Teletherapy has been around for many years in some capacity, whether it be over video, the phone or even through text messaging. In more recent years, there has been an explosive increase in the use of telehealth services. The ability to access therapy online is not only convenient and time-efficient, but for many, it also opens up the door to specialized services that were previously inaccessible.
It is widely accepted that exposure and response prevention (ERP) therapy is the gold standard for effectively treating individuals with obsessive-compulsive disorder (OCD). Unfortunately, there had been a notable shortage in clinicians who are trained to administer this type of treatment. This lack of resources resulted in individuals with OCD either having to travel great distances for treatment, getting treatment from professionals who are not specifically trained to treat OCD or not getting treatment at all.
Online therapy bridges the access gap to ERP treatment by removing the location barrier. However, some people may have reservations about online therapy. Prior to engaging in any type of therapy it is important to know the facts. What exactly is ERP therapy? Can it really be effective online? And if so, how do I find an ERP therapist online?
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ERP is a form of cognitive behavioral therapy (CBT) that involves a guided and purposeful exposure to the thoughts, images, objects or situations that evoke anxiety and trigger obsessions. Asking an individual with OCD to actively expose themselves to their triggers can be not only challenging but also frightening — that is why it is so important that the clinician administering ERP treatment be specifically trained to do so.
The response prevention part of ERP comes into play once the obsession(s) are triggered. This step involves the challenge of refraining from engaging in compulsive behaviors aimed to ease rising anxiety. It may seem counterintuitive to ask someone to purposefully expose themselves to their fears and then to avoid any response that may alleviate their anxiety. However, over time, as you experience your triggers without responding with compulsions, the triggers begin to lose their power. This gradual decline of anxiety that occurs as a result of the exposure and prevention of compulsive responses is referred to as habituation.
ERP treatment conducted online is the same as ERP treatment conducted in person. It follows the same evidence-based interventions, which have been clinically proven to effectively treat OCD. Research has found ERP therapy administered online to be equally as effective as when it is conducted in person.
The greatest difference between ERP therapy in person versus ERP therapy online is the setting in which the treatment is taking place. In person, ERP might occur in a hospital or in a therapist’s office with the clinician in the same room. Online, ERP sessions most frequently occur in the client’s home, with the clinician being present on a nearby computer screen. The former may seem like the best option, as having the therapist with you in a controlled environment can feel safer. Clients may have thoughts like, “hospitals are clean” or, “if anything bad happens I will be okay because I am in a hospital,” or, “my therapist would not let any harm come to me.” While these thoughts may be reassuring, they may actually be counterproductive for ERP therapy. The goal of ERP is to confront your fears and anxieties in your daily life, not in the controlled setting of a hospital. In that sense, online ERP therapy done in your home may have some additional advantages. Online sessions allow the therapist to work with you in settings and situations where your triggers are most likely present — and where your obsessions are most likely to occur. This can be your home or another place you spend a lot of time in.
For example, an individual with contamination OCD may avoid cleaning their home due to a fear that the items on the ground will contaminate them. With in-person treatment, the ERP therapist would likely give the client an assignment to clean a portion of their home and then discuss the experience with them during the following session. With online treatment, the therapist does not need to wait until the next session, nor do they need to rely on the client’s account of what happened several days or more after the fact. Rather, they can actually be “in the room” with their client as they expose themselves to their triggers and work on refraining from responding with compulsions. Additionally, the online format allows the therapist and client to engage in conversation around the exposure and response prevention experience immediately after, while the feelings are still fresh in the client’s mind.
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If you or someone you know is dealing with OCD, no matter where in the United States you live, an NOCD therapist can help. NOCD is effective and affordable, and all NOCD therapists are licensed and trained to treat OCD utilizing ERP therapy. If you want to learn more about working with an NOCD therapist, you can get started by booking a free 15-minute call with an NOCD team member today.