Dr. Niles Cook
OCD & Anxiety Specialist | Exposure and Response Prevention (ERP) Therapy in Northern Virginia
If you've ever felt trapped in a cycle of intrusive thoughts, compulsions, reassurance-seeking, or constant overthinking, you're not alone. OCD and anxiety often convince people that the answer is to think harder, gain more certainty, or eliminate doubt entirely—but those efforts frequently end up strengthening the problem.
Niles Cook, PsyD is a licensed clinical psychologist specializing in the treatment of obsessive-compulsive disorder (OCD) and anxiety disorders in Northern Virginia. He provides evidence-based psychotherapy using Exposure and Response Prevention (ERP), the gold-standard treatment for OCD.
Dr. Cook helps clients learn to respond differently to anxiety, uncertainty, and intrusive thoughts so they can spend less time managing fear and more time living according to what matters to them. His approach is structured, active, and collaborative, with a focus on creating meaningful behavioral change rather than getting stuck in endless analysis.
Who I Help
People who feel stuck in cycles of intrusive thoughts, mental checking, reassurance-seeking, or constant overthinking.
People who can usually see that their fears don’t fully make sense, but still feel unable to stop engaging with them.
People who find themselves:
analyzing thoughts or feelings repeatedly
seeking certainty that never feels enough
avoiding situations that trigger anxiety or doubt
getting caught in mental rituals (reviewing, praying, checking, “figuring it out”)
struggling with perfectionism, guilt, or fear of making the wrong decision
Many of the people I work with are dealing with obsessive-compulsive disorder (OCD), including presentations such as relationship OCD (ROCD), scrupulosity, contamination fears, harm-related intrusive thoughts, or perinatal OCD. Others are struggling with generalized anxiety, chronic worry, or perfectionism that functions in a very similar cycle.
Clinical Approach to OCD & Anxiety Treatment
Dr. Cook’s approach is grounded in evidence-based treatment for obsessive-compulsive disorder (OCD) and anxiety disorders, with a focus on understanding and interrupting the cycles that maintain symptoms over time.
Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP) is the gold-standard psychological treatment for OCD.
ERP helps clients learn to respond differently to intrusive thoughts, sensations, and uncertainty without relying on compulsions or avoidance.
Treatment typically involves:
Gradual exposure to feared thoughts, sensations, or situations
Prevention of compulsive behaviors and mental rituals
Reduction of avoidance and reassurance-seeking behaviors
Building tolerance for uncertainty and distress over time
Over time, ERP helps reduce OCD-driven patterns and supports long-term changes in how the brain responds to perceived threat.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is used to support broader anxiety-related concerns and complements ERP work when appropriate.
CBT focuses on:
Identifying patterns of thinking that amplify anxiety
Reducing cognitive distortions that maintain distress
Strengthening more flexible and adaptive responses to uncertainty
Conditions Treated
Dr. Cook provides treatment for obsessive-compulsive disorder (OCD) and anxiety-related conditions. His work focuses on OCD presentations and patterns driven by intrusive thoughts, uncertainty, and compulsive responses.
Obsessive-Compulsive Disorder (OCD)
Anxiety & Related Conditions
Generalized anxiety disorder (GAD)
Chronic worry and rumination
Health anxiety
Panic-related anxiety patterns
Perfectionism and performance anxiety
Anxiety-driven avoidance behaviors
Reassurance-seeking and compulsive checking patternsConditions Treated
Background & Training
Dr. Cook’s clinical foundation was built across major national medical and specialty anxiety settings. Prior to co-founding Red Elm Psychotherapy, he served as a senior clinician and the Director of Training at a premier specialty OCD and anxiety clinic, where he supervised doctoral-level clinicians in evidence-based modalities including ERP.
In addition to his clinical practice, Dr. Cook has dedicated years to academia and research. He served as a University Professor and Clinical Supervisor at Pacific University, teaching evidence-based treatments for anxiety and related disorders. He has also served as a consultant to schools and organizations across the West Coast .
His formal clinical journey includes:
Doctorate of Psychology (PsyD): Clinical Psychology, Pacific University (Oregon)
Clinical Internship: Completed in New Haven, Connecticut
Clinical Residency: Completed in San Jose, California
Professional Affiliations: International OCD Foundation (IOCDF) Directory Listing
Location & Services
Dr. Cook is based in Northern Virginia and offers:
In-person therapy in Vienna, VA
Virtual therapy for clients throughout Virginia
Get Started
If you’re looking for structured, evidence-based treatment for OCD or anxiety, you can reach out to schedule a consultation.