Exposure and Response Prevention (ERP)

"What is ERP?"

Exposure and Response Prevention (ERP) is considered the gold standard for the treatment of Obsessive-Compulsive Disorder (OCD). ERP is considered a first-line treatment in the treatment of OCD - meaning if you have an OCD diagnosis and have not tried ERP, you are missing out on the most evidence-based and well research treatment for the disorder, and it is likely worthwhile to give it a try. ERP is a form of CBT and has a very strong evidence base in reducing symptoms and improving functioning for people with OCD.

Exposure = the practice of facing thoughts, images, objects, or situations that trigger your fears/anxiety; facing the source of your fears and uncertainties that fuel your thoughts.

Response Prevention = Resisting the urge to engage in the compulsive behaviors in response to the obsessions.

"What's it like to do ERP? "

For clients seeking ERP for OCD, I typically start by doing a thorough assessment of their current OCD symptoms, called the YBOCS or C-YBOCS. This will give us great info on the types of obsessions and compulsions the client is struggling with, as well as a severity rating of the symptoms. We will use the information from this assessment to create a plan for ERP treatment.

Often the next step is creating a hierarchy and working through feared situations/stimuli. This can be real life exposures, or what we refer to as in-vivo exposures (such as if a client has a fear of germs/contamination then we might try touching something considered dirty and not washing hands), or imaginal exposures (such as writing a scenario where the client touches something they worry is contaminated and sitting with the anxiety of what would/could happen next).

For clients with specific phobias/emetophobia, panic, or other anxiety disorders, the process will be similar to what's descibed above, but tailored to your specific symptoms. We will complete an assessment, create a hierarchy, and build an exposure plan accordingly. For panic, we may do something called interoceptive exposures, which are specific to feared body sensations that often occur in panic attacks/panic disorder.

The best way to learn what it will be like for you to address your specific OCD symptoms with ERP is to schedule a free phone consultation with me - to do so click here!

"What if doing exposures is too hard? Building a hierarchy and doing the things I fear sounds terrifying! "

I collaborate with clients (and their families) to develop an ERP plan that meets them where they are in treatment - there is no one-size-fits-all approach! We tailor the exposures to a client's specific fears/worries/OCD symptoms, and build the hierarchy based off where the client feels they are willing to start and what they feel they can tolerate.

My experience has been that clients often are surprised with how much they can actually handle when engaging in exposures, and this builds hope and allows them to feel proud of themselves for conquering anxiety, obsessions, fears, and intrusive thoughts.

Exposure and Repsonse Prevention is often hard work but I find time and time again that the clients who come to me ready to try it make progress in getting their symptoms managed and learn how to get back to living their lives!

"Is ERP only used for OCD? What if I think I'd benefit from ERP for a different problem I'm facing?"

I have successfully utilized ERP to assist clients struggling with OCD (across many/all subtypes such as contamination, religious/scrupulosity, harm, relationship, sexual, checking, etc.).

Additionally, I commonly and successfully use ERP to address

anxiety / excessive worries
specific phobias (such as emetophobia)
panic disorders / panic attacks.

If you'd like to know more about how I'd use ERP to assist you in meeting your unique therapy goals, please reach out to schedule a free consultation call!

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