Supporting someone with OCD: what the latest research says

ERP means gradually facing what triggers obsessions while practising not carrying out the ritual. In NordLOTS, 269 children and teenagers received CBT with ERP, with further CBT or medication when needed. Over three years, 28 children, about 10% of the whole group, relapsed after reaching remission; ten of them regained remission. About 36% were in remission at every follow-up [1]. These figures describe different patterns of recovery, rather than a single success rate.

In Norway, 73% of 77 adults were in remission immediately after the intensive Bergen 4-Day Treatment and 69% at four years. This study had no comparison group and involved the programme's developers [2]. In a Swedish online-CBT trial, improvements were still evident two years later [3].

A US study followed 213 adults with OCD in everyday care for five years. Of the 39% who reached partial or full remission, 59% later relapsed. Relapse was more common after partial remission than full remission, 70% against 45% [4]. This was not a follow-up of one set course of ERP, so its rates should not be compared directly with the trials above. If therapy is ending while OCD still takes up much of their day, ask what further help or follow-up might be appropriate.

In the Swedish trial, 93 adults who'd finished online CBT were randomly offered a short online booster course, or none. Over two years the booster group had fewer relapses and relapsed more slowly. The difference in symptoms only lasted a few months, but day-to-day functioning was better at follow-ups through two years [3]. NICE's current guideline says therapists should explain, towards the end of treatment, how to use what's been learned if symptoms return [5]. OCD-UK says NICE's September 2026 draft update doesn't cover relapse prevention adequately, and OCD Action says it has nothing for people who stay unwell after their first treatment [6][7]. The consultation closes on 21 October 2026, and the 2005 guideline applies until a final version is out [8]. Before therapy ends, ask about a written relapse prevention plan and a quick way back if things slip.

Next check due: 21 October 2026. Details to check: NICE consultation and current guideline status.

A 2025 review of 39 studies, with 3,666 relatives, estimated that more than nine in ten relatives in the included samples went along with the OCD at least weekly, and almost half every day, most often by giving reassurance or waiting for rituals to finish [9]. A 2024 review of 108 studies, with 8,928 people with OCD, linked more of this "accommodation" with more severe symptoms, and found it fell sharply when the person had CBT. How much a family accommodated at the start didn't predict how well the person did in treatment [10]. These are associations, not evidence that relatives caused the symptoms. Being deeply drawn in does not mean therapy will fail.

A 2020 review of 15 publications found promising results from bringing partners or relatives into adults' CBT. The small set of comparisons favoured family involvement over individual ERP, but the studies and inclusion rules varied, so this does not establish a benefit for every family [11]. In a preliminary trial of 18 patient - relative pairs, relatives were randomly offered two sessions about accommodation or no extra sessions. Patients whose relatives received the sessions improved more quickly [12]. NICE says treatment should help relatives reduce involvement in rituals and reassurance sensitively [5]. If the person agrees, ask to join a session.

Researchers followed up 35 of an original 46 people who had group CBT with relatives involved in two sessions. Accommodation had fallen by 39% after treatment and by 51% at the three-year follow-up [13]. This small follow-up cannot establish that reducing accommodation prevents relapse. Before the last session, ask the therapist to help you write down the approach you've agreed and how to respond if new requests for reassurance or rituals arise.

In a Danish trial of 130 children and teenagers aged 8 to 17, 14 sessions of family-based CBT with exposure did better than 14 family sessions of information and relaxation. The gap was modest, just under the size the researchers had set as clinically important, and far fewer families dropped out of the CBT (4 against 12) [14]. NICE's draft supports involving families in CBT for many young people [8]. If you're the parent, ask the CAMHS team how you'll be involved, and what follow-up there'll be once treatment ends.

OCD can start during pregnancy or after a birth, and existing OCD can worsen [15]. In a Canadian study, 388 mothers provided the relevant data and 44% reported unwanted thoughts of deliberately harming their baby. These thoughts, and OCD, were not associated with more self-reported physical aggression towards the baby [16]. This was one study using mothers' reports; an unwanted, distressing thought is different from an intention to act.

If someone with past OCD is expecting, agree early who to contact if symptoms return. OCD-UK suggests asking the GP about the local perinatal mental health service [15]. Respond calmly if they disclose frightening thoughts, and help them seek professional support. If there is an intention to act or anyone may be in danger, use the urgent-help advice below.

Body dysmorphic disorder (BDD) is a preoccupation with flaws in appearance that others can't see or think are minor. NICE's draft cites research finding that 18.6% of people attending cosmetic and reconstructive surgery services had significant BDD symptoms, against an estimated 2% of adults generally. It says cosmetic procedures rarely improve BDD and can make it worse [8]. The BDD Foundation advises relatives to stay out of debates about appearance, to give plenty of emotional support, and not to offer to pay or lend money for surgery [17].

A Swedish trial of 120 adults compared face-to-face CBT, therapist-guided online CBT and unguided online CBT. It did not establish that guided online treatment was no worse than face-to-face treatment on the main outcome. A later analysis found response rates of 45%, 77% and 16% respectively, but the guided-versus-face-to-face difference was not statistically clear [18]. NICE restricts the OCD programmes assessed in its digital-therapy guidance, including Space from OCD, to research use [19]. If online treatment is suggested, ask how a therapist will support it.

A Norwegian treatment that packs exposure work into four full days, in small groups with one therapist for each patient. In its main trial, 15 of 16 adults responded straight afterwards, against 2 of 16 with self-help and none on a waiting list [20]. The Bergen clinics say they treat people entitled to Norwegian healthcare [21]. A local UK access route has not been verified for this article; ask their specialist team about suitable intensive treatment.

Next check due: 3 November 2026. Details to check: Local availability.

A CBT app with support from a coach. A US trial randomised 80 adults. Among those assessed after twelve weeks, 21 of 31 app users responded, compared with 5 of 37 people on a waiting list. Koa Health, which makes the app, funded the study, and several researchers had company links [22]. NICE conditionally recommends NHS use while more evidence is gathered, subject to the required regulatory and NHS approvals [19]. That does not guarantee local availability.

Some private clinics offer magnetic stimulation for OCD. NICE says it should only be used in research, because the evidence on how well it works is too limited [23]. Talk it through with a psychiatrist before paying for a course.

A chatbot can become another way of repeatedly seeking reassurance. In a 2026 analysis of 100 posts on an OCD forum, people described using chatbots to seek reassurance, to confess and to make decisions [24]. The linked version is an arXiv preprint, marked conditionally accepted for CHI EA 2026; it also links a conference DOI. It is a small analysis of forum posts, not a trial showing how chatbots affect symptoms. If they use one, ask what for, without judgement, and suggest they tell their therapist so it can become part of the plan.

OCD Action's helpline is open Monday to Friday, 9.30am to 8pm, for people with OCD and the people in their lives. You'll usually leave a message and get a call back [25]. OCD-UK runs online support groups, has free recorded talks on helping a family member or partner, and runs free workshops for parents of children aged 5 to 18 with OCD, funded until 2027 [26].

Next check due: 3 November 2026. Details to check: Helpline hours and funded workshops.