Online vs In-Person ERP in Ontario: Which Is Better?
By Justin La Rose, RP, M.Psy · Registered Psychotherapist (CRPO) · Clinical Director, The OCD Clinic
Evidence last reviewed: October 2026
For most people, online ERP works about as well as in-person ERP. A 2023 review of 22 trials found no significant difference between remote and face-to-face CBT for OCD (Salazar de Pablo, 2023), though people with more severe OCD may do better in person. Online has a real advantage when the OCD shows up at home.
The short answer
- OCD trials: Across 22 randomized trials with 1,796 people, remote CBT for OCD showed no significant difference from face-to-face treatment (Salazar de Pablo, 2023).
- Severity matters: The same review found that people with more severe OCD symptoms may do better in person (Salazar de Pablo, 2023).
- Video therapy in general: A review of video-delivered mental health services found them broadly comparable to in-person care, across conditions rather than OCD alone (Batastini, 2021).
- Where we see people: The OCD Clinic offers ERP online anywhere in Ontario and in person in Toronto at Yonge and Bloor, starting with a free 20-minute consultation.
When is online ERP the better choice?
Online ERP is often the better choice when your OCD lives at home, or when getting to an office is the obstacle. Exposures happen in the environment where the OCD actually shows up. In my practice, some of the most useful online sessions happen in the kitchen, the car or the bathroom, right where the rituals live, which matters a lot for checking OCD and contamination OCD.
Online also removes commute time, widens access for people outside major cities and makes scheduling easier. More on how it works in online OCD therapy across Ontario.
When does in-person ERP make more sense?
In-person ERP can make more sense when OCD is severe, when home has no private space, or when an exposure works better with a therapist in the room. The review above found people with more severe symptoms may do better face to face. If you’re not sure where you sit, see how to tell if OCD is severe. In-person sessions are part of our OCD treatment in Toronto, and many clients do a hybrid. A 2026 BMJ review recommends exactly that kind of flexibility: start in whichever format fits, use in-person sessions where an exposure or the relationship needs it, and move exposures into your real environment by video (Abramowitz, 2026).
| Online | In person | |
|---|---|---|
| Evidence for OCD | No significant difference from face to face in trials (Salazar de Pablo, 2023) | May suit more severe OCD, per the same review |
| Where exposures happen | Your real environment: kitchen, car, bathroom | The office, with exposures planned around it |
| Travel | None | Getting to Yonge and Bloor in Toronto |
| Who it reaches | Anyone in Ontario | People who can get to Toronto |
| Privacy | Needs a private room at home | Built in |
Does the format matter more than the therapist?
No. What matters more than format is whether your therapist actually does ERP. It’s like a trainer at the gym: what counts is whether they’ll put you through the reps, not which room you’re standing in. That’s the line between the two types of therapy, and it’s why a therapist doesn’t need to share your experience to help.
Individual sessions are $250 with a senior clinician or $225 with an associate clinician, and the first 20-minute consultation is free. See fees for details. If you live in the US, the UK or Ireland, online OCD coaching is the route.
Frequently asked questions
Can exposures really be done over video?
Yes. Your therapist guides the exposure live while you do it in your own space, and many exposures are easier to set up at home than in an office. Others, like a trip to a public washroom, are planned together and done between sessions.
Do I need to live in Toronto to work with The OCD Clinic?
No. Online sessions are available anywhere in Ontario. In-person sessions are in Toronto at Yonge and Bloor.
Can I switch between online and in-person sessions?
Yes. Many clients do a hybrid: in-person for certain exposures and online for the rest. You can talk through what fits in the free 20-minute consultation.
Where can you go deeper?
Not sure which format fits your OCD? Book a free 20-minute consultation and we'll recommend the right setup for you, wherever you are in Ontario.
Book a Free ConsultationHow we researched this page
This page draws on a 2023 meta-analysis of 22 randomized trials of remote versus face-to-face CBT for OCD (Salazar de Pablo et al., 2023) and a 2021 review of video-delivered mental health services (Batastini et al., 2021), alongside how we run sessions at the clinic. The OCD review pooled remote CBT broadly, so it isn’t a test of live video ERP specifically, and the Batastini review covers mental health care in general, not OCD. Which rooms make good exposure settings is clinical observation.
A note on my perspective
I run a private clinic that treats OCD with ERP, and I'm paid when people book with us. Read what I write with that in mind. Public and lower-cost routes exist too, and the Ontario OCD treatment guide lays them out next to ours.
About the author
Justin La Rose, RP, M.Psy is a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario (CRPO) and Clinical Director of The OCD Clinic in Toronto. He has worked in mental health for more than 25 years and treats OCD with Exposure and Response Prevention (ERP). You can confirm his registration on the CRPO public register.
Client stories on this site are composites, with names and identifying details changed. How we write client stories
How to cite this page
La Rose, J. (2026). Online vs In-Person ERP in Ontario: Which Is Better?. The OCD Clinic. https://theocdclinic.ca/ocd-faq/online-vs-in-person-erp-in-ontario