What is Exposure and Response Prevention Therapy (ERP)?
by Striving for Synergy
Psychotherapy & Counselling Clinic
Let’s Learn About ERP
Exposure and response prevention therapy (ERP) is designed to reduce the compulsive responses individuals have to situations that trigger their obsessions. It does so by gradually exposing patients to obsession-provoking situations in a safe environment.
The exposure component of ERP pertains to all aspects of a triggering situation – the thoughts, images, and objects that provoke obsessions or elicit anxiety. Importantly, this form of therapy is not designed to remove distressing thoughts, rather it equips individuals with coping skills to use when distressing situations prevent themselves. These skills effectively work to prevent compulsions from taking over once patients are triggered to engage in them – hence “response prevention” in ERP.
Treatment has the end goal of freeing patients from their obsessive-compulsive cycle by retraining the brain to not view the object of obsession as a threat anymore. Essentially, ERP is effective because it reduces the anxiety feeding obsessions and compulsions.
When is ERP Useful?
Take a form of OCD for example, where a patient has the obsession of fear of germs. This fear of germs may elicit a compulsive response in the form of over-washing their hands; even though their skin may be becoming raw from overdoing it and be causing them chronic tardiness.
In this case, treatment using ERP would entail the patient being exposed to an object that elicits their germ obsession, ie. a doorknob. The patient would then be encouraged to touch their face, phone, or wallet as a means of spreading the germs. Importantly, ERP would encourage the patient to stop themselves from hand washing; a crucial step as this prevents the obsession to be reinforced through avoidance.
All together, ERP would have worked to aid the patient in both tolerating the distress of having germs on their palm and the uncertainty of what is to follow. Of course, this is an advanced example of what ERP would entail, it would firstly take more low-to-moderate anxiety-provoking exposures before reaching this level.
Is ERP Right for You?
ERP is mainly used to treat anxiety-related disorders, such as OCD, PTSD, social anxiety disorder, etc.. This is as it focuses on reducing the body’s alarm response to any form of anxiety provoking situation through habituation – which refers to teaching the brain to no longer fear an obsession or anxiety-triggering situation after repeated safe exposure to it. However, it’s important to discuss with a therapist whether ERP is the right choice of therapy for you.
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