Exposure and Response Prevention (ERP) for OCD

Exposure and Response Prevention (ERP) is a well-researched and highly effective form of behavioral treatment for OCD; in fact, it is considered the gold standard in the treatment of clients with obsessive compulsive conditions. 

ERP involves teaching clients with OCD coping skills and then gradually exposing them to situations that provoke their worried thoughts in a safe and manageable manner. During exposure exercises, clients use the coping skills they've learned to manage increasingly longer or more intense experiences with feared situations.  With practice, clients ultimately learn to overcome their urges to avoid or perform compulsive rituals (i.e., response prevention) in the face of gradually more intense anxiety provoking situations.  

• One example of ERP treatment might be having a client with obsessive worries about germs refrain from washing his or her hands after tying shoes or after taking out the trash. Relaxation and cognitive coping skills would be used by the client to help manage their anxiety about germs during the period in which they are resisting the urge to wash their hands.  

• Another example might be to have a client with obsessive worries about "harming" a loved one learn to use refocusing skills to enable them to give a hug to a family member rather than avoid  physical contact. 

With successful ERP treatment, clients with OCD come to realize that, while they may not be able to avoid or eliminate the "triggers" of their OCD symptoms, they can learn to manage their responses to these "triggers" in order to live a much more confident and worry free life.

ERP is a highly collaborative form of therapy.  That is, it is most effective when clients and therapists work together to design exercises that are adequately challenging while also taking into consideration each individual's tolerance for exposure treatment.  ERP exercises are also more likely to be effective when clients take an active role in setting the pace of their own progress.

 ERP is recommended by the American Psychological Association and many other organizations for its wealth of scientific backing. 

Exposure  refers to clients confronting the thoughts or situations that prompt their obsessive worries; response prevention refers to the use of coping skills to prevent dysfunctional compulsive behaviors that are usually associated with trying to forget or avoid the feared thought or situation.   

ERP exercises typically demand some creativity.  It usually takes a great deal of thought and experience to design a set of increasingly intense exposure exercises that are sufficiently personalized and adequately relevant to a client's anxiety, all the while maintaining a safe environment for therapy.

At Carolina Anxiety Care, Dr. Futtersak brings more than 30 years of experience as a cognitive behavioral therapist helping clients with anxiety and OCD.  Dr. Futtersak acts as both teacher and coach in helping clients accomplish exposure expercises.  He provides coping skills training to clients and encourages them to take on sufficiently challenging exposure exercises while remaining responsive to their feedback and allowing them to set the pace of their own progress.