Exposure and Response Prevention (ERP) in California and Oregon

ERP is a form of Cognitive Behavioral Therapy (CBT) that is evidence-based and very effective in treating Obsessive-Compulsive Disorder (OCD). ERP helps clients slowly and gradually confront their fears and obsessions without engaging in compulsive behaviors, ultimately reducing anxiety over time and living a purposeful life.

ERP helps clients retrain their minds to face anxiety-provoking situations and thoughts without resorting to rituals or avoidance behaviors. By repeatedly confronting their fears, clients realize that the discomfort they anticipate is manageable and that compulsive behaviors are not necessary to cope with distress.

When Is ERP Used?

ERP is designed to help clients live well without having to engage in compulsions. Anxiety will reduce and clients are left feeling more confident in their ability to handle difficult emotional experiences.

ERP is used to treat various conditions, including:

  • Obsessive-compulsive disorder (OCD)

  • Anxiety disorders

  • Phobias

  • Eating disorders

ERP can help clients realize that their minds may sometimes misinterpret situations. They can also learn that emotions and urges are fleeting, and that they possess greater resilience than they may have believed.

How ERP Works
ERP involves two main steps:

  1. Exposure:
    Clients are exposed to situations, objects, or mental images that typically provoke obsessive thoughts, anxiety, or compulsions.

  2. Response Prevention:
    Clients practice resisting the compulsive behaviors or avoidance tactics that they would typically use to reduce their anxiety. This process teaches them that they can tolerate discomfort and that compulsions are unnecessary.

Through repeated exposure to feared stimuli without engaging in compulsions, clients gradually learn to manage their anxiety and reduce their obsessive-compulsive patterns.

What to Expect in ERP
The process begins with a thorough assessment of the clients unique OCD patterns through the use of a log.

  • Collaborative Exposure Brainstorming:

    Based off of your log, you and your therapist, you will collaborate a number of different exposure exrcies that will help you learn how to lean in to uncertainty and discomfort in the service of your values

  • Client led Exposure:
    Clients will choose which exposure exercises they are most willing to do. The therapist will teach and model the client how to do specific exposure exercises with the client. The client will become your own exposure expert. are systematically exposed to situations or stimuli that provoke anxiety or obsessions. The client is then slowly and gradually exposed to situations that provoke anxiety or obsessions. For example, someone with a fear of contamination might be asked to touch a public doorknob.

  • Response Prevention:
    The therapist teaches clients helpful replacement behaviors. The client will cut back on compulsive responses and learn more adaptive values-based responses to obsessions and urges. The client works to avoid their usual compulsive responses, such as excessive handwashing after touching a doorknob. Over time, they become accustomed to the anxiety without relying on compulsions.

  • Relapse Prevention:
    As treatment concludes, therapists and clients develop a relapse prevention plan, ensuring long-term success in managing OCD or other conditions.

What to Look for in an ERP Therapist
When seeking a therapist for ERP, it's important to find a licensed mental health professional with specialized training and experience in exposure and response prevention. In addition to qualifications, it is essential to choose a therapist with whom you feel comfortable.

While ERP is highly effective for OCD, it is also valuable to find a therapist with skills in complementary therapies to address your individual needs.