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While both Harm OCD and desire to harm someone involve thoughts relating to harm, distinct features can help differentiate between the two.

"At the beginning of the COVID-19 pandemic, I found myself overwhelmed with anxiety. I was rightfully worried about the transition of over 500 individuals and families to telehealth... To my very pleasant surprise, my anxieties did not come to fruition." Read Dr. Rosmarin's findings about how in person and telehealth therapy helped prevent patient's anxiety during the pandemic.

Telehealth allows for increased access to care, providing a flexible option for families, and allows for exposure work in the home setting where compulsions may be the strongest. Yet, telehealth does not come without challenges.

In 2009 I decided to step out of my comfort zone and open a solo private practice. I’ve enjoyed the last 15 years in private practice, and looking back, there are some choices I made that were on point, some that were errors in judgements, but all were learning experiences.

How do I know if I have self-harm OCD or if I actually want to kill myself? This is a significant differentiation to make because it can have treatment-impacting and even life-threatening consequences.

Whether we hear the term from a client, another provider, or our own classification of someone’s symptoms, “compulsions” tend carry with them some level of assumption – that this might just be OCD.

Harm inducing types of thoughts, images and urges are typically referred to as Harm OCD and they can cause significant distress and anxiety in sufferers.

Now that telehealth and in-person services are available, what are important factors for clinicians, youth, and families to consider?

For Jill, it was useful to know that the house wouldn’t burn down if she stopped checking; but it was more important to learn that she would still be a worthwhile human being even if it did.   

Many mental health professionals are now conducting patient visits virtually. I am one of the only psychologists left in my building who has stayed behind to continue in-person work while abiding by COVID protocols. Since our practice specializes in refractory OCD spectrum disorders and anxiety disorders a lot of the work done at our outpatient clinic requires in-vivo exposures, which cannot be replicated on Zoom.