For clients that suffer from debilitating anxiety or obsessive compulsive disorder (OCD), their daily lives are likely extremely challenging. They may watch other people easily navigate work and family obligations, wishing they could do the same. However, it may seem that even the simplest activities are sometimes out of reach. The good news is that treatment is within reach. Exposure and response prevention (ERP) therapy provides therapeutic benefits and allows clients to embrace a fuller, more vibrant life.
ERP therapy, developed by British psychologist Victor Meyer, in the mid-1960s, is based in the belief that exposing a person to something they fear (or are anxious about) over and over, will help decrease their anxiety over time. ERP includes two parts, which take place at the same time: exposing a person to what they fear (exposure) and preventing them from reacting a certain way (response) because of that fear. In general, clients feel a great deal of anxiety due to the stimulus.
Some trials have found this treatment as effective as medication. In addition, the benefits of ERP therapy may last longer than a medication course. Effects of successful treatment can be present after treatment is over, but when a person stops taking medication, their symptoms will most likely return.
ERP Therapy Components
Cognitive behavioral therapy (CBT) forms the general basis for ERP. With CBT, clients learn to change their thinking patterns and therefore their actions. With ERP, clients face their fears and anxieties to change their reactions to them.
ERP therapy is effective in treating obsessive compulsive disorder (OCD). For example, a client has an aversion to germs, so she obsessively washes her hands any time she touches something that she feels is dirty. In ERP therapy, she’ll touch something dirty, but won’t be able to wash up afterward. By not being allowed wash her hands, the therapist prevents her from taking flight as part of the body’s natural “fight or flight” response. With prolonged and repeated exposure, her reactions and anxiety will gradually diminish. This process is called “habituation,” when she learns that nothing bad occurs if she no longer performs certain rituals.
Other disorders that ERP is used to treat include:
When it’s not possible to present a real situation that creates anxiety, therapists can substitute sound or visual effects to mimic it, so clients feel similar anxiety from the simulation. It’s vital that clients work with therapists with skill in and experience with ERP therapy. The right professionals understand that ERP therapy needs to be controlled and safe. They’ll present easier challenges first and work their way to more difficult issues. In time, clients become so used to the stimulus that it no longer has the same negative affect on them.