Exposure and Response Prevention Therapy

What is Exposure and Response Prevention Therapy?

Exposure and Response Prevention Therapy (ERP) is a form of Cognitive-Behavioural Therapy (CBT) that helps encourage you to practice confronting your thoughts, fears, and situations that may cause you a significant amount of anxiety and/or stress (APA; American Psychological Association, 2018; Law & Boisseau, 2019). It helps work to expose you to various events or situations that cause anxious thoughts and behaviours in a safe environment to help reduce avoidance and/or compulsive behaviours (APA, 2018; Law & Boisseau, 2019). ERP was originally developed and utilized to treat individuals experiencing Obsessive Compulsive Disorder but is also effective for other mental health disorders listed below (APA; American Psychological Association, 2017; Law & Boisseau, 2019; Reid et al., 2021).

Who can Benefit from Exposure and Response Prevention Therapy?

ERP can be beneficial for individuals experiencing any of the following (APA, 2017):

  •  Obsessive Compulsive Disorder (OCD)

  •  Post-traumatic Stress Disorder (PTSD)

  •  Generalized Anxiety Disorder (GAD)

  •  Panic Disorder (PD)

  •  Social Anxiety Disorder (SAD)

  •  Phobias

ERP has also been noted to be effective for a wide range of ages including children, adolescents, and adults (Law & Boisseau, 2019; Reid et al., 2021).

Exposure and Response Prevention Therapy Techniques and Components

There are many different ERP techniques, components, and strategies. Before beginning with ERP your therapist will provide you with psychoeducation about ERP and work to understand your current fears, compulsions, obsessions, stressors and anxious thoughts and behaviours (Law & Boisseau, 2019). Next, your therapist will help you to determine which type of strategy and techniques may best be suited to you. Below are some techniques and strategies used in ERP(APA, 2017):

Imaginal exposure involves vividly imagining a specific object, situation, and/or activity that tends to induce stress, fear, and anxiety.

In vivo exposure involves directly facing a specific object, situation, and/or activity that tends to induce stress, fear, and anxiety.

Interoceptive exposure refers to purposefully bringing about physical sensations and experiences that may be feared. For example, an individual experiencing panic disorder who may be afraid of having a heart attack may be instructed to run on the spot or participate in any other type of exercise to increase heart rate to help learn that the sensation is not always dangerous.

Graded exposure involves listing feared objects, situations, and/or activities, in a hierarchy from least feared to most feared. Your therapist will work with you to work on the mild exposures first before moving onto the moderate and most difficult exposures.

Flooding is the opposite of graded exposure. Your therapist will work with you to begin exposure with your most feared object, situation, or activity and work towards your least feared object, situation, or activity.

Systemic desensitization refers to being gradually exposed to a fearful or anxiety provoking object, situation, or activity while performing relaxation and grounding exercises at the same time to reduce stress and anxious symptoms related to that object, situation, or activity.

How can Exposure and Response Prevention Therapy Help?

Through ERP techniques and interventions, your reactions and behaviours to feared stimuli may begin to decrease over time (APA, 2017). In addition, ERP techniques may help you increase your own confidence when facing and coming into contact with feared stimuli and help you to become comfortable with fearful experiences (APA, 2017).

If you are experiencing phobias, anxiety, or OCD and are interested in ERP, please contact us at

(647) 267-9853. Joel and Jessica are both counsellors at Vaughan Counselling and Psychotherapy with experience in ERP.

References

APA; American Psychological Association. (2017). What is exposure therapy? https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy

APA; American Psychological Association. (2018, April 19). APA dictionary of psychology: Exposure and response prevention. https://dictionary.apa.org/exposure-and-response-prevention

Law, C., & Boisseau, C. L. (2019). Exposure and response prevention in the treatment of Obsessive-Compulsive Disorder: Current perspectives. Psychology Research and Behavior Management, 1167-1174. https://doi.org/10.2147%2FPRBM.S211117

Reid, J. E., Laws, K. R., Drummond, L., Vismara, M., Grancini, B., Mpavaenda, D., & Fineberg, N. A. (2021). Cognitive-Behavioural Therapy with exposure and response prevention in the treatment of Obsessive-Compulsive Disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry, 106, 152223. https://doi.org/10.1016/j.comppsych.2021.152223

Vaughan Counselling and Psychotherapy