Exposure Response Prevention (ERP) Therapy

What is Exposure Response Prevention (ERP)?

ERP is a Cognitive Behavioural Therapy (CBT) intervention based on the idea that, with gradual but repeated exposure to a feared object, feeling or situation, the fight-flight-freeze response will eventually subside.

What does it look like?

With the aim of reducing or removing the fight-flight-freeze response, ERP seeks to gradually, but repeatedly, expose us to the object or situation we fear until the anxiety/fear subsides or until we learn that our feared outcome either doesn’t occur, or that we can cope with it. Exposure tasks start easy, and progressively get more and more difficult, but it is important to remember that you are in the driver’s seat and the task is supposed to be set up to be a success. Tasks can involve in vivo exposures (exposures conducted in real life), imaginal exposures (exposures conducted in the imagination), virtual reality exposures (exposures conducted in virtual reality), interoceptive exposures (exposures that purposefully bring on physiological sensations) and/or thought exposures (exposures that purposefully bring up difficult thoughts). During any of these exposure tasks, ERP requires that you prevent any of your typical responses to the fear.

This includes any compulsions, physical or cognitive avoidance, reassurance, rituals, or behaviours that make it less likely for the feared outcome to occur. It can also include coping strategies, but this can be discussed with your psychologist. ERP is typically provided over 5-20 weekly or fortnightly 50-minute sessions (or however many sessions you require), which include exposure homework tasks, and can be used in combination with other interventions.

How effective is it?

ERP is the gold standard treatment for OCD, meaning that it is a well-established therapy, and is the most effective and recommended treatment for OCD. The only way to break free from the OCD cycle is to stop your compulsions through ERP.