Treatments by disorder

Intrusive obsessions paired with compulsions that temporarily relieve anxiety and reinforce the loop.

OCD is maintained by the compulsion, not the thought. Treatment that reduces compulsions (overt and mental) breaks the cycle and lets new safety learning form. Medication (SSRIs at higher-than-depression doses) often adjuncts therapy in moderate-to-severe cases.

Preoccupation with perceived flaws in appearance, with repetitive checking or camouflaging behaviors.

BDD sits in the OCD spectrum. Treatment is ERP-style — exposure to feared appearance situations + response prevention of mirror-checking, comparing, reassurance-seeking, and grooming rituals. High suicide risk; screen carefully.

Persistent difficulty discarding possessions, with accumulation that compromises living space.

Hoarding is its own DSM-5 diagnosis, distinct from OCD. Treatment combines motivational work, in-home sorting practice, and cognitive work on beliefs about possessions. Progress is slow and relapse-prone.

Trichotillomania (hair-pulling), excoriation (skin-picking), and related repetitive grooming behaviors.

BFRBs respond best to Habit Reversal Training (HRT) and its modern expansion, the Comprehensive Behavioral (ComB) model. Shame is high; reduce moralizing language about the behavior.

Persistent low mood, anhedonia, and behavioral withdrawal; thinking turns rigid and self-critical.

Depression responds to multiple evidence-based therapies. Choice depends on severity, recurrence history, interpersonal context, and client preference. For 3+ prior episodes, relapse prevention (MBCT, maintenance IPT) becomes central. Severe presentations usually benefit from combined therapy + medication.

Recurrent depressive and (hypo)manic episodes; mood stabilization is medication-led with adjunctive therapy.

Bipolar disorder is primarily medication-managed (mood stabilizers, atypical antipsychotics). Psychotherapy is adjunctive — psychoeducation, prodrome monitoring, and circadian/sleep regulation reduce relapse.

Acute and prolonged grief responses to loss; normal in nearly all cases, occasionally complicated.

Most grief is non-pathological and does not require treatment. When grief becomes prolonged (>12 months, impairing), targeted therapies help. Differentiate from depression — overlap exists but the focus differs.

Depression, anxiety, OCD, or PTSD during pregnancy or the postpartum year.

PMADs are common (~15–20% of birthing parents) and highly treatable. Screen with EPDS at multiple time points. Untreated perinatal depression has measurable effects on infant attachment and development — treat actively.

Chronic worry across multiple life domains, often with intolerance of uncertainty.

GAD is driven by worry as a strategy — clients believe it prepares or protects them. Treatment targets worry behavior, intolerance of uncertainty, and avoidance, alongside relaxation and metacognitive beliefs about worry itself.

Recurrent panic attacks plus fear of future attacks; often with agoraphobic avoidance.

Panic is maintained by catastrophic misinterpretation of body sensations (I'm dying, going crazy) and by avoidance/safety behaviors. Interoceptive exposure — deliberately producing the sensations — is the core intervention.

Fear of negative evaluation that drives avoidance, safety behaviors, and post-event rumination.

Treatment targets self-focused attention, safety behaviors, and avoidance of feared social situations. Behavioral experiments that drop safety behaviors are more effective than habituation alone.

Marked, persistent fear of a specific object or situation, with avoidance.

Single-session exposure-based treatment (Öst) achieves clinically meaningful gains in many specific phobias. The active ingredient is exposure with inhibitory learning maximizers.

Excessive worry about having a serious illness, checking and reassurance-seeking behaviors.

Treated as an OCD-spectrum / anxiety problem. Cognitive misappraisal of body sensations + checking/reassurance behaviors maintain the disorder. ERP-style work targets the safety behaviors directly.

Re-experiencing, avoidance, negative cognition/mood, and hyperarousal following a traumatic event.

Trauma-focused psychotherapies outperform medication for PTSD. Three first-line options have comparable efficacy; choice often depends on client preference and avoidance level. Stabilization and resourcing precede reprocessing in complex trauma.

Prolonged, repeated interpersonal trauma with disturbances in self-organization, affect, and relationships.

Complex trauma requires phase-based treatment: safety/stabilization → processing → integration/reconnection (Herman). Single-shot trauma protocols often destabilize without preparation. Parts-based and somatic approaches are well-suited.

Disruptions in identity, memory, consciousness, or perception — usually trauma-rooted.

Phase-based treatment (ISSTD guidelines): safety/stabilization → trauma processing → integration. Standard trauma protocols without preparation typically destabilize dissociative clients. Specialist supervision is essential.

Pervasive instability of affect, identity, and relationships, with impulsivity and self-harm.

Several manualized therapies show RCT support. Choice depends on availability, training, and presentation. All share: long treatment, explicit hierarchy targeting life-threatening behavior, and therapist consultation/support.

Persistent difficulty initiating or maintaining sleep, with daytime impairment.

CBT-I is the recommended first-line treatment over sleep medication, with comparable short-term and superior long-term outcomes. Core components: sleep restriction, stimulus control, cognitive restructuring, and sleep hygiene.

Anorexia, bulimia, and binge eating disorder — disordered eating maintained by overvaluation of weight/shape.

Different diagnoses have different first-line treatments. Weight restoration in anorexia is non-negotiable before psychotherapy gains traction. Bulimia and BED respond well to enhanced CBT.

Problematic use across alcohol, opioids, stimulants, cannabis, or other substances.

Combined approaches outperform single modalities. Engagement and ambivalence work (MI) precedes change-focused treatment. Medication-assisted treatment (MAT) is essential for opioid and alcohol use disorders.

Compulsive engagement in non-substance behaviors (gambling, gaming, pornography, shopping) despite harm.

Gambling disorder is the only DSM-5 behavioral addiction, but treatment principles generalize. Combine motivational engagement, stimulus control, cognitive work on distortions (gambler's fallacy, escape coping), and relapse prevention.

Negative cycles, contempt, withdrawal, or attachment injuries between partners.

Two strongly evidence-based approaches dominate couples therapy. They are largely complementary — EFT goes deeper into attachment emotion, Gottman provides structured assessment and skill-building.

Pain persisting beyond expected healing time, often with depression, anxiety, and functional impairment.

Goal is improved functioning and quality of life rather than pain elimination. Psychotherapy is one component of multidisciplinary pain management.

Persistent inattention, impulsivity, and/or hyperactivity that began in childhood and impairs adult functioning.

Adult ADHD is primarily medication-responsive (stimulants first-line). Psychotherapy is adjunctive — skills, structure, and managing the emotional impact (shame, demoralization, RSD). Coaching and CBT for adult ADHD have the strongest evidence.

Recurrent outbursts disproportionate to the provocation, with relational and occupational fallout.

Skills-based + cognitive interventions show the strongest effects. Identify the precipitating chain, install pause + de-arousal skills, then address underlying beliefs about respect, control, and threat.

Emotional or behavioral symptoms in response to an identifiable stressor, exceeding what would be expected.

Time-limited and stressor-bound — most clients respond to brief, focused work. The diagnosis itself is often used when symptoms don't meet full criteria for depression or anxiety but functioning is impaired.

Positive symptoms (hallucinations, delusions), negative symptoms, and cognitive disturbance.

Antipsychotic medication is the foundation. Psychotherapy is adjunctive but meaningfully improves outcomes — reducing distress from voices, improving functioning, and supporting recovery. Coordinated Specialty Care models are first-line for first-episode psychosis.

Difficulties with desire, arousal, orgasm, or pain that cause distress or relational strain.

Sex therapy integrates psychoeducation, sensate focus, cognitive work on performance anxiety, and — when relevant — couples work. Always rule out medical contributors and medication side effects first.