ERP Therapy

ERP is a specific form of cognitive behavioral therapy and is considered the gold-standard, most effective treatment for OCD. It's endorsed by the American Psychiatric Association, the International OCD Foundation, and the UK's National Institute for Health and Care Excellence, and decades of research support it.

The name describes exactly what happens in treatment. Exposure means gradually and intentionally facing the thoughts, images, objects, or situations that trigger your obsessions. Response prevention means resisting the urge to perform the compulsion or ritual that would normally follow.

How it actually treats OCD

Together, we build a personalized list of triggers, ranked from mildly uncomfortable to most distressing. We start where you're ready to start — not by throwing you into your worst fear on day one — and work through that list at a pace we set together.

In each exposure, you'll face a trigger and then practice sitting with the anxiety it brings up, without doing the compulsion that usually follows. This is uncomfortable by design. But it's also where the change happens: your brain gets direct evidence that the anxiety rises, peaks, and comes back down on its own, and that the feared outcome you were trying to prevent either doesn't happen or is more manageable than you expected. Over repeated practice, this new learning starts to compete with and outweigh the old fear response, so triggers lose their grip.

I'll coach you through each exposure, help you plan realistic homework between sessions, and adjust the pace as your confidence builds. This isn't about gritting your teeth through anxiety for its own sake — it's a structured, collaborative process aimed at giving you your life back from OCD.

What to expect

• An assessment first. Before any exposure work begins, we'll spend time understanding your specific obsessions, compulsions, and triggers, and how OCD is currently affecting your life.
• A shared plan. You'll help build the exposure hierarchy, so you always know what we're working toward and why.
• Gradual, not overwhelming. Exposures are chosen collaboratively and build in difficulty as you're ready.
• Practice outside session. Lasting change comes from applying these skills in daily life, not just in the therapy room.
• Real, lasting relief. Most people who complete ERP see a significant reduction in OCD symptoms — not by eliminating intrusive thoughts entirely, but by changing your relationship to them so they no longer run your life.

References

• American Psychiatric Association. (2007). Practice guideline for the treatment of patients with obsessive-compulsive disorder (guideline watch, 2013). Read it here
• Ferrando, C., & Selai, C. (2021). A systematic review and meta-analysis on the effectiveness of exposure and response prevention therapy in the treatment of obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 31, 100684.
• International OCD Foundation. Exposure and response prevention (ERP). Read it here
• National Institute for Health and Care Excellence. (2005). Obsessive-compulsive disorder and body dysmorphic disorder: Treatment (CG31). Read it here