Exposure Response Prevention Therapy (ERP)

What is Exposure Response Prevention Therapy?

ERP is a structured form of exposure therapy that helps clients learn to manage and prevent their response to a feared stimulus.

Example:

A client with OCD struggles with obsessive thoughts every time they encounter a specific experience (stimulus). This stimulus causes distress, and the compulsion (a response pattern) is an attempt to calm that anxiety. The problem is, the anxiety continues to return whenever the client is exposed to the stimulus and they must continue to engage in the same compulsion in order to experience relief. Compulsions increase in length and complexity over time, becoming more impairing.

The goal of ERP is to help a client learn to refrain from their response (what we call response prevention) whenever they are exposed, and instead help them learn to tolerate the underlying anxiety which is essential for sustained recovery. In ERP, it is important that the exposure and the response prevention occurs at the same time for the treatment method to be most effective.

What To Expect

1. Clients receive psychoeducation to learn more about how OCD works including examples of cognitive errors i.e. the fact that one’s compulsions may have become more elaborate in order to maintain the same decrease in anxiety, but the anxiety continues to come back irregardless.

2. The clinician and client will create a hierarchy of exposures to work through in treatment. During exposures, a client will confront their stimulus (objects or thoughts that prompt distress) and stay in those situations, without engaging in any response behavior or mental ritual, until the anxiety decreases. Distress is rated with SUDS (subjective units of distress/discomfort), usually on a scale of 0-100 or 0-10.

3. While ERP induces anxiety, it does so in a controlled and gradual way for the purpose of recovery. With time, frequency, and habituation, the exposures help clients build a tolerance to the anxiety they feel, and eventually, start to experience it decrease.

Clients working through ERP can expect weekly homework and weekly treatment sessions that are 60-90 minutes long.

While the length of treatment can vary based on the specific needs of a client and the number of compulsions they may have, most individuals will see a substantial decrease in symptoms after 12 to 16 weeks.

The Goals of Exposure Response Prevention Therapy (ERP):

• Help clients habituate to increasing levels of exposure and develop a higher distress tolerance

• Help clients to see that we can have anxiety without losing control, and that anxiety itself is not dangerous

• Boost a client’s sense of self-efficacy through this powerful treatment process

Who Can Benefit from ERP?

ERP is beneficial for clients diagnosed with:

• OCD

• Trichotillomania

• Excoriation disorder

• Other body-focused repetitive behaviors

Exposure Response Prevention Therapy (ERP) - New York City | Washington, DC

We provide Exposure Response Prevention Therapy (ERP) to young adult clients at all of our locations including The Dorm New York, NY and The Dorm Washington, DC.