What does the research say about ERP? 

Exposure and Response Prevention (ERP) is not just a theory; it is consistently backed by decades of strong scientific evidence. ERP is widely recognized by major mental health organizations as the most effective psychological treatment for Obsessive-Compulsive Disorder (OCD) and is considered the "gold standard" of care.

• High Success Rate: Research indicates that approximately 60% to 85% of patients who complete a course of ERP achieve significant relief from their obsessive-compulsive symptoms.

• Lasting Improvement: Patients who respond to ERP often report lasting improvements, helping them maintain a reduced reliance on compulsions long after treatment concludes.

• Superior to Medication Alone: Studies comparing ERP to medication (like SSRIs) have shown that ERP is often more effective at reducing OCD symptoms, both alone and when combined with medication.

• Recommended First-Line Treatment: Given its proven efficacy, ERP is recommended as the first-line treatment for mild-to-moderate OCD in children, adolescents, and adults.

The overwhelming consensus in the scientific community is that ERP is an evidence-based and highly effective method for breaking the debilitating cycle of OCD.

What does ERP therapy look like? 

ERP therapy begins with an assessment and diagnosis phase to identify the specific types of anxiety that you're experiencing. This phase also uncovers themes regarding automatic thoughts that drive your anxiety/OCD. During this time, you may be assigned some journaling homework to document triggering situations, your response patterns, thoughts, and feelings. 

The information gathered from the initial stage is used to put together a list of guided exposures followed by exposure homework that you will first complete with the therapist in session and then on your own on a regular basis in order to teach your brain that it doesn't need to run from or do a ritual to escape anxiety. These exposures are rated by yourself on a scale of 1 to 10 with regard to how distressing they seem to you.  The therapist will help you pick some of your less distressing exposure scenarios to start with, and you will work up to more difficult exposures over time as you gain confidence. By the time you reach the most disturbing exposures, they may not seem nearly as disturbing as when you started.

Here are some of the main types of exposures that are commonly used in ERP:

• In Vivo Exposures are actual, real-life situations that give you anxiety. For example, if you have a fear of water, a beginning In Vivo  exposure may be sitting 100ft away from a swimming pool for a period of time.

• Imaginal Exposures involve vividly imaging specific situations that you are afraid of. For example, if you have a fear of water, an imaginal exposure may be picturing yourself swimming in great detail.

• Interceptive Exposures create the physical sensations of feared situations in small doses. For example, if you suffer from panic attacks and a tight chest is a symptom of the panic attack, doing a breathing exercise where you hold your breath on purpose would be considered an interoceptive exposure.

It's important to note that you, the client, are in control of this process from start to finish.

Who should not engage in ERP?

Please inform your therapist immediately if you suffer from one of the following conditions. It may be the case that you cannot engage in ERP until this condition is resolved. Please message me if you struggle with one of these conditions and would like a referral to a resource that can help you:

•  Suicidal thoughts or actions

• Homicidal thoughts or actions

• Psychosis

• Severe Dissociation

• Severe Emotional Dysregulation (such as that associated with Borderline Personality Disorder or Complex PTSD)

• Substance Use Disorders