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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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Why ERP Didn't Work Before: Pacing, Fit, and What's 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 1110 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 117 min read


OCD Therapy in Tennessee: What the First Month of ERP Looks Like
Last reviewed: 03/11/2026 Reviewed by: Dr. Kiesa Kelly Starting OCD therapy can feel like signing up for a month of panic. Many people delay because they assume they’ll be thrown into the hardest exposure on day one, or that therapy will turn into endless reassurance seeking. Most evidence-based OCD treatment is more structured, gradual, and collaborative than that. In this article, you’ll learn: What typically happens before treatment officially starts What your first OCD th

Ryan Burns
Mar 117 min read


Medical Trauma or Health Anxiety? How Therapy Can Help
Last reviewed: 03/10/2026 Reviewed by: Dr. Kiesa Kelly Medical trauma therapy is for the moments when your body reacts like danger is back in the room, even though you’re “just” scheduling an appointment, waiting for results, or noticing a new symptom. If your nervous system now treats healthcare (or your own body) as a threat, you’re not imagining it, and you’re not alone. Research has documented posttraumatic stress symptoms after medical illness and treatment, including in

Kiesa Kelly
Mar 109 min read


Therapy for High-Masking Women: Burnout and Perfectionism
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


ADHD or Anxiety? How Therapy Shifts by the Real Driver
Last reviewed: 03/10/2026 Reviewed by: Dr. Kiesa Kelly If you’ve been asking yourself “Is it ADHD or anxiety?” you’re not alone. The overlap is real, especially for high-achieving adults who have learned to power through until they can’t. The good news is that once therapy targets the true driver, things often feel clearer and more workable. In this article, you’ll learn: Why ADHD vs anxiety symptoms can look nearly identical day to day Signs ADHD may be the first domino (eve

Kiesa Kelly
Mar 109 min read


Specialized Therapy or General Counseling: How to Choose
Last reviewed: 03/10/2026 Reviewed by: Dr. Kiesa Kelly If you’re trying to decide between specialized therapy and general counseling, you’re not alone. Many people start with “therapy” as a broad idea, then realize they need something more specific, like treatment that targets OCD loops, insomnia, trauma responses, or executive function struggles. In this article, you’ll learn: What people usually mean by “general counseling” (and when it helps) What makes therapy “specialize

Ryan Burns
Mar 1010 min read


CBT-I vs Sleep Hygiene: When Insomnia Needs Specialized Care
Last reviewed: 03/09/2026 Reviewed by: Dr. Kiesa Kelly If you’ve been Googling “treatment for insomnia” at 2:00 a.m., you’ve probably seen the same advice: cut caffeine, get off screens, keep your bedroom cool. Those are useful sleep hygiene habits. But for many people, insomnia is not a “bad routine” problem. It’s a stuck pattern in the brain and body that often needs an evidence-based plan like cognitive behavioral therapy for insomnia (CBT-I). [1][2] In this article, you’l

Ryan Burns
Mar 97 min read


How to Choose an OCD Therapist: ERP vs I-CBT and Questions to Ask
Last reviewed: 03/09/2026 Reviewed by: Dr. Kiesa Kelly If you’re searching for an OCD therapist, you’re likely hoping for one thing: relief that actually lasts. OCD is highly treatable when therapy is OCD-specific and skills-based, not just supportive conversation. Evidence-based guidelines consistently recommend CBT approaches that include exposure and response prevention (ERP), and medication may also be part of care for some people. [1,2] In this article, you’ll learn: How

Ryan Burns
Mar 98 min read


OCD Therapy vs Anxiety Therapy: Why Intrusive Thoughts Differ
Last reviewed: 03/09/2026 Reviewed by: Dr. Kiesa Kelly If you’re stuck in a loop of intrusive thoughts and “what ifs,” it’s easy to assume you just have anxiety. Sometimes that’s true. But sometimes the engine underneath is OCD—and OCD therapy works differently than general anxiety therapy. Here’s the tricky part: OCD doesn’t always look like handwashing or being “super organized.” For many people, the compulsions are mostly internal: mental checking, replaying, analyzing, co

Ryan Burns
Mar 911 min read


ADHD Treatment Without Medication: What Therapy Can Help With
Last reviewed: 03/09/2026 Reviewed by: Dr. Kiesa Kelly If you’re searching for ADHD treatment without medication, you’re probably not looking for a debate about meds. You’re looking for relief, follow-through, and a plan that doesn’t rely on willpower you “should” have. The good news is that therapy can be a practical, evidence-based way to reduce ADHD-related impairment, even if medication is not part of your plan right now.[1] In this article, you’ll learn: What people usua

Ryan Burns
Mar 910 min read


What Type of Therapy Do I Need? A Decision Guide by Symptom
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 98 min read


When Intrusive Thoughts Start to Feel Constant
Last reviewed: 03/04/2026 Reviewed by: Dr. Kiesa Kelly If you’re dealing with constant intrusive thoughts, it can feel like your brain is stuck on a station you never chose. The thoughts may be disturbing, “out of character,” or just plain exhausting. And the harder you try to make them stop, the louder they can seem. In this article, you’ll learn: Why intrusive thoughts can multiply when you pay them extra attention How rumination and other mental rituals can keep thoughts “

Ryan Burns
Mar 59 min read


Why OCD Attacks the Things You Care About Most
Last reviewed: 03/05/2026 Reviewed by: Dr. Kiesa Kelly If you’ve ever wondered why OCD attacks what you care about, you’re not imagining a pattern. Obsessive-compulsive disorder often latches onto the people, values, and identities that matter most to you, then demands certainty that you’re “safe,” “good,” or “sure.” When intrusive thoughts hit what you love most, it can feel deeply personal. And it can also be a treatable OCD pattern. In this article, you’ll learn: Why OCD t

Ryan Burns
Mar 58 min read


Why OCD Gets Worse Under Stress: 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 58 min read


Rumination OCD: Why 'Figuring Out' Intrusive Thoughts Backfires
Last reviewed: 03/04/2026 Reviewed by: Dr. Kiesa Kelly If you live with rumination OCD, you may feel like you’re doing the responsible thing: carefully thinking through an intrusive thought until it makes sense. But that “one more round” of overthinking intrusive thoughts can quietly become a compulsion, keeping the obsession active and training your brain to treat uncertainty like an emergency. In this article, you’ll learn: What rumination looks like in OCD (and how it diff

Ryan Burns
Mar 49 min read


The OCD Doubt Cycle: Why Nothing Ever Feels Certain
Last reviewed: 03/04/2026 Reviewed by: Dr. Kiesa Kelly If you live in the ocd doubt cycle, you may know the feeling: you check, ask, replay, or analyze… and still don’t feel sure. Your mind keeps reaching for one more piece of certainty so you can finally relax. The tricky part is that OCD doesn’t actually reward certainty. It rewards the chase for certainty. In this article, you’ll learn: Why OCD is sometimes called the “doubting disorder” How the OCD rumination cycle keeps

Ryan Burns
Mar 49 min read


Mental Compulsions in OCD: Signs, Examples & ERP Therapy
Last reviewed: 03/04/2026 Reviewed by: Dr. Kiesa Kelly Mental compulsions ocd are rituals that happen entirely in your mind. Instead of washing, checking locks, or asking for reassurance out loud, the compulsion might be reviewing, repeating, mentally checking, or ruminating until it feels “settled.” These silent compulsions can take up hours, and they can be just as exhausting as visible rituals. In this article, you’ll learn: What mental compulsions are (and how they differ

Ryan Burns
Mar 410 min read


The Avoidance-Anxiety Cycle: Why Avoidance Makes It Worse
Last reviewed: 06/03/2026 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 39 min read


Exhausted but Can’t Sleep: Why It Happens and How CBT-I Helps
Last reviewed: 03/03/2026 Reviewed by: Dr. Kiesa Kelly If you’re exhausted but can’t sleep, it can feel like your body and brain are arguing: you’re drained, but your mind won’t slow down. This “tired and wired” experience is common in anxiety, stress, and burnout. In this article, you’ll learn: Why fatigue doesn’t guarantee sleep How nervous system arousal blocks sleep How insomnia becomes a learned pattern Habits that accidentally reinforce insomnia How CBT-I rebuilds sleep

Ryan Burns
Mar 38 min read
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