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Exposure and Response Prevention

What is ERP?

Exposure and Response Prevention (ERP) is a form of psychotherapy intended to help those with obsessive thoughts refrain from responding with compulsions or rituals. ERP, which gradually exposes clients to stimuli that induce their maladaptive responses, belongs to the category of treatment known as cognitive behavioral therapy (CBT).


ERP is commonly used to alleviate obsessive-compulsive disorder (OCD), a condition in which people repeatedly experience unwanted and distressing thoughts or feelings, often in response to specific stimuli. A person with OCD may touch a doorknob in a public restroom and worry intensely that she has been infected; another may have intrusive, taboo thoughts about violent or sexual acts and fear that he may cause someone harm. In OCD, these frequent, uninvited thoughts provoke anxiety and lead to compulsive rituals—such as excessively washing one’s hands or ruminating about troubling matters. The compulsive rituals may temporarily reduce anxiety, but in the long term, they promote a cycle of obsession and compulsion that prolongs distress. ERP is a proven approach to breaking the cycle.


ERP (Exposure and Response Prevention) therapy is a type of cognitive-behavioral therapy (CBT) that is commonly used to treat anxiety disorders, particularly obsessive-compulsive disorder (OCD). Here are some potential benefits of ERP therapy:

  1. Reduced anxiety: ERP therapy aims to gradually expose individuals to the feared situation or object, and over time, this exposure can help to reduce anxiety levels.

  2. Decreased obsessive-compulsive behaviors: ERP therapy is designed to help individuals with OCD reduce their compulsive behaviors by gradually exposing them to their feared situations or objects and preventing them from engaging in compulsive behaviors.

  3. Improved quality of life: By reducing anxiety and OCD symptoms, ERP therapy can help individuals improve their overall quality of life and engage in more activities that they may have avoided due to their anxiety or OCD.

  4. Long-term effectiveness: Research has shown that ERP therapy can be effective in reducing symptoms of anxiety and OCD over the long term, even after treatment has ended.

  5. Fewer relapses: ERP therapy has been shown to be effective in reducing the likelihood of relapse, meaning that individuals who have received ERP therapy are less likely to experience a return of their symptoms.

Overall, ERP therapy is a highly effective treatment for many people, especially those with OCD.


ERP (Exposure and Response Prevention) therapy is typically recommended for individuals who are struggling with anxiety disorders, particularly those with obsessive-compulsive disorder (OCD). ERP therapy may also be helpful for individuals who are struggling with phobias, panic disorder, or other anxiety-related disorders.

Individuals with OCD may experience intrusive and distressing thoughts or images, which can lead to compulsive behaviors or mental rituals that are aimed at reducing anxiety or preventing harm. ERP therapy helps individuals learn to confront their fears and anxieties in a safe and structured environment, which can ultimately help them reduce their compulsive behaviors and improve their quality of life.


It is important to note that ERP therapy is typically conducted by a licensed therapist who has received specialized training in this technique. ERP therapy may not be appropriate for everyone, and a mental health professional can help determine whether this type of therapy is the best fit for a particular individual.


During an ERP (Exposure and Response Prevention) therapy session, the therapist and client work together to gradually expose the client to anxiety-provoking situations or objects, while preventing the client from engaging in compulsive behaviors or mental rituals. Here are the typical steps involved in an ERP therapy session:

  1. Setting goals: The therapist and client will work together to identify specific goals for the session, such as exposure to a particular situation or object.

  2. Developing a hierarchy: The therapist will help the client develop a hierarchy of anxiety-provoking situations or objects, starting with the least anxiety-provoking and working up to the most anxiety-provoking.

  3. Exposure: The client will be exposed to the situation or object that triggers their anxiety, starting with the least anxiety-provoking situation/object and gradually working up to the most anxiety-provoking.

  4. Prevention of compulsive behaviors: During exposure, the therapist will prevent the client from engaging in compulsive behaviors or mental rituals that are aimed at reducing anxiety.

  5. Mindfulness: The therapist may also use mindfulness techniques to help the client stay focused on the present moment and reduce anxiety.

  6. Debriefing: After exposure, the therapist and client will debrief and discuss the client's experience, including any anxiety, thoughts, or feelings that arose during exposure.

  7. Homework: The therapist will assign homework for the client to practice exposure on their own outside of the session.

Overall, ERP therapy is a structured and gradual approach to therapy that aims to help individuals gradually confront their fears and anxieties in a safe and controlled environment, ultimately reducing the frequency and severity of their symptoms. The therapist works collaboratively with the client to set goals, develop a hierarchy, and provide support and guidance throughout the exposure process.

"I find many individuals tiptoe around with other "treatments" and eventually return back to using ERP. The hard truth is that it's not a fun treatment but the reward is where it's at."
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