Exposure and Response Prevention (ERP): Overcoming OCD and Anxiety

What is Exposure and Response Prevention?

Exposure and Response Prevention (ERP) is a specific type of Cognitive Behavioral Therapy (CBT) and is considered the first-line, gold-standard psychological treatment for Obsessive-Compulsive Disorder (OCD).

The therapy involves two components. Exposure involves directly confronting the thoughts, images, objects, and situations that trigger anxiety. Response Prevention refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been triggered.

How ERP Works

• The Fear Ladder — Together with your therapist, you create a hierarchy of your fears, starting from the least anxiety-provoking to the most.
• Systematic Exposure — You deliberately expose yourself to the triggers on the list, starting from the easiest ones.
• Habituation — By sitting with the anxiety without performing the compulsion, you allow your brain to learn that the situation is not dangerous and that anxiety will naturally subside on its own.

Who Can Benefit from ERP?

• Obsessive-Compulsive Disorder (OCD)
• Specific Phobias
• Social Anxiety Disorder
• Illness Anxiety Disorder (Hypochondriasis)
• Body Dysmorphic Disorder (BDD)

Sources & Clinical Evidence

• International OCD Foundation (IOCDF). Guidelines and Facts on ERP Therapy. States that ERP is the most effective treatment for OCD.
• Olatunji, B. O., et al. (2013). Efficacy of CBT for OCD. Psychiatry Research.