Predictors of licensed mental health counselors accurately diagnosing and recommending empirically supported treatments for obsessive compulsive disorder

For over a decade, research has supported that obsessive-compulsive disorder (OCD) is frequently misdiagnosed and not treated with OCD-specific, empirically supported treatments (ESTs) by healthcare professionals. This has resulted in barriers for those seeking effective treatments. Empirical findings are mixed regarding predictors for misdiagnosis and non-OCD-specific treatment recommendations among mental health professionals. Additionally, there is a dearth of research investigating licensed mental health counselors’ (LMHCs) accuracy in OCD assessment and treatment recommendations. In this study, we examined LMHCs’ diagnostic impressions and treatment recommendations for OCD across subtypes, focusing on (a) accuracy of diagnosis, (b) whether OCD-specific ESTs were recommended, and (c) whether theoretical orientation, years of experience, and clinical specialty influenced OCD diagnosis and treatment recommendations. Case vignettes were used in an online survey to gather data from LMHCs ( N =130) who were asked to diagnose and provide treatment recommendations based on the presented symptoms. Over 62% of LMHCs accurately diagnosed OCD and recommended OCD-specific ESTs across varying subtypes. LMHCs were six times more likely to diagnose OCD accurately in nontaboo subtypes. Those with a theoretical orientation that included an OCD-specific EST (exposure therapy, CBT, ACT) were over five times more likely to recommend an OCD-specific EST. These results supported that OCD treatment remains an issue in the field, with LMHCs, among other types of mental health professionals, contributing to the concerns.