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News and Research
Science-backed Information for Better Care
ScienceWorks is a modern telepsychology practice offering evidence-based care for: Autism & ADHD, Anxiety & Depression, OCD, Trauma, Insomnia, Kids & Families, and more.
These conditions frequently co-occur, can be difficult to diagnose, and also difficult to treat - often requiring specialist knowledge and direct clinical experience to achieve the best possible outcomes.
That's why research and training are the foundation of our work.
Our goal is sharing our knowledge with our friends, clients, and partners to build a stronger, more informed mental health community.
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OCD, ADHD, and Autism: How Specialized Therapy Changes the Plan
Last reviewed: 03/11/2026 Reviewed by: Dr. Kiesa Kelly When OCD / ADHD / autism overlap, it can feel like you’re trying to solve the wrong problem. You may be working hard on anxiety skills, routines, or productivity, but the stuck part stays stuck. That’s often a sign OCD is driving the plan, even if it doesn’t look like “classic” OCD. In this article, you’ll learn: How OCD can mimic (or hide behind) autism and ADHD traits Why executive function and sensory load can make sta

Ryan Burns
Mar 117 min read


Why ERP Didn’t Work Before: Pacing, Provider Fit, and What to Do Next
Last reviewed: 03/11/2026 Reviewed by: Dr. Kiesa Kelly If you’re thinking, “ERP didn’t work for me,” you’re not alone. Many people try Exposure and Response Prevention (ERP) for OCD, feel overwhelmed or misunderstood, and leave believing they “failed” treatment. In reality, ERP therapy not working often points to a pacing problem, a planning problem, or a provider-fit problem, not a character flaw. In this article, you’ll learn: Why a bad-fit experience can create shame (and

Ryan Burns
Mar 119 min read


High Y-BOCS Score? Understanding Y-BOCS score meaning, next steps, and when to seek specialized OCD therapy
Last reviewed: 03/11/2026 Reviewed by: Dr. Kiesa Kelly A high number on the Y-BOCS can feel alarming. If you’re searching for y-bocs score meaning, you probably want clarity about severity and a path to help, without getting pulled into more reassurance-seeking. In this article, you’ll learn: What the Y-BOCS measures (and what it doesn’t) How score ranges are typically interpreted When it’s time for OCD-specialized care What treatment planning can look like after a high score

Ryan Burns
Mar 116 min read


Online OCD Therapy in Tennessee: Does Telehealth ERP Actually Work?
Last reviewed: 03/11/2026 Reviewed by: Dr. Kiesa Kelly If you’re searching for online OCD therapy in Tennessee, you might be wondering a very practical question: can exposure and response prevention (ERP) really happen over video, and does it actually help? For many people, yes, when telehealth is structured well and you’re working with a licensed OCD therapist in Tennessee who has OCD-specific training. Research on remotely delivered CBT for OCD (including video, phone, and.

Ryan Burns
Mar 117 min read


I Keep Researching My Symptoms but Still Feel Stuck: When It’s Time to Move From Self-Education to Therapy
Last reviewed: 03/10/2026 Reviewed by: Dr. Kiesa Kelly If you’ve been asking yourself when to start therapy, you’re not alone. For a lot of thoughtful, motivated people, learning about mental health becomes a form of self-care at first, and then slowly turns into hours of searching, second-guessing, and trying to “figure it out” before you’re allowed to get help. In this article, you’ll learn: Why self-education can be helpful and also quietly exhausting Signs your research h

Ryan Burns
Mar 108 min read


Therapy for High-Masking Women: Burnout, Perfectionism, and the Cost of Looking “Fine”
Last reviewed: 03/10/2026 Reviewed by: Dr. Kiesa Kelly Therapy for high-masking women often begins with a quiet truth: you can look “fine” on the outside while feeling fried on the inside. You might be the capable one in public, and the person who crashes the moment the door closes. In this article, you’ll learn: What high masking can cost over time Why perfectionism can become protection What therapy can help with (and what “neurodivergent-affirming” actually means) When OCD

Kiesa Kelly
Mar 108 min read


Can Therapy Help if I’m Not Sure Whether It’s ADHD, Autism, OCD, or Trauma? Therapy for Overlapping Symptoms
Last reviewed: 03/10/2026 Reviewed by: Dr. Kiesa Kelly If you’ve been cycling through possibilities like ADHD, autism, OCD, and trauma, you’re not alone. Many struggles show up as the same “surface symptoms,” which is why therapy for overlapping symptoms can help even when you’re not ready to claim one label. In this article, you’ll learn: Why overlapping symptoms are so confusing Common patterns people mix up (and what clinicians listen for) What therapy can do before you ha

Ryan Burns
Mar 107 min read


What Type of Therapy Do I Need? A Decision Guide for OCD, ADHD, Autism, Insomnia, and Trauma
Last reviewed: 03/09/2026 Reviewed by: Dr. Kiesa Kelly Searching “type of therapy” can feel like walking into a hardware store without a project. The problem is not you. The word therapy covers very different tools, and the best fit depends on the pattern underneath your symptoms: obsessive doubt, executive-function overload, trauma-driven threat responses, or a sleep system that’s learned the wrong rhythm. In this article, you’ll learn: How to match symptoms to an evidence-b

Ryan Burns
Mar 97 min read


Why Avoiding Triggers Makes OCD Stronger: The OCD Avoidance Cycle
Last reviewed: 03/04/2026 Reviewed by: Dr. Kiesa Kelly OCD avoidance can feel like self-protection: “If I don’t go there, think about that, or talk about it, I’ll finally feel calm.” The problem is that avoidance and OCD feed each other. Each time you step away from a trigger, your brain gets the message: That was dangerous, and avoidance saved me. Over time, the OCD avoidance cycle expands, and life gets smaller.[1] In this article, you’ll learn: What avoidance looks like in

Ryan Burns
Mar 56 min read


Accepting uncertainty OCD: What “Accepting Uncertainty” Actually Means in Treatment
Last reviewed: 03/04/2026 Reviewed by: Dr. Kiesa Kelly If you’re working on accepting uncertainty OCD, it can sound like someone is asking you to “be okay” with the one thing your brain treats as intolerable: not knowing. But in evidence-based OCD treatment, acceptance is not a mindset you force. It’s a response you practice. In this article, you’ll learn: Why OCD demands absolute certainty (and why that promise never lasts) What “acceptance” means (and what it does not mean)

Ryan Burns
Mar 58 min read


Why OCD Feels So Convincing: How OCD Can Feel Real (Even When You Know It’s Irrational)
Last reviewed: 03/04/2026 Reviewed by: Dr. Kiesa Kelly OCD has a frustrating superpower: it can make a thought feel like a warning, a feeling feel like proof, and doubt feel like a problem you must solve right now. That “I know it’s irrational, but it still feels true” experience is a big part of why ocd feels real. In this article, you’ll learn: Why OCD thoughts can register like threats instead of “just thoughts” How anxiety turns attention into a magnifying glass Why logic

Ryan Burns
Mar 57 min read


Why OCD Gets Worse Under Stress: Understanding Flare-Ups and Relapse Triggers
Last reviewed: 03/04/2026 Reviewed by: Dr. Kiesa Kelly If you’ve ever wondered why OCD gets worse under stress, you’re not imagining it. Stress doesn’t “create” OCD out of nowhere, but it can turn the volume up on intrusive thoughts, anxiety, and compulsions, leading to OCD flare ups that feel sudden and intense. [1,2] In this article, you’ll learn: Why stress makes OCD feel more urgent Common ocd relapse triggers during busy or uncertain seasons Why compulsions and reassuran

Ryan Burns
Mar 57 min read


Why Avoidance Makes Anxiety Stronger Over Time: The Avoidance Anxiety Cycle
Last reviewed: 03/03/2026 Reviewed by: Dr. Kiesa Kelly Avoidance can feel like the safest choice when anxiety spikes, but the avoidance anxiety cycle is one of the main reasons anxiety stays strong over time. When we repeatedly step away from what scares us, the brain doesn’t get the “new data” it needs to learn that fear can rise and fall without catastrophe. [1,2] In this article, you’ll learn: What avoidance looks like (including subtle safety behaviors) Why avoidance brin

Ryan Burns
Mar 36 min read


Why OCD Feels So Real: Understanding OCD What If Thoughts and the “What If” Trap
Last reviewed: 03/03/2026 Reviewed by: Dr. Kiesa Kelly If you live with OCD what if thoughts, you already know this isn’t “just worrying.” A single doubt can land in your mind like an emergency alert: What if I hurt someone? What if I’m lying to myself? What if I missed something important? And the more you try to reason it away, the more real and convincing it can feel. In this article, you’ll learn: Why OCD often begins with doubt and uncertainty (not certainty) Why your br

Ryan Burns
Mar 38 min read


Intrusive Thoughts vs. Intent: Why Intrusive Thoughts OCD Doesn’t Mean You Want It
Last reviewed: 03/02/2026 Reviewed by: Dr. Kiesa Kelly If you live with intrusive thoughts OCD, you know how convincing they can feel: a shocking image or “what if” pops in, and your brain treats it like evidence. You don’t want the thought, but you also can’t stop analyzing it. That loop is often OCD, not a hidden desire. In this article, you’ll learn: What intrusive thoughts are (and why they happen to everyone) How OCD turns normal mental noise into an emergency Why reassu

Ryan Burns
Mar 27 min read


Online ERP Therapy: What Telehealth ERP Actually Looks Like (Between Sessions, Too)
Last reviewed: 02/23/2026 Reviewed by: Dr. Kiesa Kelly Online ERP therapy can feel mysterious at first, especially if you’ve only heard “exposure therapy” described as something extreme. In real life, telehealth ERP is usually structured, collaborative, and designed to help you practice in the places OCD actually shows up, including at home. In this article, you’ll learn: The biggest misconception about ERP (and why “exposure” isn’t flooding) What an ERP session looks like on

Ryan Burns
Feb 238 min read


“Pure O” and OCD Mental Compulsions: Why Screeners Can Miss It
“Pure O” can look like “just thoughts,” but OCD mental compulsions often happen silently: rumination, mental checking, reviewing, and reassurance seeking. Here’s why screeners can miss it and what to do next.

Ryan Burns
Feb 198 min read


Niche vs “Generalist”: How to Choose a Therapy Niche That Builds Momentum
Choosing between niche and generalist work can feel risky. This guide on how to choose a therapy niche shows when specialization builds momentum, when generalist work is strategic, and how to position your practice so the right-fit clients and referrers can find you.

Ryan Burns
Feb 26 min read


Pure O & Mental Rituals: What Counts as a Compulsion (Even When It’s “Only in Your Head”)
Pure o ocd often looks like nonstop thinking—checking your feelings, replaying conversations, praying “until it feels right,” or debating with yourself for certainty. These mental rituals are compulsions, even when no one can see them. Here’s how to spot them and what evidence-based treatment (ERP and I-CBT) looks like.

Kiesa Kelly
Dec 21, 20258 min read


I-CBT for OCD: How Inference-Based Therapy Works (and Who It May Help)
I-CBT for OCD helps people reduce obsessional doubt by correcting the reasoning that fuels intrusive thoughts—often without intensive exposure exercises. Learn how inference-based CBT works, who it helps (including “pure-O”), and what an I-CBT plan at ScienceWorks looks like, so you can choose the right path for assessment, therapy, or coaching at ScienceWorks Behavioral Healthcare.

Kiesa Kelly
Oct 12, 20257 min read
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