Niles Cook, PsyD

Who I Work With

Dr. Cook specializes in working with adults and high-functioning professionals across the lifespan. His practice is focused on helping individuals navigate the complexities of OCD and anxiety while maintaining demanding careers and personal lives.

In addition to his adult practice, Dr. Cook works with adolescents and young adults who are motivated to engage in the active, behavioral work of ERP to reclaim their independence.

Specialized Areas of Focus

• Relationship OCD (ROCD): Helping individuals navigate debilitating doubts about partner compatibility and the "rightness" of their relationships.

• Scrupulosity & Moral OCD: Working with clients stuck in cycles of religious or moral "perfectionism," guilt, and the constant need for certainty.

• Perinatal & Postpartum OCD: Supporting parents through intrusive thoughts related to infant safety, harm, or "taboo" themes that often arise during the transition to parenthood.

• Sensorimotor & Somatic OCD: Addressing hyper-awareness of bodily functions (breathing, blinking, swallowing) that has become a source of distress.

• Harm & Identity Themes: Providing a non-judgmental, evidence-based space to address intrusive thoughts regarding violence, sexual orientation (HOCD), or gender identity.

Clients often come to treatment feeling stuck, frustrated, or discouraged — especially if they’ve tried therapy before without lasting change.

How I Work

Dr. Cook’s approach is active, direct, and grounded in evidence-based care. He moves beyond traditional talk therapy to focus on the "heavy lifting" of behavioral change. Sessions are collaborative and goal-oriented, designed for clients who are ready to regain freedom from anxiety-driven patterns.

Primary Modalities:

• Exposure and Response Prevention (ERP): The gold-standard for OCD.

• Cognitive Behavioral Therapy (CBT): Challenging the thought patterns that fuel distress.

Our Treatment Focus:

• Breaking the Cycle: Identifying and reducing the compulsive behaviors and avoidance that keep OCD alive.

• Building Tolerance: Learning to navigate uncertainty and "sit with" discomfort rather than fleeing from it.

• Ending the Mental Loop: Changing ingrained patterns of rumination, overthinking, and constant reassurance-seeking.

• Sustainable Change: Focusing on long-term behavioral transformation—not just temporary symptom relief.

Co-Occurring Concerns

When OCD co-occurs with depression, mood concerns, or other anxiety symptoms, treatment is tailored to the full clinical picture.

Dr. Cook integrates:

• Emotional regulation work

• Behavioral activation

• Cognitive restructuring

A strong therapeutic relationship is central to his work. He prioritizes building a collaborative, trusting environment where clients feel supported while engaging in meaningful, challenging change.

Background & Training

Dr. Cook’s clinical foundation was built in hospital settings and specialty OCD clinics. Today, in addition to his private practice, he serves as a clinical supervisor, teaching and mentoring the next generation of doctors in the specialized delivery of ERP. While his experience covers the full spectrum of ages, he currently focuses on providing high-level care for adults and older adolescents navigating complex OCD and anxiety.

Diversity & Inclusion

Dr. Cook provides affirming, evidence-based care to individuals from diverse backgrounds, including LGBTQIA+ clients.

He has specific experience working with:

• OCD themes related to identity and sexuality

• The impact of minority stress on anxiety and mental health

His approach is grounded in cultural humility, respect, and a commitment to understanding each client’s unique context.

Location + Logistics

Dr. Cook is based in Northern Virginia and offers:

• In-person therapy in Vienna, VA

• Virtual therapy throughout Virginia