Finding an OCD specialist who truly understands Exposure and Response Prevention shouldn't require guesswork. We built a scoring tool to surface verifiable expertise across the entire country — and the patterns in the data tell a clear story.
The Olee Index is a 100-point scoring system that evaluates OCD treatment providers on publicly verifiable signals of expertise — ERP methodology clarity, specialized training, IOCDF directory listing, research publications, institutional affiliations, and public-facing specificity about OCD subtypes. It now covers 5,681 providers across all 50 US states, the District of Columbia, and Puerto Rico.
We built it because patients searching for an OCD therapist face an overwhelming information problem. Thousands of providers list OCD on their profiles. Very few have built their careers around it. And until now, there was no systematic way to tell the difference before that first appointment.
What follows is what we learned from scoring all 5,681 providers — the patterns that emerged, what they mean for patients and for the field, and where the limits of this approach lie.
The two largest clusters sit between 40–49 and 50–59, accounting for 60% of all providers. Only 9% scored 80 or above.
A 28-point gap — the widest of any single factor, and it held up as the dataset grew from 1,357 to 5,681 providers. Publishing on OCD means a provider has subjected their clinical thinking to peer review. It doesn't guarantee excellence in every case, but across 236 publishing providers, it's the clearest available signal that someone has engaged with OCD at an unusually deep level.
This is the finding that should change how patients evaluate providers. BTTI-trained clinicians holding a master's degree average 77.3 on the Olee Index. The overall average for PhD and PsyD holders is 60.5. Specialized OCD training — not the diploma — is what separates providers who score well from those who don't.
BTTI-trained providers account for 442 of the 5,681 in the dataset, yet they represent 195 of the 515 providers scoring 80 or above — 38% of the entire top tier from just 8% of the provider pool. No other single training signal concentrates quality at that scale.
Providers with vs. without each signal, across 5,681 providers nationally.
Publications, specialized training, and IOCDF listing all correlate with higher scores — but at very different magnitudes. Publications and training produce the largest gaps. The IOCDF listing, while valuable as a starting point for patients, shows a narrower spread nationally. With 3,386 providers now listed on the IOCDF directory (60% of our dataset), it has become more of a baseline inclusion criterion than a sharp differentiator. What matters more is what a provider did after listing themselves — the training they pursued and the expertise they built.
The IOCDF therapist directory is the most commonly recommended resource for finding OCD specialists. It's a good first step. But our data shows it's not sufficient on its own. Nearly 4 in 5 IOCDF-listed providers have no verifiable record of BTTI, an OCD fellowship, or comparable specialized training. Over a third score below 50 on the Olee Index. The directory casts a wide net — which helps with access — but patients still need to evaluate the individual provider's depth of specialization.
Mean sub-component scores. The gap is consistent and wide across every dimension — especially training.
The radar chart tells the story visually: top-tier providers don't just outperform on one dimension — they dominate on every axis simultaneously. The widest gap is in specialized training (17.0 vs 2.3 out of 20), which reinforces the central finding: verifiable OCD-specific training is the strongest structural differentiator between the providers who have built their careers around this disorder and those who treat it among many other things.
The degree component is only 4 points of the 100-point rubric. The remaining gap reflects co-occurring expertise signals.
PhD and PsyD holders average 60.5 compared to approximately 53 for master's-level clinicians. The gap is real but more compressed than many would expect — and it nearly disappears once you control for training. A BTTI-trained LCSW (average: 77.3) outscores the average doctorate by a wide margin. The degree is a marker of a career path that sometimes leads to deeper specialization, but the degree alone is not what creates that depth.
Top tier (80+) vs. bottom tier (<40) — percentage of providers by practice type.
Among top-tier providers, 98% practice at named OCD-specialty clinics. Among the bottom tier, 68% have no named practice listed and 29% are affiliated with large telehealth platforms. This pattern held nearly identically from our initial 4-state sample to the full national dataset — it's structural, not regional.
When we first analyzed four coastal states, only 13% of top-tier providers accepted insurance — suggesting a sharp divide. The national data tells a more hopeful story. Across all 50 states, about half of top-tier OCD specialists accept insurance, particularly in the Midwest and South. The gap still exists — providers who explicitly practice out-of-network average 71.9 — but it's not the wall that the coastal data initially suggested. Patients with insurance have more options for high-quality OCD care than the earlier numbers implied.
Best access vs. worst access. Five states have zero providers scoring 80+.
Massachusetts has roughly one top-tier OCD specialist per 241,000 people. Puerto Rico has one per 1.6 million. Alaska, Montana, Rhode Island, and Wyoming have zero. A patient in Massachusetts has roughly eight times better geographic access to elite OCD care than a patient in Puerto Rico — and infinitely better access than someone in Alaska.
The states with the most providers aren't the ones with the best quality ratios. California has 901 providers but only 6% score in the top tier. Tennessee has 88 providers but 18% are top-tier. Volume and quality are not the same thing.
The Olee Index doesn't tell you who's a good or bad therapist. It answers a narrower question: how much publicly verifiable evidence exists that this provider has deeply specialized in OCD?
Clinical outcomes. We have no data on symptom reduction, therapeutic rapport, or patient satisfaction. A high score indicates verifiable expertise signals — it is not a guarantee of any individual patient's experience.
Causation. The score captures a pattern — the traits we measure are observably more common among providers recognized as OCD leaders. It doesn't cause excellence. It identifies probability.
What happens in session. A provider who delivers excellent ERP but has a minimal web presence will score lower than their skill warrants. We measure what patients can verify independently before booking. We encourage all providers to make their approach more visible.
Equity in training access. Doctoral programs, prestigious fellowships, and research opportunities aren't equally accessible. We weighted ERP evidence and OCD specialization most heavily to partially counteract credential-based bias — but acknowledge the system exists within broader structural inequities.
Right now, patients choosing an OCD therapist are navigating an opaque marketplace. A directory listing looks the same whether the provider completed a year-long OCD fellowship or took a single weekend workshop. The information asymmetry has real consequences — patients cycle through generalists for years before finding someone who truly understands OCD.
We built the Olee Index to reduce that guessing. To take the signals that OCD researchers and insiders already use informally when referring colleagues, and make them available to patients in a structured way.
Is it perfect? No. It measures probability, not certainty. Publicly visible evidence, not everything that matters. But as a starting point for informed decision-making — across 5,681 providers in every US state — the data suggests it's a meaningful improvement over the status quo.
The Olee Index is a 100-point scoring system that evaluates OCD providers on publicly verifiable signals of expertise — including ERP methodology clarity, depth of OCD specialization, specialized training, research output, and institutional affiliations. It currently covers 5,681 providers across all 50 US states, DC, and Puerto Rico.
About half do. Nationally, 51% of providers scoring 80+ accept insurance — a much higher rate than in coastal states alone. Specialists in the Midwest and South are more likely to be in-network. If you have out-of-network benefits, those can be applied toward specialists who don't. The key is not assuming all in-network OCD providers are equivalent — filter by training and specialization signals within your panel.
Ask about BTTI or equivalent specialized OCD training — it's the single most predictive signal in our data (average score 78.9 with BTTI vs 53.6 without). Beyond that, look for providers who clearly describe their ERP methodology, practice at clinics with an explicit OCD focus, and use specific language about OCD subtypes rather than treating OCD as generic anxiety.
No. The Olee Index measures the probability that a provider has deep, verifiable OCD expertise — not clinical outcomes for any individual patient. Therapeutic rapport, availability, and practical factors like insurance and location also matter. A score of 60 with good fit may serve you better than a score of 90 with poor fit. Use the index as one input among several.
It depends on your situation. For treatment-resistant OCD, complex comorbidities, or rare subtypes, patients often benefit from the deeper expertise that higher-scoring specialists offer. For a first course of ERP with a straightforward presentation, an in-network provider scoring 55+ may deliver excellent results. The most important factor is receiving actual ERP from someone with genuine OCD training, regardless of price.
It depends on where you live. Massachusetts, Maryland, and DC have the best access ratios (roughly 1 specialist per 240,000–390,000 people). States like Tennessee, North Carolina, and Virginia also have strong concentrations. Five states — Alaska, Montana, Rhode Island, Wyoming, and Guam — currently have zero providers scoring 80+. Puerto Rico has only 2 for 3.2 million people. If local options are limited, telehealth with an out-of-state specialist is often the best path forward.
Looking for an OCD specialist in the U.S.?
We scored thousands of providers on the signals that predict quality care.