Exposure and Response Prevention (ERP) is the premier CBT technique for the treatment of Obsessive Compulsive Disorder (OCD). Invented in the 1980s, it has been extensively research-tested over the decades, establishing Exposure and Response Prevention as the gold-standard treatment for OCD. ERP is a part of most successful treatments for OCD.
ERP first starts with a careful assessment of the OCD. What are the fears and what does that person do in the face of these fears? How extensive is the avoidance? What are the compulsions that the person does when fearful? Once a “map” of the OCD has been devised, a graded hierarchy of the fear situations is constructed.
Exposure: When the client is ready, s/he starts to face that situation, thoughts, images, or objects that triggers the obsessions and cause the person anxiety. Response Prevention: At the same time, the individual voluntarily refrains from doing any of the avoidance and the compulsive rituals that s/he normally does when in the fear situation. This allows the individual to test out the veracity of the fear beliefs and, over time, to reduce or eliminate the anxiety that is generated in the OCD situations. It sounds scary but practicing ERP rapidly starts to generate confidence in the person who engages in it consistently. All of this is done under the guidance of a therapist at the beginning but it is a learnable skill, so that the OCD sufferer soon learns how to do it on his or her own.