you can still access the member portal and attend the support groups. 

Quality of Care and User Satisfaction 

My experience with NOCD was overall relatively positive. I was matched quickly with a therapist who was a good match for me in temperament and approach. The member portal was fairly easy to navigate and I enjoyed the online message boards. I found comfort and camaraderie in the support groups I attended. 

However, I also found attending two sessions per week, coupled with all of the online forms and assessments, to be intensive and time-consuming. If I had a traditional full-time job or children, I do not think I would have had the time to do it all. 

While I appreciated sharing my background with my therapist before we began treatment, it also seemed that once we began ERP treatment, my family and personal history weren’t really given much consideration. 

I also had mixed feelings about the ERP techniques. I found some of it helpful, but some of it wasn’t. In fact, I suspected some aspects of the ERP could exacerbate my OCD symptoms if I pursued the treatment further. It is also worth noting NOCD’s website may be overstating the effectiveness of ERP. NOCD claims it has a 90% success rate, though some peer-reviewed studies show only around 50% to 60% of people receiving ERP for OCD experience improvement in their symptoms.

That being said, having a therapist who understood OCD well was a positive experience. It seems other NOCD patients felt similarly, as 40% of survey participants chose therapists due to the specialized treatment they offered. Additionally, 25% of participants felt like their therapist was open-minded and 23% felt like their therapist was a good listener. 

Most survey participants who used NOCD would suggest it to a family or friend, with 64% responding they would very likely or likely recommend it to someone who had similar issues. This makes sense as 78% of survey users also felt that they had found a therapist at NOCD that met most or all of their needs.   

Privacy Policy 

The privacy policy of NOCD is fairly standard and available to review on its website. NOCD uses cookies and pixels to collect data, such as the type of device you use to access their website, your device hardware model, IP address, and mobile operating system.

Unlike many companies, NOCD does not configure its site with a Facebook login option to pull information about its members that is stored with Facebook. NOCD also doesn’t collect geolocation data as a location tracking feature is not enabled.

Recently, the Mozilla Foundation released a report on NOCD’s privacy policies that was critical of the company. Specifically, the foundation called out NOCD’s practices of collecting personal information from its clients through third parties sites and vendors. It also indicated NOCD may be leaking private information, such as that its clients have OCD. NOCD has rebutted these claims, however.

NOCD vs. Competitors 

While NOCD is the only online therapy company that solely focuses on OCD treatment, there are other options out there for people with OCD looking to explore online therapy. For example, other online therapy companies, such as Wellnite and Talkspace, treat OCD as well as other disorders. And of the users we surveyed at those companies, only 9% and 6% specifically sought OCD treatment, respectively. 

For Wellnite, 75% of survey respondents felt most or all of their needs were met by their therapist, while 78% felt they were at Talkspace. These rates are competitive with NOCD, where 78% of respondents also felt most or all of their needs were met. 

However, NOCD ranked lower in its overall rating compared to these other two companies. For Talkspace, for example, 90% of respondents gave it a positive rating (ranking it either excellent, very good, or good), while 80% of Wellnite users gave it a positive rating. For NOCD, its overall rating was 71%. 

Talkspace and Wellnite may be ranking higher than NOCD because both companies offer medication management, which NOCD does not, as it doesn't offer psychiatry services. They may also be ranking higher because they offer a much wider array of services and conditions they offer treatment for (and different treatment types) rather than just OCD and ERP as a modality. 

Personally, I find it hard to compare something so specialized as an OCD treatment company to companies offering more broad-ranged services. Without knowing specifically how these other companies approach OCD treatment or which survey respondents are referring to OCD treatment in their reviews, it is difficult to say whether I would recommend the other companies to someone with this diagnosis. 

OCD is still a very misunderstood and highly stigmatized condition, though more and more of us with it now embrace it as a form of neurodivergence. Many or most of the therapists I have seen in private practice did not understand OCD well, even when they were experienced in treating other overlapping conditions—so the quality of care you’d receive for treating your OCD at a company like Talkspace may vary widely by which therapist you’re matched with. This might make NOCD seem like a safer place to start. However, since NOCD specializes in ERP, some people with OCD to whom that doesn’t appeal as a treatment may want to seek out other services with broader treatment alternatives.

Final Verdict

NOCD is a mental health platform with a very specific mission that offers solid services, but it also has some drawbacks. It is a great fit for someone with a diagnosis of obsessive-compulsive disorder who is interested in pursuing ERP as a treatment and whose insurance covers NOCD’s services. NOCD is staffed with highly qualified mental healthcare professionals with diverse identities, all of whom have some credentials or background in OCD treatment. 

However, those whose insurance does not cover the service may find it expensive. NOCD may also not be the best fit for someone who has not had success with ERP as a therapy method. 

Despite these drawbacks, NOCD clients are generally satisfied with the services they received. Seventy-one percent of participants responded that they had an excellent, very good, or good experience with the service. Of those who were no longer with NOCD, nearly a quarter (24%) felt they met all of their therapeutic goals, while another 28% discontinued therapy because they felt much better. That’s why we would recommend NOCD to people with OCD interested in trying ERP—especially if your health insurance plan is accepted.

Methodology

To fairly and accurately review the best online therapy programs, we sent questionnaires to 55 companies and surveyed 105 current users of each. This allowed us to directly compare services offered by gathering qualitative and quantitative data about each company and its users’ experiences.

Specifically, we evaluated each company on the following factors: website usability, the sign-up and therapist matching processes, therapist qualifications, types of therapy offered, the service's quality of care, client-therapist communication options, session length, subscription offerings, client privacy protections, average cost and value for money, whether it accepts insurance, how easy it is to change therapists, overall user satisfaction, and the likelihood that clients would recommend them.

We also signed up for the companies in order to get a sense of how this process worked, how easy to use the platform is, and how therapy takes place at the company.