Exposure and response prevention (ERP) is the leading evidence-based therapy for obsessive-compulsive disorder (OCD). For therapists who are new to ERP, it can feel both exciting and intimidating to learn and implement a new treatment modality. Mastering ERP can lead to life-changing outcomes for clients living with OCD, but it requires a solid foundation of skills and knowledge to build off of. Here are some tips for therapists who are looking to thrive in this specialty.
Before getting started with ERP, it is imperative to have a solid understanding of what OCD is, as well as how it operates. OCD is characterized by obsessions (intrusive and unwanted thoughts, images, or urges) and/or compulsions (repetitive physical or mental acts that are performed to alleviate distress or discomfort).
The driving force for compulsions is the anxiety or distress caused by the obsessions. Performing compulsions provides temporary relief and negatively reinforces the OCD cycle. ERP aims to break the OCD cycle by targeting the compulsions. When clients lean into their distress without compulsions, they learn to face their fears and tolerate distress.
ERP involves clients facing their fears without performing compulsions that would typically alleviate distress and discomfort in the short term. For therapists, bearing witness to clients’ distress in session can be challenging, especially if they are used to offering reassurance or other coping skills. Leaning into this discomfort is essential.
For ERP to work, clients have to be provided with a........