Exposure and Response Prevention (ERP)

What is ERP

Exposure and Response Prevention (ERP), also called Exposure and Ritual Prevention, is the most effective method of anxiety-spectrum treatment. This includes treatment of Obsessive Compulsive Disorder (OCD), phobias, social anxiety, and Hypochondria (health anxiety), just to name a few. Research supports the notion that treatment including ERP, coupled with Cognitive Behavioral Therapy (CBT), tends to produce optimal results when compared to other psychotherapeutic methods.

Exposure and Response Prevention, ERP, Orange County, Fullerton, OCD, Anxiety, therapy, treatment

ERP is a behavioral approach where you work toward getting closer and closer to your fears (exposure) while resisting compulsive behaviors, such as rituals, reassurance seeking, neutralizing, and avoidance (prevented response).

If you are new to treatment that includes exposure, exposure therapy can sound overwhelming, frightening, and like the last thing you want to do. You have tried everything to avoid feeling anxious and facing your fears, so facing them directly can feel like certain death, or worse! I’m here to tell you it’s truly a liberating, empowering, and for some, an invigorating experience.

How ERP works

After working through the cognitive components of CBT, you will make an inventory of all your fears and triggers, called a hierarchy. We will work together to put them in order from the easiest item to the most difficult. This list is then used to guide our work as we design exposure exercises. While starting with the easiest items on your list, repeated exposure eventually leads to reduced anxiety, which in turn leads to greater confidence as we move up your hierarchy. Mindfulness-based approaches, such as Acceptance and Commitment Therapy, are also used alongside exposure treatment to boost your willingness to face increasingly difficult situations.

The OCD Cycle

Adding psychiatric medication to your treatment can accelerate the ERP process while also making it more effective. Researchers show that supplementing CBT and ERP with medication has the most effective outcomes than just CBT and ERP or medication alone. While medication is not a “magic pill” that makes all the anxiety go away, it can provide added encouragement and confidence to behavioral therapy.  

If you are ready to make your first steps to begin ERP treatment, or would like more information on you can benefit from ERP and CBT, please contact me.

The California OCD and Anxiety Treatment Center offers specialized therapy using Exposure and Response Prevention for OCD and anxiety related disorders in its Fullerton offices. In addition to serving North Orange County, Los Angeles, and the Inland Empire, CalOCD offers online therapy, group therapy, and Intensive Out-Patient treatment.


2 thoughts on “Exposure and Response Prevention (ERP)”

  • Even if I had debilitating OCD I wouldn’t have ERP. I don’t trust the therapy and I wouldn’t trust you. What would happen if I said No? Would you respect it? Doubt it. From what I’m reading about it it’s all cheerleading not about putting the welfare and best interest of your clients first. Even OCD people have the same rights to fairness like we do. Just play by the rules instead of playing the rules .

    • Hi Darin,

      Thanks for the comment and thoughts about ERP. Upon reading about it, many people can feel uncomfortable and hesitant to try it out, however the entire process is done in collaboration between the therapist and client. The people I work with are absolutely allowed to say “no” to any exposure for any reason, and I respect their wishes. Usually, if a client says “no” it means we have started too high on their hierarchy or we need to do more work discussing Acceptance and Defusion skills and discussing the role willingness plays in feeling anxious in the face of an exposure.

      If you would like to discuss ERP more, feel free to reach out and I’ll be happy to explain it further. I’m sorry if you have had bad experiences with a therapist in the past, however not all therapists ignore their client’s needs nor dictate treatment. I hope you have a better, reparative experience in the future.

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