photo of a woman biting her fingernails who is anxious

How Does ERP Therapy Help With OCD?

Obsessive-Compulsive Disorder (OCD) is a mental health condition that affects about 1 in 40 adults and 1 in 100 children in the U.S. Its hallmark is a pattern of intrusive thoughts (obsessions) that lead a person to perform repetitive rituals (compulsions). Everyone experiences unwanted thoughts at times. With OCD, these fears and the behaviors they provoke dramatically impeded one’s ability to function on a daily basis.

Fortunately, many different treatment options have been developed over the years. One of the most common and effective is Exposure and Response Prevention (ERP). Put simply, ERP manages symptoms by exposing a person to their triggers.

More About ERP Therapy and OCD

One goal of OCD treatment is to reduce or prevent the person’s response (compulsions). Triggers and stimuli are inevitable. Dysfunctional responses are not. ERP is a behavioral designed to manage compulsions. This accomplished via specific ERP techniques, e.g.


This is when the client learns all there is to know about OCD. Such awareness demystifies the disorder and can build confidence about managing it.

Practicing Exposures

It may seem counterintuitive at first but someone with OCD can benefit from being gradually exposed to triggers in the presence of their therapist. If this is not possible at first, the therapist can guide the person through an imaginary scenario.

Learning to Tolerate Uncertainty

A person with OCD will experience an intrusive thought and experience distress over it. They fear the thought will come true so they create rituals to prevent this outcome. ERP guides that person to acknowledge the thought without engaging in the compulsion. Over time, this can acclimate the person to the inevitability of uncertainty and thus, neutralize the obsession.

photo of a woman biting her fingernails who is anxious

Response Prevention

Getting comfortable with uncertainty allows the treatment to move forward into response prevention. Two examples of this are:

  • Delaying the ritual: There can be immense value in lengthening the time between an obsessive thought and compulsive behavior.
  • Altering the ritual: Getting into the habit of changing the rituals around demonstrates that the compulsions are not as powerful — or necessary — as the person with OCD believes.

How ERP Works For OCD

The above techniques can:

  • Use habituation to reduce the anxiety created by both obsessions and compulsions
  • Make it apparent that the intrusive thoughts are not as unbearable as they seem
  • Help the person recognize that are far more capable of managing OCD than they might imagine
  • Most importantly, EPR can make it obvious that obsessive thoughts do not lead to terrible outcomes that require some kind of intervention

ERP is not a miracle cure and each person will progress at their own rate. But the National Institutes for Health (NIH) have found that about 50 to 60 percent of patients who “complete ERP treatment show clinically significant improvement in OCD symptoms and treatment gains have shown to be maintained long-term.”

How to Get Started With ERP

If you’re interested in Exposure and Response Prevention and believe it can help you, it starts with finding a therapist with experience in this modality. Reach out to talk and inquire about their compatibility with you. For example:

  • You will want to find out if they have often worked with individuals with OCD
  • Ask how it will be determined that you are ready for ERP
  • Get specifics on the treatment frequency, duration, and the measurement of progress 
  • Find out as much as possible about ERP and what to expect

I would love to help you address and manage the symptoms and challenges presented by Obsessive-Compulsive Disorder. Therefore, I invite you to set up a free and confidential consultation in which we can talk more about you, the treatment, and how we can support you with anxiety treatment.

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