OCD Intensive Treatment in Ontario
Specialized ERP for Moderate to Severe OCD
The Lotus OCD Intensive is a structured outpatient treatment program for adults (18+) living with moderate to severe obsessive-compulsive disorder who need more support than weekly therapy but do not require inpatient hospitalization.
This program is designed for individuals whose lives have become increasingly restricted by OCD—often impacting work, relationships, independence, and daily functioning. Serving clients across Ontario, with in-person care in Waterdown and virtual options available near Burlington, Oakville, Hamilton, Guelph, Niagara, and Toronto.
We serve clients across Ontario, offering in-person care in Waterdown and virtual treatment options near Burlington, Oakville, Hamilton, Guelph, Niagara, and Toronto.
Program Overview
The Lotus OCD Intensive is designed for individuals who find that OCD has narrowed their sense of choice, independence, and autonomy.
Many clients entering the program are off work, socially isolated, or spending large portions of their day ruminating, checking, or seeking reassurance. Some have tried weekly therapy and continue to feel stuck. Others are seeking specialized OCD treatment without the disruption of inpatient care.
The focus of this program is not only symptom reduction, but the restoration of agency, confidence, and functional living—even while uncertainty remains.
Primary Treatment Goal
The primary goal of the Lotus OCD Intensive is meaningful symptom reduction alongside the restoration of autonomy and choice—capacities that are often eroded as OCD becomes more dominant.
Treatment helps clients disengage from compulsive patterns and rebuild confidence in their ability to act according to values rather than fear. This framing distinguishes the Lotus approach from reassurance-based or symptom-only models of OCD treatment.
Treatment Model & Clinical Approach
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The Lotus OCD Intensive is grounded in evidence-based Exposure and Response Prevention (ERP), the gold-standard treatment for obsessive-compulsive disorder. Treatment integrates inhibitory learning-based ERP with rumination-focused ERP principles, allowing clinicians to precisely target both behavioural and mental compulsions.
In addition to ERP, treatment draws from Acceptance and Commitment Therapy (ACT), particularly practices that support acceptance of uncertainty, willingness to experience discomfort in service of recovery, and reconnection with personal values through exposure work.
This integrated model supports meaningful, values-aligned behavioural change rather than symptom suppression alone.
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At Lotus, compulsions are understood as actions taken to prevent mistakes, avoid feared consequences, or feel relief in the moment. Even when those actions occur mentally rather than behaviourally.
This includes mental reviewing, internal or external reassurance-seeking, thought monitoring, and attempts to “figure things out” or mentally check for certainty.
A central focus of treatment is helping clients develop a clear, functional understanding of how rumination operates as a compulsion and why—even when it feels necessary—it ultimately strengthens OCD over time. Clients learn that life becomes more manageable without compulsive engagement, even while uncertainty remains present.
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Rather than abruptly removing reassurance, avoidance, or safety behaviours, treatment begins with education and shared understanding.
Clients are supported in understanding why these behaviours are understandable and relieving in the short term, how they unintentionally maintain OCD in the long term, and how to gradually reduce reliance on them in a clinically appropriate, values-aligned, and manageable way.
The pace of change is individualized and guided by each client’s recovery goals, level of distress, and functional needs
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Treatment within the Lotus OCD Intensive is both directive and collaborative. Clinicians provide clear structure, guidance, and expertise in ERP while actively involving clients in exposure design, pacing decisions, and the identification of meaningful recovery goals.
Restoring choice, agency, and empowerment is not only a guiding value of the program—it is a core treatment outcome. Over time, clients are supported in taking increasing ownership of their exposure practice and recovery process.
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All clients complete a structured assessment process that includes standardized OCD measurement tools, such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), alongside detailed functional analysis.
Lotus Counselling Services collaborates with private psychiatric service providers to ensure diagnostic clarification is available when needed and that medication options can be explored in a timely, coordinated manner.
Program Structure & Intensity
The Lotus OCD Intensive is a structured outpatient program for adults (18+) with moderate to severe OCD who are experiencing significant impairment in daily functioning.
The program operates on a rolling intake basis and is tailored to each client’s symptom profile, clinical presentation, and recovery goals.
Flexible Delivery Format
Treatment may be delivered fully virtual, in-person, or through a hybrid model depending on client location and clinical need. When appropriate, exposure work may also occur outside the therapy office to support real-world practice.
Individualized Treatment with Group Support
Treatment is primarily individual, allowing for highly personalized exposure planning and rumination-focused work.
Clients are strongly encouraged to participate in the WeOCD Support Group, which provides peer support during active treatment, reinforcement of ERP principles, and a structured after-care option following program completion.
As treatment progresses, intensity is gradually reduced with a deliberate shift toward independent exposure practice, increased autonomy, and self-directed skills use.
The total program length is approximately three months, though pacing is individualized.
During the initial phase of treatment:
2–3 sessions per week
90-minute sessions
Approximately 4.5–5 hours per week
Emphasis on therapist-assisted exposures and skill development
Between-Session Support and Involvement of Supports
To support momentum and real-world application, the program includes structured between-session support such as exposure homework coaching, brief messaging or email support, and optional family or support-person sessions.
Support-person sessions focus on reducing unhelpful accommodation and aligning recovery efforts without reinforcing OCD.
OCD Presentations Treated
The Lotus OCD Intensive treats all OCD presentations, including contamination OCD, harm OCD, sexual intrusive thoughts and sexual orientation OCD, pedophilia-themed OCD (POCD), relationship OCD (ROCD), religious or scrupulosity OCD, health anxiety and somatic OCD, primarily mental compulsions (“Pure-O”), perinatal OCD, moral OCD, and symmetry or “just-right” OCD.
We treat all OCD theme presentations. OCD is limited only by the human imagination. Regardless of content, treatment focuses on the underlying mechanisms of OCD—not the topic of fear.
What to Expect: The Treatment Journey
Clients begin with an intake consultation to assess fit and readiness. A comprehensive OCD assessment informs a personalized treatment plan. ERP begins early, with careful attention to understanding, readiness, and pacing.
Exposures are collaboratively designed and progressed based on learning rather than fear reduction alone. Setbacks and symptom spikes are treated as expected parts of recovery. Over time, clients move toward increased independence and self-directed practice.
Outcomes, Philosophy, and Expectations
Progress in the Lotus OCD Intensive is defined not by the absence of anxiety, but by restored freedom and choice.
Treatment is considered successful when clients feel less controlled by OCD, have reduced avoidance and compulsive behaviours, make decisions based on values rather than fear, and experience increased confidence, agency, and autonomy.
We do not promise certainty, elimination of anxiety, or a cure. Recovery emphasizes living with uncertainty, reducing engagement with compulsions, and progress rather than perfection.
Who Delivers the Program
Elisha Schafer, MSc, RP
Clinical Director and OCD Specialist
Elisha Schafer is the Clinical Director of Lotus Counselling Services and an Adjunct Clinical Professor with McMaster University’s Department of Psychiatry and Behavioural Neurosciences. She has over ten years of experience treating OCD and formal training in rumination-focused ERP with Dr. Michael Greenberg. Her clinical focus includes OCD and compulsive behavioural conditions.
Frequently Asked Questions
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ERP involves discomfort, but it is purposeful, collaborative, and carefully paced. Discomfort is not the goal, learning is.
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Treatment focuses on reducing reliance on reassurance. Clients are supported in understanding why reassurance feels helpful short-term but maintains OCD long-term.
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This is common. Treatment targets the underlying OCD process, not the theme.
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Readiness is assessed collaboratively. Treatment moves at a pace that balances effectiveness with compassion.
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Yes. The Lotus OCD Intensive is based in Waterdown, Ontario, and serves adults across Ontario through both in-person and virtual care. Clients regularly attend from Burlington, Oakville, Hamilton, Guelph, Niagara, and the Greater Toronto Area. Our intake coordinator will help determine the best format based on location and clinical needs.