What is ERP and Does It Work For OCD?

If you’ve researched treatments for obsessive compulsive disorder (OCD) you’ve likely come across ERP, or exposure and response prevention. Widely recognized as the best form of cognitive behavioral therapy (CBT) for OCD treatment, ERP is practiced by most therapists who treat OCD. It’s incredibly popular — and effective — making it a fantastic treatment option for anyone struggling with OCD. Whether you’re learning more about OCD treatment options for yourself or for a loved one, here’s everything you need to know about ERP, how it works, and why it’s the treatment of choice for most individuals with OCD.

What is ERP? How does it work? 

ERP is a form of cognitive behavioral therapy that was developed in order to treat people experiencing OCD, post-traumatic stress disorder (PTSD) or phobias. Sometimes referred to as exposure therapy, ERP was designed to help people with OCD learn how to identify and cope with their triggers. The process works by exposing patients to different types of situations in order to provoke their obsessions, creating the opportunity to practice the prevention of compulsion responses in a safe and controlled environment. Ultimately, the goal of ERP is to free individuals from obsessive cycles and compulsions so they can live more comfortably.

The response prevention portion of this treatment is one of the most important elements of the process. Working on response prevention helps those with OCD learn how to respond differently to the things that bring about compulsivebehaviors, which over time can help them to essentially condition themselves not to respond to obsessions . Once people learn how to resist  their compulsions, they find ways to accept and work with their obsessions instead of struggling against them. 

As those going through ERP learn to better handle their compulsions and the feelings brought on by obsessions, they’re able to habituate, or get used to, those feelings and reduce their use of compulsions to manage them.

Why is Exposure Response Prevention the gold standard of OCD treatment? 

Studies show that ERP is hands-down the most effective form of treatment for OCD. It can be uncomfortable or intimidating at first—after all, it is designed to expose people to situations that will provoke their compulsions while bringing about the resulting distress—but it’s definitely worth the work. This method has been proven to be a powerful tool that can help free people from obsessive cycles, allowing them to experience more control in their day-to-day lives.

In fact, ERP is so effective that some studies credit it with single-handedly changing the outlook for individuals with OCD from “poor” to “very good,” meaning that OCD — which used to be referred to as treatment-resistant — can finally be addressed and overcome. 

Is ERP the same as CBT?

You might see the term cognitive behavioral therapy, or CBT, thrown around in reference to ERP and wonder if they’re interchangeable terms. After all, CBT treatments involve working with a therapist to address and change both thinking and behavioral patterns, making it a popular form of psychotherapy designed to help people learn how to cope with problems in order to reduce — or eliminate — symptoms. However, while these terms are related, ERP and CBT aren’t the same thing.

Think of CBT like an umbrella term that houses several different therapy types. There are various specific forms of CBT that work best from patient to patient, and ERP is just one type of cognitive behavioral therapy. It’s like CBT is ice cream and ERP is the flavor mint chocolate chip; it’s a type of behavioral therapy that often works best in treating OCD.

While other forms of CBT can be effective in treating OCD — as can medication options like serotonin reuptake inhibitors (SRIs) — the type of CBT treatment offered can vary widely from provider to provider. For example, while you might find a therapist who practices CBT, they might not have experience with ERP, meaning that even if they’re a wonderful and experienced therapist, they might not be able to provide the best treatment options for someone living with OCD. 

If you or someone you love is seeking a provider for OCD treatment, we highly recommend looking for someone who is familiar with CBT as a whole and ERP as a specialty. That way, your therapist can discern specifically when ERP is needed and if they have the capacity to conduct it, or if you need to be referred to a different provider.

How to find an ERP clinician in your area 

The most important thing to look at when you’re seeking a care provider for ERP is making sure they have specific training or experience with this therapy type. Look for providers who have completed clinical internships, fellowships or residencies focused on ERP. People can also search for providers who are members of the International OCD Foundation (IOCDF) or the Association for Behavioral and Cognitive Therapies (ABCT), as both of these sites allow you to filter searches for therapists in your area who specialize in or have experience with ERP.

Thanks to technology, people aren’t just limited to therapists within driving distance. ERP is available through online therapy options as well. In fact, some therapists find that virtual, therapist-assisted ERP can actually be incredibly beneficial. Because this treatment can be conducted from within an individual’s home environment, where they may experience heightened anxiety or increased OCD triggers, therapists can help people face their daily fears in real time. Plus, virtual therapy is effective and accessible, meaning people with OCD no longer have to worry about fitting treatment into a busy schedule or finding a qualified therapist in small towns or rural areas that may not have access to providers specializing in ERP.

If you’re looking for a virtual therapist to provide ERP treatment, our network of highly trained specialists is available nationwide to people in all 50 states, and it’s also one of the most cost-effective options available today. When you schedule a free call with our team, we guarantee to help you find a licensed therapist in your state trained in ERP, and more than 90% of people who are seen within two weeks of booking their first appointment.

With the right therapist and resources, ERP can change lives. It might feel overwhelming at first, but ERP is definitely the gold standard of treatment for OCD, and it’s the first step on the road to freedom and more control over your life.

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If you or someone you know is struggling with OCD, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment with the NOCD clinical team to learn more about how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.