If your mind gets stuck on unwanted thoughts, and you feel driven to do something over and over to make the worry go away, you are not alone — and it is not your fault. Obsessive-compulsive disorder (OCD) is common, it is well understood, and it responds to treatment. You are welcome here.
What OCD is
OCD has two parts. Obsessions are unwanted thoughts, images, or urges that keep coming back and cause a lot of anxiety. Compulsions are the things people do — actions or mental rituals — to try to relieve that anxiety or prevent something bad from happening. The relief is brief, so the cycle repeats. OCD affects roughly 1 in 40 adults (National Institute of Mental Health, n.d.). It is far more than “being neat” or “liking things a certain way.”
Signs and symptoms
Obsessions often center on themes such as:
- Contamination or germs.
- Fear of harming yourself or others, even when you never would.
- A need for symmetry, order, or things feeling “just right.”
- Unwanted taboo thoughts about violence, religion, or sex.
Compulsions can include washing, checking, counting, repeating, arranging, or seeking reassurance — over and over. Many people also do rituals in their head where no one can see. Having an intrusive thought does not mean you want to act on it; in OCD, those thoughts are distressing precisely because they go against who you are.
How it is understood and evaluated
There is no blood test for OCD. A careful, nonjudgmental evaluation — the thoughts you are having, the rituals you feel pulled to do, and how much time and distress they cause — is how we understand it. Because of shame, many people hide their symptoms for years; you can share at your own pace, and nothing you describe will surprise us.
Brief OCD screening — and why it helps
A short, structured questionnaire is one of the simplest ways to put words to symptoms that are easy to hide. We use brief, validated OCD questionnaires — administered, auto-scored, and documented on the CNS Vital Signs assessment platform and billed under code 96127 (brief emotional/behavioral assessment) — including the Adult Obsessive-Compulsive Disorder Inventory (20-item short form) and, for younger patients, the Child Obsessive-Compulsive Disorder Inventory (20-item short form) (CNS Vital Signs, n.d.). They take only a few minutes, are scored the same way every time, and give your provider an objective starting point — and a simple way to track your progress over time.
How it is treated — and how we approach it at OhanaPsych
OCD is very treatable. The strongest evidence supports a specific kind of cognitive behavioral therapy called Exposure and Response Prevention (ERP) — the gold-standard talk therapy for OCD — together with medication, and the combination tends to work better than therapy alone (Skapinakis et al., 2016). The medications with the best evidence are serotonin reuptake inhibitors: the SSRIs fluoxetine, fluvoxamine, sertraline, and paroxetine, and the related medicine clomipramine. For OCD these are often used at higher doses than for depression and can take 6 to 12 weeks to show their full effect, so patience pays off.
In our practice we approach this work with aloha and without judgment, with the goal of restoring lōkahi (balance and harmony) so the rituals take up less of your life and you can reconnect with your ʻohana and the things you care about. We coordinate care with ERP-trained therapists and your primary-care team so everyone is working together.
Getting care by telehealth
Most of our care is delivered by secure video, so you can begin from a private, comfortable place of your own. Some parts of care — such as certain controlled medications — still follow the federal Ryan Haight Act and DEA rules and may call for an in-person step; we will tell you clearly if that applies to you.
Lasting access by telehealth
As we complete the final stages of becoming a Rural Health Clinic (RHC), telehealth for mental-health care is here to stay with us. Under Medicare’s rural-health rules, RHCs are permanently authorized to provide behavioral and mental-health care by telehealth — including into your home, anywhere in Hawaiʻi — not under the temporary flexibilities that expire and must be renewed. For our patients, that means dependable, lasting telehealth access to the care you need.
Wherever you live, OhanaPsych is your statewide practice. We provide care across the entire state of Hawaiʻi by telehealth, reaching every island — Hawaiʻi Island, Maui, Oʻahu, Kauaʻi, Molokaʻi, Lānaʻi, and Niʻihau. If you would rather be seen in person, you have that option at our offices in Hilo and Honolulu.
When to reach out
You do not need to be in crisis to reach out — new patients are welcome. Call (808) 777-9460 or start your request online.
If you or someone you love is thinking about suicide or self-harm, get help right away. Call or text the 988 Suicide & Crisis Lifeline (call or text 988, or chat at 988lifeline.org). In Hawaiʻi, Hawaiʻi CARES is available by calling or texting 988, or at 808-832-3100 / 800-753-6879. In a life-threatening emergency, call 911.
Medically reviewed by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner, OhanaPsych / Ohana Care Clinic.
Last reviewed: June 28, 2026. Citations verified: June 28, 2026.
This page is general health education from OhanaPsych. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think you may have a mental health condition, reach out to us or another licensed provider. In an emergency, call 911.
References
CNS Vital Signs. (n.d.). CNS Vital Signs computerized rating instruments. https://www.cnsvs.com/WhitePapers/CNSVS-RatingInstruments.pdf
National Institute of Mental Health. (n.d.). Obsessive-compulsive disorder (OCD). https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd
Skapinakis, P., Caldwell, D. M., Hollingworth, W., Bryden, P., Fineberg, N. A., Salkovskis, P., … Lewis, G. (2016). Pharmacological and psychotherapeutic interventions for management of obsessive-compulsive disorder in adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 3(8), 730–739. https://doi.org/10.1016/S2215-0366(16)30069-4
Frequently Asked Questions
Does OhanaPsych accept QUEST, Medicaid, and insurance for OCD care?
Yes. We are in network with the Hawaiʻi QUEST Integration plans — AlohaCare, HMSA, ʻOhana Health Plan, and UnitedHealthcare Community Plan — and we also accept Medicare and most commercial insurance. If you are not sure about your coverage, contact our office and we will help you check.
Can I receive OCD care by telehealth, or do I need to come into the office?
We offer both. You can be seen in person at our Honolulu or Hilo office, or by secure telehealth from anywhere in Hawaiʻi. Some visits or treatments may require an in-person appointment, and we will let you know if that applies to your care.
How do I make an appointment for OCD care?
You can request an appointment through our online scheduling page, or call us at (808) 777-9460 for Honolulu or (808) 867-8002 for Hilo. We welcome new patients and will help match you with the right provider.
Who provides OCD care at OhanaPsych?
Care is provided by our team of licensed, board-certified psychiatric providers. You can read about each member of our team on our Providers page.
