Intrusive thoughts, constant anxiety, and a mind that won’t settle.

Specialized OCD and perinatal therapy in Virginia for intrusive thoughts that feel real, sticky, and hard to ignore.

Treatment that helps you break the cycle- not just manage symptoms

Online across Virginia | In-person in Vienna

Therapy office at Red Elm Psychotherapy in Vienna, VA, featuring a dark blue bookshelf, antique books, and a wall sconce.

Intrusive thoughts that don’t feel like yours.
Images you never asked for.
Questions that won’t stop looping.

We specialize in OCD and perinatal mental health—helping people navigate intrusive thoughts, anxiety, and internal distress that often stays hidden behind high levels of functioning.

From the outside, it can look like you’re holding everything together. Internally, it’s exhausting.

Intrusive thoughts, constant doubt, and the urge to “figure it out” can take over quickly. Reassurance helps briefly—but the anxiety always returns.

More time spent thinking.
More second-guessing.
More decisions shaped by fear instead of what actually matters.

For many, the transition through pregnancy and postpartum can intensify these patterns.

Read more about intrusive thoughts postpartum.

You’re not looking for vague support.
You want therapy that is structured, direct, and actually effective.

Specialized, structured, and grounded in what actually works

We’re Dr. Niles Cook and Dr. Erin Cook—licensed psychologists specializing in OCD and perinatal mental health.

Therapy with us is structured and collaborative. We assess carefully, explain clearly, and set expectations so you know what the process looks like from the start.

For OCD and anxiety, we use evidence-based treatment, including Exposure and Response Prevention (ERP), to help you step out of the cycle of intrusive thoughts and compulsive patterns. The work is direct and sometimes uncomfortable—but it leads to real change.

For perinatal clients, we combine research-informed care with steady, relational support. We consider the full picture—sleep, mood, identity shifts, relationships—so the work feels grounded and realistic.

This is specialized care: focused, clear, and built to be effective.

Dr. Niles Cook and Dr. Erin Cook of Red Elm Psychotherapy collaborating in their Vienna, VA therapy office.

Specialized Care for OCD and Perinatal Mental Health

Red Elm Psychotherapy clinician mapping out a specialized OCD treatment plan in their Northern Virginia office.

Intrusive thoughts, constant doubt, and compulsive patterns that don’t respond to reassurance.

We provide specialized treatment for OCD—including contamination fears, harm obsessions, scrupulosity, relationship OCD, and intrusive thoughts that feel disturbing or out of character.

Our work is grounded in Exposure and Response Prevention (ERP), the gold-standard treatment for OCD, delivered in a structured, collaborative way that helps you step out of the cycle—not just manage it.

Learn more about how OCD cycles work.

A comforting and safe therapy environment at Red Elm Psychotherapy in Vienna, VA, featuring a cozy armchair and tissues for emotional support.

Anxiety, intrusive thoughts, and emotional overwhelm during pregnancy or after your baby arrives.

We specialize in perinatal mental health—including postpartum anxiety, depression, perinatal OCD, birth trauma, and the psychological impact of high-risk pregnancies.

You love your baby—and something still feels off. Our work helps you understand what’s happening and move toward steadiness, clarity, and confidence.

Read more about postpartum anxiety and what it actually feels like.

A specialized ERP therapy session for OCD at Red Elm Psychotherapy in Vienna, VA, focusing on evidence-based recovery.

Break the cycle of OCD and anxiety at its source.

A structured, evidence-based approach designed specifically for OCD and anxiety.

Instead of trying to eliminate thoughts or reduce anxiety directly, ERP helps you change your response—so intrusive thoughts lose their power over time.

This is active, focused work that builds confidence, reduces avoidance, and creates lasting change.

Why ERP feels so hard (and why that matters).

We also support women navigating perinatal OCD and the emotional impact of high-risk pregnancy.

Doctoral-level, specialized care

We’re Dr. Niles Cook and Dr. Erin Cook, licensed psychologists specializing in OCD and perinatal mental health.

Our work is structured, collaborative, and grounded in evidence-based treatment—including Exposure and Response Prevention (ERP)—so you’re not just talking about symptoms, but actively changing the patterns that keep anxiety and OCD going.

We offer private-pay therapy across Virginia via telehealth, with in-person sessions available in Vienna for clients seeking focused, high-quality care.

A home office with a wooden desk, a black and gold desk lamp, a notebook and a pen holder on the desk, a dark wooden bookshelf in the corner with decorative items, a white vase with dried plants, and wall art, against a green paneled wall.

You don’t have to keep managing this on your own

If this feels familiar, you don’t have to keep managing it on your own.

We’ll help you understand what’s happening—and what actually works.

Typically responds within 24 hours.