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Treatment Guide

Exposure and Response Prevention (ERP): Overcoming OCD and Anxiety

The gold-standard behavioral therapy for treating Obsessive-Compulsive Disorder and severe anxiety.

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.

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