Therapy Specialist

A therapy specialist is more like a mental health surgeon — very focused, very trained.

What they do:

• Treat specific conditions (e.g., OCD, trauma/PTSD, eating disorders, perinatal mental health, substance use)

• Use evidence-based, targeted treatments

  • OCD → ERP

  • Trauma → EMDR, CPT, PE

  • Eating disorders → FBT, CBT-E

Best for:

• Diagnosed or clearly defined conditions

• When symptoms are stuck, severe, or treatment-resistant

• When you want a structured, skills-based plan

Therapy Generalist

A therapy generalist is kind of like a primary care provider for mental health.

What they do:

• Work with a wide range of concerns
  (anxiety, depression, stress, life transitions, relationship issues, grief, etc.)

• Use broadly effective approaches
  (CBT, supportive therapy, insight-oriented work, coping skills)

• Adapt to whatever shows up week to week

Therapy specialists matter because not all mental health concerns respond to “general support” alone. Some conditions need precision, not just care.

Some diagnoses don’t improve — and can even worsen — with non-specialized therapy.

Examples:

• OCD → needs Exposure and Response Prevention (ERP), not reassurance or avoidance

• PTSD → needs trauma-informed methods like EMDR, CPT, or PE

• Eating disorders → require structured, protocol-based care

• Perinatal mental health → involves medical, hormonal, and attachment-specific expertise

Specialists are trained to use the right tool for the right problem.

More efficient, less trial-and-error

With specialists:

• Treatment is more targeted

• Clients often see change faster

• Less time spent wondering, “Why isn’t this working?”

That matters emotionally and financially.

Short answer? No — and it’s not a knock on therapists.
Long answer below, because this is really important for OCD and related disorders.

Obsessive-compulsive and related disorders (OCD, BFRBs, hoarding, etc.) are mechanism-driven conditions, not insight-driven ones.

That means:

• Understanding why you have OCD doesn’t stop it

• Talking it out doesn’t retrain the brain

• Relief-seeking can actually strengthen symptoms

OCD improves when the brain learns it doesn’t need compulsions — and that requires specific behavioral learning.

A therapist without OCD-specific training might:

• Reassure fears (“That won’t happen”)

• Help clients avoid triggers

• Encourage thought-challenging in ways that become compulsions

• Focus heavily on insight, trauma-hunting, or “why this started”

All of those can feed the OCD cycle, even when the therapist is caring and skilled.

So… can any therapist technically treat OCD?

They can work with someone who has OCD — but that’s different from treating OCD itself.

Think of it like:

• Any doctor can notice a heart problem

• A cardiologist treats it effectively

OCD is similar: it needs a clinician who understands its patterns deeply.

Waiting lists aren’t usually about popularity or exclusivity — they’re about capacity and clinical fit, especially for obsessive-compulsive and related disorders (OCRDs).

While many therapists provide general mental health care, far fewer are trained to treat OCRDs using evidence-based approaches like Exposure and Response Prevention (ERP).

Most graduate programs:

• Do not require ERP training

• Spend limited time on OCD and related disorders

• Focus on general anxiety treatment, which is not the same as OCD care

This creates a gap between need and qualified providers.

Ethical OCD treatment involves:

• Careful assessment

• Structured, individualized ERP or I-CBT (evidenced based treatments)

• Close monitoring to avoid symptom reinforcement

Because this work is intensive, responsible specialists limit caseloads to ensure quality and safety. That naturally leads to waiting lists.

OCRDs are:

• More common than many people realize

• Often misdiagnosed or underdiagnosed

• Frequently referred after other therapies haven’t worked

As awareness improves, more people are seeking proper OCD care — but the number of trained specialists has not kept up.

Most therapists would love to make care affordable and accessible. The reality is that the insurance system often makes it difficult to provide ethical, high-quality mental health care, especially specialized treatment.

Insurance companies frequently reimburse therapists:

• Far below the cost of providing care

• At rates that don’t reflect advanced training or specialization

• Sometimes months later, or not at all

For specialists (like OCD providers), years of additional training, consultation, and certification are never compensated.

Insurance often requires:

• A medical diagnosis (even when it’s not clinically helpful)

• Rigid session limits

• Treatment approaches they approve — not always the most effective ones

For OCD and related disorders, this can interfere with:

• The pace of ERP or I-CBT

• Session length or frequency

• Ethical clinical decision-making

A superbill is a detailed receipt that allows clients to seek out-of-network reimbursement from their insurance.

It usually includes:

• Therapist’s license and NPI number

• Diagnosis code

• Service code (CPT)

• Date and cost of each session

Clients submit the superbill directly to their insurance company.

Depending on your plan, insurance may:

• Reimburse a percentage of the session fee

• Apply it toward your out-of-network deductible

• Cover part of care even if the therapist isn’t in-network

Reimbursement amounts vary by plan.

• A superbill is not a guarantee of reimbursement

• Clients pay the therapist directly

• The insurance company decides what they’ll reimburse

Therapists provide the documentation — insurance controls the outcome.

PAPERWORK FOR FILING CLAIM IS THROUGH YOUR INSURANCE COMPANY; CONTACT THEM DIRECTLY FOR INSTRUCTION