Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP) is one of the most effective approaches for treating obsessive compulsive disorder (OCD) and anxiety difficulties involving compulsions or avoidance. Although the name can sound intimidating, ERP is a carefully planned and collaborative process that helps you gradually face feared situations while learning to resist the urge to carry out compulsions.
What is ERP?
ERP stands for Exposure and Response Prevention. It is a specific behavioural technique that is typically used within cognitive behavioural therapy (CBT). When using ERP, we deliberately approach our difficult thoughts and feelings and refrain from engaging in our compulsions. For example:
If we were struggling with contamination, we may choose to deliberately touch a door handle and then refrain from washing our hands.
If we were struggling with health concerns, we may deliberately bring to our minds distressing thoughts that we were ill and then refrain from seeking reassurance from others.
By refraining from the compulsion, we learn that anxiety naturally rises and falls on its own, and that we can cope without engaging in the behaviour.
Why we use ERP
ERP is recommended by NICE as a first-line treatment for obsessive compulsive disorder (OCD). Decades of research show it to be one of the most effective psychological treatments available for OCD.
ERP can often produce meaningful improvements in a relatively short period of time, particularly when clients are ready to engage actively in behavioural change.
How we use ERP
ERP can often sound overwhelming. In overly simplistic terms, it is saying, "just stop doing the compulsions and you will be fine." But most clients seek help from a therapist because they are unable to do this.
We work collaboratively, and you will only be asked to engage in ERP if you choose to, and when you feel ready. We begin by building a shared understanding of how your anxiety and compulsions are maintained. We then design exposure exercises together, at a pace that feels challenging but manageable.