Three recent studies, and what they may mean for people living with OCD
Obsessive-compulsive disorder, or OCD, is still widely misunderstood.
It is often reduced to being tidy, perfectionistic, or liking things “just so”. But clinically, OCD can be deeply distressing. It can involve intrusive thoughts, images, doubts, urges, fears, compulsive behaviours, mental checking, avoidance, reassurance-seeking, and repeated attempts to feel certain.
For many people, OCD does not look obvious from the outside. Inside, it can feel relentless.
The good news is that OCD research continues to move forward. Three 2026 studies offer a useful snapshot of where the field is heading: better understanding of how common OCD is, continued refinement of psychological treatments, and cautious interest in newer treatment approaches.
As a psychotherapist working with OCD, anxiety disorders and relationship difficulties, I think it is important to hold both things together: hope and clinical caution.
New research matters. But not every promising finding should immediately become a treatment recommendation.
1. Psilocybin and OCD: promising, but not yet routine treatment
One of the most discussed OCD studies of 2026 is a randomized clinical trial by Moreno and colleagues, published in the Journal of Psychopharmacology, looking at repeated doses of psilocybin for OCD.
The findings were certainly interesting.
After eight weeks of treatment, participants who received at least four high doses included a substantial proportion who met the study’s definition of response. 73.3% achieved at least a 35% reduction in Yale-Brown Obsessive Compulsive Scale scores, and 40% met criteria for remission. Some improvements were still evident at six months, although effects had reduced.
That is worth paying attention to. But it is also important not to overstate what this means.
The researchers themselves concluded that larger trials are needed to establish efficacy and refine treatment protocols. In other words, this is promising research, not evidence that psilocybin should now be treated as a standard OCD intervention.
For me, the most important message is not simply “psilocybin may help OCD”. It is that researchers are continuing to explore how entrenched patterns of fear, threat, uncertainty and compulsive behaviour might be shifted.
That may become important in the future. But psilocybin remains an emerging research intervention for OCD, not a first-line psychological treatment. It should not be interpreted as a reason to self-medicate with psychedelic substances.
2. Which psychotherapy works best for OCD?
A second important paper by Wang and colleagues examined the effectiveness and acceptability of different psychotherapies for OCD through a network meta-analysis.
The researchers included 68 controlled trials, covering 76 comparisons and 4,019 patients across seven psychotherapeutic approaches. This kind of research is clinically valuable because it does not simply look at one therapy in isolation. It helps compare the wider evidence across different interventions. The key message is not that one therapy label solves everything.
The findings support psychotherapy as an effective treatment approach for OCD, while also highlighting differences between interventions and limitations in the existing evidence. The authors note heterogeneity and methodological issues across the trials, which means the results need careful interpretation. This matters.
OCD therapy should not become a competition between modalities.
For many people, CBT with Exposure and Response Prevention, often called ERP, remains central to evidence-based OCD treatment. ERP works by helping a person face feared thoughts, sensations, situations or uncertainties while reducing the compulsive responses that keep the cycle going. But good therapy is not just about applying a protocol.
It is about understanding the person in front of us.
Important clinical questions include:
- What is maintaining this person’s OCD?
- What are they avoiding?
- What reassurance are they repeatedly seeking?
- What mental rituals are happening silently?
- What beliefs about responsibility, threat, morality, uncertainty or control are driving the cycle?
- How much shame are they carrying?
- What would their life look like if OCD no longer made the rules?
That is where formulation and a good assessment matters.
Treatment should be evidence-based, but it should also be personalised.
3. How common is OCD really?
The third study, by Jeong and colleagues, took a broader view. It examined the global prevalence of obsessive-compulsive and related disorders through a systematic review and modelling study.
The researchers included 112 population studies and used Bayesian modelling to estimate OCD prevalence across different diagnostic systems.
Their findings show something important: estimates of OCD prevalence vary depending on the diagnostic criteria being used.
For OCD specifically, estimated global lifetime prevalence was approximately:
- 2.57% using ICD-10 criteria
- 3.10% using DSM-III criteria
- 2.28% using DSM-IV criteria
- 2.82% using DSM-5 criteria
The study also found that prevalence increased sharply during adolescence and reached the highest levels around the late twenties to early thirties.
Why does this matter? Because OCD is not rare. And yet many people still spend years struggling before receiving an accurate formulation or appropriate treatment.
Some people interpret intrusive thoughts as evidence that they are dangerous, immoral, broken or fundamentally different from everyone else. Others do not realise that mental reviewing, checking feelings, replaying conversations, reassurance-seeking, or Googling for certainty can all become compulsive behaviours.
Better recognition matters. Earlier identification matters. Access to psychologically informed, personalised treatment matters.
What do these studies tell us together?
These three papers ask very different questions. One looks at an emerging biological treatment. One looks at psychotherapy. One looks at how common OCD may be globally.
But together, they point towards an important direction:
The future of OCD treatment I am hopeful will be more individualised for the person sitting in front of us. We can be interested in new treatments without prematurely declaring them established. We can value psychological therapy while still asking difficult questions about what works, for whom, and why.
And we can improve recognition of OCD so that people are not left alone with symptoms they feel ashamed of or unable to explain.
Where do CBT and ERP fit?
ERP remains one of the most important psychological treatments for OCD. At its heart, ERP helps a person gradually face feared thoughts, situations, sensations or uncertainties while reducing the compulsions that normally follow. This is not about forcing someone to “stop thinking” intrusive thoughts.
In fact, trying to eliminate thoughts can become another form of mental struggle.
Instead, evidence based therapy helps someone build a different relationship with uncertainty and internal experience.
The goal is not: “I need to know for certain that nothing bad will happen.”
It may become: “I can tolerate not knowing, and I can choose what I do next which has my best interest and values at the forefront.”
That distinction can be life changing.
What about compassion-focused therapy?
OCD can be accompanied by enormous shame. A person may have an intrusive thought and then feel horrified that it appeared in their mind at all.
They may ask themselves:
What kind of person thinks this? What does this thought say about me? What if having the thought means I secretly want it? What if I am dangerous? What if I am bad?
Compassion-focused work can be very helpful here, especially when OCD is wrapped in self-criticism, disgust, guilt or fear of being judged.
But compassion is not reassurance. It is not about telling someone, “Your feared outcome definitely will not happen.” It is about helping them respond to distress without adding another layer of shame and threat. Used carefully, compassion-focused therapy can sit alongside an OCD formulation and ERP work, rather than replacing it.
Where might EMDR fit?
This is where clinical caution is especially important. EMDR has an established evidence base for PTSD. But that does not mean we should automatically describe EMDR as a primary established treatment for OCD.
OCD has specific maintaining mechanisms, including compulsions, avoidance, reassurance-seeking, intolerance of uncertainty and inflated responsibility. These need to be understood clearly. Where EMDR is considered as part of a person’s wider treatment, the formulation needs to remain central. A critical incident which may be enmeshed with a person’s OCD is an example of where we may explore EMDR to rescript a stuck belief in relation to a previous incident.
The same principle applies to every therapy: Start with the person and the maintaining cycle, not the therapy label.
The most important message for people with OCD
Perhaps the most encouraging message from current research is that OCD is receiving serious scientific attention.
We are learning more about:
- how common OCD is;
- how it develops;
- how it persists;
- which psychological treatments help;
- who may benefit from which approach;
and whether newer interventions may eventually have a role.
But research also reminds us of something vital
There is a difference between promising and proven. The 2026 psilocybin trial is exciting, but it is not a reason to abandon established treatment or experiment outside a properly regulated research or clinical context.
The psychotherapy evidence supports the importance of psychological treatment, while reminding us not to reduce therapy to simplistic claims about one modality being right for everyone.
And the global prevalence research reminds us just how many people may be affected by OCD, often quietly. OCD can be extraordinarily persuasive. But an intrusive thought is not a confession. A feeling is not a fact. Uncertainty is not a danger. And the presence of an obsession does not define the person experiencing it. Modern OCD treatment is increasingly about helping people understand these distinctions and, gradually, reclaim a life that is bigger than OCD.
OCD therapy and clinical supervision
If you are living with OCD, intrusive thoughts, compulsive checking, reassurance-seeking, rumination or relationship OCD, evidence-based psychological therapy can help you understand what is maintaining the cycle and begin to respond differently.
I am Tara O’Donoghue a licensed BABCP accredited senior psychotherapist with over 17 years’ experience working in mental health, offering specialist therapy for OCD alongside anxiety disorders in Marylebone, London and online. My approach is formulation-led and evidence-informed, integrating CBT, ERP, Compassion-Focused Therapy and EMDR where clinically appropriate.
I also offer clinical supervision and consultation for licenced psychologists, psychotherapists and therapists working with OCD and anxiety disorders, with a focus on formulation, maintaining cycles, ERP, shame, reassurance-seeking and evidence-informed clinical decision-making.
To enquire about therapy or supervision, please contact: info@homebasedtalkingtherapy.com
Location: Marylebone and online
References
- Moreno FA, Allen KE, Wiegand CB, et al. A randomized clinical trial of repeated doses of psilocybin for the treatment of obsessive-compulsive disorder. Journal of Psychopharmacology. 2026;40(5):837–849.
- Wang Y, et al. Effectiveness and acceptability of different psychotherapies for obsessive-compulsive disorder: network meta-analysis. British Journal of Psychiatry. 2026.
- Jeong YD, et al. Global Prevalence of Obsessive-Compulsive and Related Disorders: A Systematic Review and Modeling Study. American Journal of Psychiatry. 2026.
This article is intended for educational purposes only and does not constitute individual clinical advice or a recommendation for any particular treatment.