What is Exposure and Response Prevention? ERP is the evidence based, gold standard of treatment for Obsessive Compulsive Disorder (OCD). ERP is a type of exposure therapy specifically developed to treat OCD and provided by an ERP trained licensed therapist.
What is OCD? OCD occurs when an individual is stuck in a cycle of obsessions and compulsions. Obsessions are unwanted thoughts that may feel intrusive, and can include urges, or images that trigger distressing emotions. Compulsions are behaviors or mental rituals that a person with OCD engages in as a way to decrease emotional distress brought on by the obsession and an attempt to get rid of the obsession in the moment. Almost everyone has obsessive thoughts and/or compulsive behaviors at times. This dose not mean that that individual has OCD. In order for an individual to qualify for a diagnosis of OCD the obsessions and compulsions must be extreme enough that it takes up over an hour of their day each day. The obsessions and compulsions must also cause high levels of distress, or get in the way of the individual's values and goals, such as maintaining important relationships, completing home and work tasks, etc.
How Does ERP work? ERP begins with exposure to the thoughts, images, situations, objects that bring up anxiety and provoke obsessions. This means we purposefully engage with and confront what triggers obsessions. Response prevention means NOT doing the compulsive behavior even when an obsession is already occurring. ERP helps to retrain your brain until you no longer feel threatened by the obsession or it's trigger.
Exposure can be difficult and anxiety producing. What we know is that over time, practicing exposure with a trained clinician can lead to a significant decrease in OCD symptoms to the point where they are no longer impactful or life interfering. On the other hand, continuing to engage in compulsions will strengthen and maintain OCD. Your therapist will make a exposure plan with you to help you be successful in achieving your treatment goals.
Talk Therapy vs. ERP While talk therapy can be an effective treatment for some, there is no research evidence that shows it as effective for OCD. ERP and approved medications are the evidenced based treatments for OCD.
Shawn Wood, LCSW is licensed to provide ERP in TX, CA, MA, ND, & VT. Rachel Burgreen, LCSW-S is licensed to provide ERP in Texas.
To find out more about ERP visit: https://iocdf.org/about-ocd/ocd-treatment/erp/