What is Exposure and Response Prevention?
Exposure and Response Prevention (ERP) is a specific type of Cognitive Behavioral Therapy (CBT) and is considered the first-line, gold-standard psychological treatment for Obsessive-Compulsive Disorder (OCD).
The therapy involves two components. Exposure involves directly confronting the thoughts, images, objects, and situations that trigger your anxiety. Response Prevention refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been triggered.
International OCD Foundation: An Introduction to ERP
How ERP Works
When confronted with a trigger, the natural instinct is to perform a compulsion (or avoidance) to reduce the anxiety. While this works in the short term, it reinforces the cycle of OCD.
- The Fear Ladder — Together with your therapist, you create a hierarchy of your fears, starting from the least anxiety-provoking to the most.
- Systematic Exposure — You deliberately expose yourself to the triggers on the list, starting from the easiest ones.
- Habituation — By sitting with the anxiety without performing the compulsion, you allow your brain to learn that the situation is not dangerous and that anxiety will naturally subside on its own.
ERP Therapy Specialists
Verified Oregon therapists
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PROMA, Licensed Professional Counselor, Co-Founder/Director · Bend, OR
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Who Can Benefit from ERP?
ERP is the definitive treatment for OCD, but it is also highly effective for several related conditions:
- Obsessive-Compulsive Disorder (OCD)
- Specific Phobias
- Social Anxiety Disorder
- Illness Anxiety Disorder (Hypochondriasis)
- Body Dysmorphic Disorder (BDD)
Sources & Clinical Evidence
- International OCD Foundation (IOCDF). Guidelines and Facts on ERP Therapy. States that ERP is the most effective treatment for OCD.
- Olatunji, B. O., et al. (2013). Efficacy of cognitive behavioral therapy for obsessive-compulsive disorder. Psychiatry Research. A meta-analysis confirming the large effect sizes of ERP in symptom reduction.