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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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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 48 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 49 min read


The Avoidance-Anxiety Cycle: Why Avoidance Makes It Worse
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 37 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 37 min read


Intrusive Thoughts vs. Intent: Why 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


How Long Does OCD Treatment Take? What to Expect from ERP
Last reviewed: 03/02/2026 Reviewed by: Dr. Kiesa Kelly If you’re searching “how long does OCD treatment take,” you’re probably hoping for a clear finish line. ERP (Exposure and Response Prevention) is a first-line, evidence-based therapy for OCD, but the timeline depends on a few predictable factors like severity, co-occurring symptoms, and how consistently you can practice between sessions. [3,4] In this article, you’ll learn: Why there’s no single ERP timeline (and what act

Ryan Burns
Mar 27 min read


Demand Avoidance in Adults: When Everyday Tasks Feel Like Threats
Last reviewed: 03/02/2026 Reviewed by: Dr. Kiesa Kelly If demand avoidance in adults shows up in your life, you may recognize the feeling: a simple request (send an email, make an appointment, start the dishes) can land in your body like a threat. You might even hear yourself thinking, “why do I resist everything?” even when you genuinely want the outcome. In this article, you’ll learn: What “demand avoidance” means and how it relates to PDA-style patterns Why autonomy can fe

Ryan Burns
Mar 28 min read


What Happens in ERP Therapy? A Week-by-Week Look
Last reviewed: 03/02/2026 Reviewed by: Dr. Kiesa Kelly If you’re Googling what happens in ERP therapy, you’re probably doing something very understandable: trying to feel more certain before you start something that sounds scary. ERP (exposure and response prevention) is the most studied psychotherapy for OCD, but most people don’t get a realistic “this is what sessions actually look like” walkthrough. ERP is structured, collaborative, and paced to help you build skills, not

Kiesa Kelly
Mar 29 min read


Medical Trauma Therapist: Signs Your Body Is Still Bracing
Last reviewed: 02/23/2026 Reviewed by: Dr. Kiesa Kelly If you’re looking for a medical trauma therapist, you might be carrying something that’s hard to name. Maybe you’re “fine” on paper, but your body tenses when the portal notification pops up. Maybe you cancel appointments you actually need. Maybe you’re exhausted from being on alert. Medical trauma isn’t only about one dramatic moment. It can come from pain, frightening procedures, serious illness, repeated exposures, or

Ryan Burns
Feb 238 min read


ROCD vs Relationship Anxiety: How to Tell the Difference
Last reviewed: 02/23/2026 Reviewed by: Dr. Kiesa Kelly If you’re stuck in “ROCD vs relationship anxiety” questions, you’re not alone. Both can involve fear, doubt, and a strong urge to figure it out right now. The difference is that ROCD (relationship OCD) runs on intrusive doubt plus compulsive attempts to get certainty, and those attempts usually make the doubts louder over time. In this article, you’ll learn: The short answer: what makes ROCD different from relationship an

Ryan Burns
Feb 238 min read


Online ERP Therapy: What Telehealth ERP Looks Like for OCD
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


Y-BOCS Scoring: What Your OCD Severity Score Means
Last reviewed: 04/23/2026 Reviewed by: Dr. Kiesa Kelly Y-BOCS scores help describe OCD severity. In other words, Y-BOCS scoring is meant to be a guide, not a verdict about you. What matters most is how OCD is functioning in real life, how much it is limiting your week, and what kind of treatment support is needed next.[1][4] If you felt a rush of fear or shame after seeing a higher number, that reaction makes sense. Many people read a score and immediately start wondering wha

Kiesa Kelly
Feb 239 min read


PHQ-9 Score Interpretation: What Each Severity Range Means
Your PHQ-9 score is between 0 and 27. Here's what each depression severity range means, what to do next, and how to decide whether screening is enough or it's time to see a clinician.

Kiesa Kelly
Feb 1910 min read


Autistic Burnout Symptoms: Signs, Causes, and Supports That Help
Autistic burnout symptoms can look like exhaustion, skill loss, and sensory overload after long-term stress. Learn signs, causes, and supports that actually help.

Ryan Burns
Feb 196 min read


ADHD, Perimenopause, and Burnout: Demand Avoidance in Midlife
Last reviewed: 03/18/2026 Reviewed by: Dr. Kiesa Kelly If you’re searching for demand avoidance ADHD perimenopause, you’re usually trying to name a very specific midlife experience: you used to carry a lot, compensate hard, and keep moving, and now even one more email, one more errand, or one more decision can make your system slam on the brakes. This page is about what can happen when ADHD, burnout, and perimenopause stack together, and demands start to feel unmanageable. It

Kiesa Kelly
Feb 128 min read


No Minimum Caseload Therapist Job: What It Really Means
“No minimum caseload therapist job” can mean freedom, or it can mean you’re on your own. Here’s how to tell the difference, ask the right questions, and build a steady caseload without hustle culture.

Ryan Burns
Feb 17 min read


1099 vs W2 Therapist in Tennessee: What Changes (and What Doesn't)
Choosing between a 1099 vs W2 therapist Tennessee role is less about “better” and more about fit: autonomy, support, benefits, and how pay is structured. Use this guide to compare offers, ask smarter questions, and spot red flags before you accept.

Ryan Burns
Feb 17 min read


ROCD: Relationship OCD Signs, Cycle, and What Helps
ROCD (relationship OCD) can make normal relationship uncertainty feel urgent and dangerous, pulling you into “Do I really love them?” loops. This guide breaks down common ROCD symptoms, the obsession–compulsion cycle, and how ERP and I-CBT help you relate to doubts differently.

Ryan Burns
Dec 21, 20257 min read


Low-Demand Therapy for PDA-Style Demand Avoidance: What It Is
If you’ve lived with PDA-profile demand avoidance (in yourself or in your child), you already know the frustrating paradox: the more someone pushes, the less it works. What looks like “refusal” or “opposition” on the outside is often an internal nervous system threat response to demands—especially when those demands feel trapping, controlling, or impossible to escape. This is where low demand therapy for demand avoidance can be a game-changer. A low-demand, autonomy-supportiv

Ryan Burns
Dec 15, 20258 min read


Demand Avoidance in ADHD: Signs, Overwhelm, and What Helps
Demand avoidance ADHD therapy helps you tell the difference between overwhelm and defiance—so you can reduce shutdowns, stop power struggles, and build supports that actually work.

Ryan Burns
Dec 14, 202510 min read
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