Exposure and Response Prevention (ERP)
Exposure and response prevention (ERP) is a type of cognitive-behavioral therapy (CBT) that is particularly effective for treating obsessive-compulsive disorder (OCD). ERP breaks the cycle of obsessions (intrusive, distressing thoughts) and compulsions (repetitive behaviors intended to reduce anxiety).
The person gradually and intentionally confronts situations, thoughts, or images that trigger their anxiety or distress. This is done in a safe and controlled manner, often starting with less distressing situations and progressing to more challenging ones. The exposures might be to thoughts (e.g., contamination), physical places (e.g., public restrooms), or specific actions (e.g., touching certain objects).
Response prevention involves actively resisting the urge to perform compulsive behaviors or rituals (such as washing, checking, or seeking reassurance) that are typically used to reduce anxiety. By refraining from these compulsions, a person learns to tolerate the anxiety without undoing it, that the anxiety associated with the obsessions will decrease over time (a process called habituation), and that they can cope without engaging in compulsive responses. As the cycle of obsession and compulsion is broken, the intensity, duration, and frequency of OCD symptoms are reduced.
ERP is one of the most evidence-based treatments for OCD and considered the gold-standard for treatment of OCD.
