Here’s How to Handle Your Therapist Not Knowing ERP

4 min read
Keara Valentine
By Keara Valentine

Therapy is an effective way to treat obsessive-compulsive disorder (OCD), but not every type of therapy is beneficial for OCD. In fact, some types of therapy can be counterproductive to treating the condition. When it comes to OCD, the right type of therapy is crucial for proper treatment. How do you make sure your therapist is properly trained in treating OCD? And what should you do if your therapy isn’t working? In this article, we’ll discuss what you need to know to make sure you receive the best treatment for OCD.

Exposure and response prevention (ERP) therapy is considered the gold standard for OCD. This treatment specifically targets your obsessions and compulsions. During ERP therapy, you will review with your therapist the thoughts or scenarios that are causing you the most anxiety, and then work to come up with a specialized treatment plan to face them through gradual, controlled exposure.

Other types of therapy may help a patient with OCD feel better in the short term, but ERP therapy has a proven track record of effectively treating OCD in the long term. It has been found effective for 80% of OCD patients, and the majority experience results within 12-20 sessions. If your therapist does not know ERP therapy, it may be best to speak to them about your concerns and how to connect with an ERP-trained therapist. 

What types of therapy can be counterproductive for OCD?

Talk therapy and cognitive behavioral therapy (CBT) are two very common types of treatment you are likely to encounter when conducting a general search for therapists. Some therapists may say they treat OCD with cognitive therapy (a type of CBT), eye movement desensitization and reprocessing (EMDR) or other forms of treatment. While these treatments can be very helpful for other mental health conditions, they can be problematic for treating OCD. Here are the common ones you may encounter while searching for therapy for OCD, and why they are not the best solution for most OCD patients: 

Talk therapy is a treatment based on speaking with a therapist about your past experiences, stressful thoughts and traumas. This can be a very effective form of treatment for depression and anxiety and other mental health conditions. When it comes to OCD, however, talk therapy is not considered effective. Patients with OCD may find that analyzing their anxieties in detail and trying to come up with solutions or explanations only increases the severity of their obsessions and compulsions.

CBT, another common form of therapy, is an umbrella term to describe multiple types of treatment like cognitive therapy that are based on providing a patient with practical tools to improve their mental health. During CBT, a patient will examine the core beliefs driving their everyday behaviors. A patient may learn breathing techniques they can use to relieve anxiety. They may work with a therapist to come up with ways to self-soothe, such as phrases to repeat to themselves during times of elevated stress. CBT can be very helpful for treating anxiety, depression, eating disorders and other conditions. But like talk therapy, there are ways CBT can be counterproductive for people with OCD and even reinforce the obsessive-compulsive cycle. For example, repeating a soothing statement could easily become a compulsion for someone with OCD. This will provide temporary relief, but not address the cause of obsessions and compulsions. While some people with OCD find some degree of relief from these therapies, they usually do not find long-term success, as the root cause of their distress is not being addressed.

EMDR is a relatively new form of nontraditional psychotherapy that has been growing in popularity. It is primarily intended to treat post-traumatic stress disorder (PTSD). During treatment, a patient will be asked to direct their eyes towards a therapist’s hands while recalling disturbing past events. While this form of treatment may be helpful for people with OCD who also have past experiences of trauma, it is not recommended as primary treatment for OCD. Being asked to go into detail about past events can further increase a patient’s obsessions and compulsions and may be a form of compulsion itself if not based in trauma.

Should I switch to an ERP therapist? 


It takes courage to seek treatment of any kind, and it can be incredibly frustrating to feel like you’re not making the progress in therapy you want to be. If you have been in your current form of therapy for 20 sessions and have not seen your OCD symptoms improve, it might be time to consider switching to ERP therapy. 

Of course, switching therapists isn’t fun, especially if you’ve already established a bond with your current provider. However, it’s important to remember that effective treatment for OCD is very specific. Without direct exposure to your obsessions and intentional prevention of your compulsions, they are unlikely to go away on their own. 

OCD can take many different forms and touch on a variety of themes, many of them taboo, and it’s important that a mental health professional is trained to effectively treat the different subtypes of OCD. This could otherwise lead to misdiagnosis. For example, someone with harm OCD will experience ongoing anxiety about not wanting to harm themselves or another person. If a therapist is not trained in OCD, they may characterize the patient as someone in danger of causing harm rather than a person experiencing OCD. Unfortunately, we are well aware that sometimes people encounter several therapists who are not familiar with the specific OCD subtype they are experiencing before finding the right treatment. Though it isn’t easy to continue to seek proper treatment, a mental health professional who is trained in OCD and ERP will be able to properly treat your condition.
If you’re interested in learning more about ERP, you can schedule a free call with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is.

Keara Valentine

Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.

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NOCD Therapists specialize in treating OCD

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Adriana Delgado

Adriana Delgado

Licensed Therapist, LMHC

My journey as a therapist has brought me in front of more and more cases of OCD, which has led to specialization in OCD treatment. My experience working at intensive in-home services for children & families, and intensive outpatient programs, has prepared me for even the biggest challenges. During sessions, I use Exposure and Response Prevention (ERP) therapy because it’s one of the most effective treatments for OCD, and works for any OCD subtype.

Alyse Eldred

Alyse Eldred

Licensed Therapist, LMFT

I’ve been a licensed therapist since 2017, and as an OCD specialist, I only use Exposure and Response Prevention (ERP) therapy. Research shows that ERP is the most effective OCD treatment available. I truly enjoy helping people understand themselves through ERP and I’m grateful to be part of a process that helps people gain control of their lives.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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