OCD is so common in neurodivergent people that I felt I really wanted to be able to offer clients something. I know an excellent Exposure Response Prevention (ERP) practitioner who I tell everyone about, but as you know if you’ve ever been “therapist shopping”, when you find someone you click with you would often rather stick with them. So, I chose to get trained in I-CBT. It’s probably my favorite training I’ve ever been on. Here’s a blog post and FAQ for the curious!
What is I-CBT, can you explain it for me?
– it stands for Inferential Cognitive Behavioral Therapy (apologies if you were looking for CBT-i for insomnia or i-CBT: internet based CBT!)
– we all draw inferences/conclusions based on our senses, including our sense of memory and our sense of logic. This is our reasoning.
– with OCD or certain presentations of anxiety, we also have a second way of drawing conclusions, which gives a lot of weight to possibilities and “what ifs”
– I-CBT draws our attention to how this happens and the way it works, so we can tell “what’s me and what’s my OCD” and we can feel the difference between “what if” and “what is”
– it explores this rather than trying to convince you of something you already know (you’ve probably tried to talk yourself out of OCD already), and instead of exposing you to the distressful thing in controlled situations where you resist the compulsion (that would be ERP)
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An example, one of the ideas in I-CBT.
If we think about this obsessional sequence:
1. Trigger
2. Obsessional doubt
3. Imagined consequence of doubt
4. Distress
5. Compulsion
We would see I-CBT works with step 1 – 3 whereas ERP (“exposure therapy”) works with step 5.
E.g.
1. Trigger: locked the door, left the house
2. Obsessional doubt: What if I didn’t lock it
3. Imagined consequence: Someone could break in
4. Distress: Fear
5. Compulsion: check the door is locked
In this example, I-CBT looks step by step at how we come to doubt that we have locked the door, because if we have OCD it seems we all do this in similar ways. You’ll likely find you can fit the different ways your OCD is impacting your life into this same “obsessional sequence. This is one of the many sections of the map you will draw of your OCD if you do I-CBT work.
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Explanation of I-CBT from the original creators:
There’s a good few studies saying it works as well as ERP. ERP remains the gold standard treatment for OCD.
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What’s the difference between i-CBT and ERP?
Both are types of CBT but i-CBT focuses on the Cognitive and ERP focuses on the Behavioral.
Who is i-CBT for?
Officially it’s for anyone with OCD and inferential confusion. You can do an inferential confusion self-assessment here. The average score for someone with OCD is 110 and for someone with clinical anxiety is 87. The average score for a control member of the public is 67. ( This assessment is not a diagnostic tool and just gives you an idea if learning about inferential confusion might be helpful for you.)
I can’t afford therapy right now. Is there any way to access free i-CBT?
The creators of i-CBT have made a lot of resources available free on their website. They are mostly aimed at clinicians but they may be of use: https://icbt.online/
They also have a self-help book you’ll see for sale in the resources of that website.
There’s no substitute for therapy but I’ve certainly heard of people getting great relief from “bibliotherapy” like this.
Tell me about OCD and ADHD?
If you want to learn more about the overlap in these then Dr. M.A. Neff has a good bog post on OCD, Autism and ADHD and Additude Magazine have a good article on ADHD and OCD.
Why are you offering i-CBT and not ERP for OCD?
Well, they are both great approaches in my opinion. But, for one thing, I don’t believe I have anything like enough training in ERP to offer it and for another, as much as I know it’s effective, its very counterintuitive for me, personally. I feel a lot more comfortable working with clients in a cognitive way, personally, especially as someone who doesn’t suffer from OCD.
Many years ago I wrote this after going to counselling as a client for the first time:
“I have never seen the monster that is chasing you, but I have read a book about it.
First, you must stop being afraid it will eat you.
Then you must stop running.
When you have done this, I can show you the third step.”
I can point out how ERP is very different to those words, but still, this is the feeling that comes up for me when I contemplate encouraging a client to do an exposure. In contrast, with i-CBT we work together to see and map out “the monster” (most of us won’t conceptualize it as a monster, it thinks it is being helpful, after all) and then when you see it, recognize and understand it, you won’t even want to do the compulsion.
I-CBT for OCD in Ireland, you say? (Here’s the self-promotion part)
I would say that i-CBT with me is a good fit if
– you prefer the sound of i-CBT to ERP right now
– you would like to start with i-CBT
– you’ve already tried ERP but still have some OCD symptoms and are hopeful i-CBT could alleviate it even further or help you recover completely
– you specifically want to work with me, e.g. because I’m someone who also has lived experience of ADHD and training in working with ADHD and Autistic clients
As I said, even though there is plenty evidence of I-CBT’s effectiveness, ERP is still the gold standard treatment for OCD, so if OCD is having a very severe impact on your life I would encourage you to start there.
You don’t need an official diagnosis for either OCD treatment in Ireland.
Where do you do I-CBT sessions for OCD in Ireland?
I don’t normally work online apart from exceptional circumstances, but I’m finding that I-CBT seems to work very well online so I’ll be offering online I-CBT sessions with new clients on Tuesdays starting 2026.
Sources:
Aardema, F. et al. (2009) ‘The expanded version of the Inferential Confusion Questionnaire: Further development and validation in clinical and non-clinical samples’, Journal of Psychopathology and Behavioral Assessment, 32(3), pp. 448–462. doi:10.1007/s10862-009-9157-x.
Inference-based cognitive behavioral therapy (2025) Inference-based Cognitive-Behavorial Therapy. Available at: https://icbt.online/ (Accessed: 11 December 2025).
Roberto Olivardia, Ph.D. (2025) When OCD and ADHD coexist: Symptom presentation, diagnosis, and treatment, ADDitude. Available at: https://www.additudemag.com/ocd-adhd-comorbid-symptoms-diagnosis-treatment/ (Accessed: 11 December 2025).
Sonneveldt, I.J. et al. (2025) ‘Inference-based CBT versus CBT with exposure and response prevention for obsessive-compulsive disorder: The role of pre-treatment anxiety and feared consequences on treatment outcome’, Journal of Obsessive-Compulsive and Related Disorders, 44, p. 100936. doi:10.1016/j.jocrd.2025.100936.
Wolf, N. (no date) Improving psychological treatment for obsessive-compulsive disorder [Preprint]. doi:10.5463/thesis.1116. Available at: https://research.vu.nl/ws/portalfiles/portal/408379916/proefschriftubnadja%20wolf%20-%2067f93790ca96d.pdf
Rebecca Bourke 
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