ERP MYTHS and WHY ITS the most effective treatment for ocd
OCD is a debilitating disorder that impacts around 1–3% of the global population (Brock, H., Rizvi, A., & Hany, M., 2024). A variety of treatment options exist, and individuals often feel overwhelmed trying to find the best approach. Oftentimes, there are waitlists and challenges in finding a therapist in-network, which can lead to treatment delays that further exacerbate symptoms. Exposure Response Prevention (ERP) remains one of the most effective frontline treatment options for individuals suffering from OCD (Ferrando, C., & Selai, C., 2021). ERP is highly effective because it changes the individual’s relationship with anxiety, gradually breaks the cycle of compulsions, and reduces anxiety-reinforcing behaviors that individuals may have been unknowingly engaging in. However, when many people hear the word “exposure,” they feel reluctant to engage in treatment. They may worry they will be forced to do something dangerous, humiliating, overwhelming, or that goes against their morals.
Here are some common myths about ERP:
1. ERP is unsafe
A competent therapist will never put clients in an unsafe situation. In my work with clients, I always ensure they are willing to participate in the exposure before asking them to engage (and in some cases, they may not be willing to that’s okay). Sometimes, simply having someone there to support you can make you more willing to take risks. Personally, I always test exposures before assigning them to clients, and I would never ask someone to do something I wouldn’t be willing to do myself. In fact, I sometimes even do the exposures alongside my clients!
2. ERP is just throwing people into their fears
Clients need to be set up for success, as ERP can at times be a challenging process. This often means starting lower on their exposure hierarchy so clients can build confidence in their ability to tolerate anxiety and trust the process. It’s important to remember that a variety of less anxiety-provoking exposures exist outside of directly facing the feared situation (in-vivo exposure). This could mean starting with imaginal, written, picture, video, sound, or interoceptive exercises before moving on to in-vivo exposure.
3. ERP will make my anxiety worse
The nature of ERP is that you will be exposed to situations that may make you anxious. This is necessary for the process of habituation to occur. As mentioned earlier, clients are not immediately exposed to their worst fear. The goal of ERP is to help clients realize they are more capable of tolerating and managing their fears than they originally believed.
Disclaimer
The content on this website, including all blog posts, articles, and resources, is provided for educational and informational purposes only. It is not intended as a substitute for professional mental health care, diagnosis, or treatment.