What is Exposure and Response Prevention Therapy? An exposure and response prevention therapist will assist in gently confronting situations or objects that trigger anxiety. By leaning in to any anxiety that arises, they can assist you in not engaging in compulsive rituals that arise as well. ERP is an approach to cognitive behavioral therapy (CBT) for obsessive-compulsive disorder that provides psychoeducation and helps individuals face fears or discomfort while teaching them how to resist compulsive behaviours. Psychoeducation Psychoeducation is a type of education designed to increase client understanding of their mental health condition, also known as educational treatment. Psychoeducation may be administered in various settings such as hospitals, schools, businesses, career centers or mental health clinics - even online via chat rooms or discussion groups. ERP therapy begins by educating you about your condition and helping identify obsessions and compulsions as well as triggers. Once they have this information, therapists will guide patients through various ERP techniques. ERP's exposure component encourages you to confront thoughts, images and objects that make you anxious or that trigger your obsessions. Your therapist may begin with low to moderately anxiety-provoking exposures before gradually increasing their severity in order to ensure you can tolerate discomfort without engaging in hand washing compulsions; this process retrains your brain so it no longer interprets triggers as threats. Graded Exposure Gradual exposure is a powerful method for breaking out of fear cycles that are self- perpetuating. We begin by gradually increasing our time spent performing an uncomfortable movement at lower intensity, and sending new information to our nervous systems that it doesn't pose a threat or cause pain. Gradual exposure helps break these vicious circles of avoidance that only further amplify them. Flooding is another form of exposure therapy, in which we gradually expose ourselves to anxiety-inducing situations for an extended period. It may involve exposure either in person or virtually (though this latter approach should generally only be used with regard to phobias). These techniques form part of Exposure and Response Prevention therapy (ERP), an evidence-based OCD treatment. ERP works by helping individuals confront their obsessions while resisting compulsive responses; additionally it encourages patients to recognize that thoughts or fears don't need to be acted on immediately. Inhibitory Learning ERP sessions allow clients to discover that they can safely tolerate anxiety-provoking thoughts or objects without engaging in compulsive rituals, and their distress does not increase as a result of doing so. They then can apply these newfound skills in various situations. The inhibitory learning approach draws upon research which indicates that new associations (e.g., dirt - no fatal disease) are not achieved through habituation but instead expectancy violation. As such, strategies which lower expectations prior to extinction (such as cognitive interventions that reduce probability overestimation) may interfere with increased expectation violation and lead to decreased extinction learning. As an exposure session for OCD related to contamination fears, clients might be asked to hold their hand in water - creating an experience between their prior expectation of their hand becoming contaminated and the non-threatening event itself. To maximize learning, therapists will reinforce this new association between contamination fears (CS) and no US (no unsuitable stimulus; US = unusable stimulus; no U is unexpected), post exposure consolidation practices such as monitoring sheets listing expected negative outcomes that did not transpire (Joos 2011), which can help consolidate learning on this type of learning about extinction learning (Joos 2011). This can consolidate extinction learning for good! Habituation Habituation is a natural phenomenon that works to decrease our response to stimuli. For instance, hearing the same banging noise over and over may become less bothersome over time, even becoming something you tune out completely - this process of habituation applies across multiple aspects from sound, smell and touch. Exposure and response prevention therapy offers people with OCD or related conditions like PTSD or anxiety disorders the chance to build up immunity against fearful situations that make them uncomfortable, such as germ contamination. A person experiencing OCD might practice touching doorknobs until their fear subsided - this form of therapy aims at habituation rather than disillusionment. An ERP session should be optimized to create both expectation violation and habituation, using cognitive interventions as needed and encouraging patients to reflect upon their experiences following every exposure session. Source: https://talkotive.com/read-blog/71678_what-is-exposure-and-response- prevention-therapy.html