You don’t have to keep organizing your life around anxiety.
When intrusive thoughts, fear, compulsions, or avoidance begin influencing what you do, where you go, or how you move through your day, it can feel exhausting.
SkyBox Therapy provides specialized virtual therapy for OCD and anxiety-related concerns, with treatment designed to help you better understand the patterns keeping you stuck and begin responding to them differently.
Shayna McGraw specializes in Exposure and Response Prevention (ERP), an evidence-based approach for OCD, while also drawing from additional therapeutic approaches based on your individual needs.
OCD and Anxiety can look different for everyone.
You may have a diagnosis and know exactly what you’re looking for. Or you may simply recognize that anxiety, repetitive thoughts, rituals, or avoidance are taking up more space in your life than you want them to.
SkyBox Therapy works with clients experiencing concerns including:
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OCD can involve unwanted or intrusive thoughts, images, sensations, or urges alongside compulsions intended to reduce distress or prevent something feared from happening.
Compulsions aren’t always obvious from the outside. They can include visible behaviors as well as mental rituals, reassurance seeking, checking, reviewing, researching, or avoiding certain situations altogether.
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Sometimes the hardest part isn’t simply feeling anxious. It’s everything you begin doing to make sure you don’t feel anxious.
You may find yourself checking, seeking reassurance, avoiding particular places or situations, mentally reviewing what happened, trying to make a thought “feel right,” or relying on routines that provide temporary relief.
Over time, those responses can reinforce the cycle you’re trying to escape.
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Anxiety may show up as persistent worry, overthinking, fear of making mistakes, difficulty tolerating uncertainty, or feeling constantly prepared for something to go wrong.
For others, anxiety becomes especially strong around social situations, judgment, embarrassment, or how they may be perceived by other people.
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When panic becomes something you’re afraid of experiencing again, you may begin avoiding the places or situations where you worry it could happen.
That can gradually make everyday life feel more restricted — whether that means avoiding driving, crowds, travel, being alone, unfamiliar places, or situations where leaving quickly might feel difficult.
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Anxiety may become focused around a specific object, experience, physical sensation, illness, or feared outcome.
Even when part of you recognizes that the level of fear may not match the actual danger, the urge to avoid, check, research, or seek reassurance can still feel incredibly strong.
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Shayna also works with body-focused repetitive behaviors and can help identify the patterns, triggers, and responses connected to these behaviors while determining the therapeutic approach that best fits your needs.
What is ERP?
Exposure and Response Prevention helps you change your relationship with fear — not to avoid it, but co-exist with it
Exposure and Response Prevention, often called ERP, is a specialized form of therapy commonly used in the treatment of OCD and certain anxiety-related concerns.
At its core, ERP helps you gradually face thoughts, situations, sensations, or triggers that bring up anxiety while practicing a different response instead of relying on the compulsions, rituals, reassurance, or avoidance you would normally use to feel better.
It isn’t about throwing you into your biggest fear or asking you to “just get over it.”
ERP is planned collaboratively, approached step by step, and adjusted based on where you are in the process.
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Exposure means intentionally and gradually practicing being in contact with something that triggers fear, uncertainty, or discomfort.
That could be a situation, thought, image, physical sensation, object, or other trigger.
Together, you and Shayna identify which exposures are appropriate and build toward more challenging work gradually rather than beginning with what feels most overwhelming.
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Response prevention is the other half of the process.
Instead of immediately using a compulsion, ritual, reassurance, or avoidance strategy to reduce the discomfort caused by a trigger, you begin practicing a different response.
Over time, this gives you opportunities to learn that you can experience anxiety, uncertainty, or an intrusive thought without automatically responding in the same way.
Understanding the OCD Cycle
Compulsions can bring short-term relief, but that relief can reinforce the cycle over time. This illustration shows why interrupting that pattern is such an important part of OCD treatment.
What ERP may look like in therapy - The work is structured, but it’s also personal.
ERP isn’t a standardized list of exercises that every client completes. Your treatment is built around your individual experiences, patterns, goals, and readiness.
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We begin by identifying the thoughts, situations, sensations, triggers, compulsions, and avoidance patterns that may be contributing to the cycle.
Psychoeducation is an important part of this stage so you can better understand what you’re experiencing and why certain responses may be keeping the pattern going.
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You and Shayna will identify treatment goals and develop a plan for approaching the work in a structured way.
For ERP, this may include creating a hierarchy that organizes possible exposures from more manageable situations to those that feel more challenging.
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When you’re ready, you’ll begin practicing exposures that have been intentionally selected based on your treatment plan.
You won’t be thrown into your biggest fear without preparation. The work is designed to challenge you while remaining manageable enough to practice successfully.
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As anxiety or uncertainty shows up, you’ll work on resisting or changing the compulsive and avoidant responses you would typically use to get immediate relief.
This is where the “response prevention” part of ERP becomes especially important.
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Therapy is an ongoing process. Shayna incorporates structure and progress tracking so you can recognize changes, identify areas that still need attention, and continue building skills both inside and outside of sessions.
Progress isn’t always perfectly linear. Some steps will feel easier than others, and treatment can be adjusted as you move through the process.
More than one tool.
Therapy should respond to the person, not just the diagnosis.
ERP may be the primary therapeutic approach when treating OCD, but it doesn’t mean every part of therapy has to fit into one method.
Depending on your needs, Shayna may also incorporate approaches and tools such as:
Acceptance and Commitment Therapy (ACT)
Cognitive Behavioral Therapy (CBT)
EFT / tapping
Psychoeducation
Additional strategies and holistic considerations that may support your overall treatment goals
The goal is to use evidence-based treatment with enough flexibility to recognize that every person brings a different history, perspective, and set of needs into therapy.
Is this type of therapy right for you?
SkyBox Therapy provides individual virtual therapy for clients ages 13 and older.
Shayna is licensed to provide therapy to clients who are physically located in Arizona.
Licensed Professional Counselor — LPC-24225
Because sessions are held through telehealth, you can participate from a private, comfortable location without adding travel time to your schedule.
You don’t need to know whether ERP is the right treatment before reaching out. The consultation and assessment process can help determine what you’re experiencing and which therapeutic approach may be most appropriate.
Common questions about ERP and Anxiety Therapy
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Exposure and Response Prevention is an evidence-based form of therapy used primarily for OCD and certain anxiety-related concerns.
The exposure portion involves gradually practicing facing thoughts, situations, sensations, or triggers that create anxiety or uncertainty.
The response prevention portion involves practicing not engaging in the compulsion, ritual, reassurance, or avoidance response you would normally use to reduce that discomfort.
Together, these skills can help change the cycle between fear and the responses that reinforce it.
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No. Exposure is only one part of ERP.
Response prevention is equally important because simply encountering something that makes you anxious while continuing to perform the same rituals or safety behaviors may reinforce the existing pattern.
ERP combines thoughtfully planned exposures with practice responding differently when anxiety or uncertainty shows up.
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ERP is best known as a first-line treatment for OCD and may also be appropriate for certain anxiety-related concerns, including specific phobias and health anxiety.
Elements of exposure-based treatment may also be incorporated when working with other anxiety concerns.
The appropriate treatment depends on your individual symptoms and needs, which is why Shayna begins by learning more about what you’re experiencing before establishing a treatment plan.
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ERP intentionally involves practicing being around situations, thoughts, or sensations that can create discomfort, so it’s normal for anxiety to increase temporarily during some exercises.
That doesn’t mean you’ll be pushed into something without preparation.
You and Shayna will work collaboratively to determine where to begin and gradually build toward more challenging steps. The intention is for the work to stretch your comfort zone in a thoughtful, manageable way while helping you develop greater confidence responding to anxiety and uncertainty.
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No.
You don’t need to arrive at therapy ready to tackle the thing that scares you most.
Treatment begins with understanding what you’re experiencing, building trust, learning about the process, and creating a plan together. ERP is gradual, and the work progresses based on your treatment goals and readiness.
You don’t have to know exactly what you need before reaching out.
If OCD, intrusive thoughts, anxiety, compulsions, or avoidance have been limiting your life, a conversation is a simple place to start.
SkyBox Therapy offers a free 15-minute consultation so you can briefly share what you’re looking for, ask questions about treatment, and determine whether working with Shayna may be a good fit.
There’s no pressure to have everything figured out beforehand.