Intrusive thoughts, constant anxiety, and a mind that won’t settle.
Specialized OCD and perinatal mental health care for intrusive thoughts that feel real, sticky, and hard to ignore.
Evidence-based treatment, including Exposure and Response Prevention (ERP), informed by behavioral science and delivered with warmth, curiosity, and genuine collaboration.
In-person in Vienna, VA | Virtual across Virginia & PSYPACT states
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 active, direct, and actually effective.
Specialized Care for OCD and Perinatal Mental Health
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.
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.
Meet the Psychologists Behind Red Elm
We’re Dr. Erin Cook and Dr. Niles Cook, licensed psychologists who founded Red Elm Psychotherapy with a shared commitment to providing specialized, evidence-based care with warmth and compassion.
We specialize in OCD, intrusive thoughts, and anxiety, with Niles bringing nearly a decade of specialized experience providing Exposure and Response Prevention (ERP) for OCD, and Erin bringing specialized expertise in OCD and perinatal mental health, including the ways intrusive thoughts and anxiety can emerge during fertility, pregnancy, and the postpartum period.
Although we bring different perspectives, personalities, and areas of expertise to our work, we share the same approach: thoughtful, individualized treatment and genuine collaboration. We believe effective therapy should be both rigorous and deeply human. Through our work with clients, we’ve seen how transformative ERP can be, and we’re passionate about providing the kind of specialized treatment that can genuinely change the way people experience their lives.
You don't have to be certain that you have OCD. You don't have to know exactly what you need. You just have to start the conversation.
Frequently Asked Questions
Still have questions about how we work or out-of-network reimbursement? Check out our quick FAQ below, or reach out anytime. If you're ready to get started, schedule a brief consultation call.
-
We are an out-of-network (OON) practice, which allows us to provide specialized, unhurried care tailored entirely to your needs rather than insurance restrictions.
-
If you have out-of-network benefits (common with many PPO plans), your insurance company may reimburse you for a significant portion of session costs. Here is how simple the process is:
Check Your Benefits: Call the member services number on the back of your insurance card and ask: "What are my out-of-network mental health benefits for outpatient psychotherapy (CPT code 90837)?"
Attend Your Sessions: You pay the standard session fee directly at the time of service via our secure client portal.
Get Your Superbill: At the end of each month, we provide you with an itemized receipt (a "superbill") that contains all the required clinical and diagnostic codes.
Submit & Get Reimbursed: You upload the superbill to your insurance provider's online portal (or use a service like Reimbursify). Your insurance company then sends reimbursement directly to your bank account or by check.
-
ERP is direct, structured, and completely collaborative. We never force you into terrifying situations. Together, we map out your specific intrusive thoughts and gradually practice sitting with anxiety without relying on compulsions—at a pace you control.
-
Yes! As PSYPACT-authorized psychologists, we can provide virtual therapy to clients living in over 40 participating states. We also offer in-person sessions at our office in Vienna, VA.
-
It’s a brief, zero-pressure conversation where we briefly discuss what you’re experiencing, answer any questions about our approach or scheduling, and ensure we are the right clinical fit for your needs.
You don’t have to keep managing this on your own
We’ll help you understand what’s happening—and what actually works.
Typically responds within 24 hours.