Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP) is a highly effective and evidence-based treatment therapy for Obsessive Compulsive Disorder (OCD) and anxiety disorders.
What it helps with
Concerns ERP can help withWhat it helps with
How it works
What a course of ERP looks likeHow it works
Early on
Map fears and rituals
You and your counsellor list what sets off your fear and the rituals that follow, like checking, washing or asking for reassurance. Then you rank them from easier to harder.
As you go
Face fears in small steps
Each exposure means facing a fear on purpose, starting small, like touching a door handle without washing. Your counsellor helps you stay with the discomfort as it often settles.
Over time
Keep practising day to day
You try exposures between sessions and bring back what you noticed. You and your counsellor decide together how long to keep going and how to handle setbacks.
ERP may suit you if you
- Get stuck in rituals like checking, washing or seeking reassurance
- Want to change how you respond to unwanted thoughts
- Avoid places or situations because of fear or panic
- Like a structured, step-by-step plan
- Feel ready to try small, planned challenges between sessions
- Want to face fears with support, at a pace you agree on
Something else may fit better if you
- Are in crisis right now: call or text 9-8-8
- Mainly want space to talk things through
- Want to work mainly on painful memories from the past
- Do not feel ready yet to face fears directly
Not sure? A free consultation can help you choose.
About
More about ERP
Exposure and Response Prevention (ERP) is a highly effective and evidence-based treatment therapy for Obsessive Compulsive Disorder (OCD) and anxiety disorders. This treatment technique was devised from CBT techniques and works by helping patients face their fears while inhibiting any actions that reduce anxiety levels in the short term.
In ERP, rather than avoiding any unwanted thoughts or situations, patients learn to react differently towards their anxiety. With the help of a professional therapist, patients realize that the feelings of anxiety naturally fade away, without the need for any rituals or avoidance techniques.
Theory
Exposure and Response Prevention therapy rests on the concept that avoidance behaviors such as performing certain compulsions increase the fear and therefore intensify the anxiety because a person is trying to prevent something unpleasant from happening. While they may bring some relief, avoidance strategies reinforce the cycle of fear and exacerbate anxiety.
ERP helps clients to disrupt the cycle by exposing them to situations or thoughts that create fear and not allowing performing the compulsions. This allows clients to get used to the new strategy through repetition and to gain confidence and reduce their fears.
Unlike cognitive-behavioral therapy (CBT), where patients learn how to eliminate negative thoughts, ERP does not focus on getting rid of unwanted thoughts but rather teaches how to react differently to those thoughts.
Techniques
ERP therapy is meticulously designed for each patient based on their unique requirements. The first step in ERP therapy involves recognizing the patient’s fears, triggers, and compulsions to develop an exposure ladder that the patient can handle.
Clients are asked to confront situations that cause anxiety and refrain from engaging in compulsions such as rituals, reassurance seeking, checking, and avoidance, among others. Alongside this, therapists offer assistance, education, and skills needed to cope with the discomfort.
Most therapists practicing ERP use mindfulness skills, CBT, and ACT in their practice where relevant.
Benefits of Exposure and Response Prevention Therapy
Exposure and response prevention can help people to:
- Decrease obsessive thoughts and compulsive behaviours
- Build Confidence in Anxious Situations
- Improve emotional coping skills and resilience
- Reduce avoidance behaviours
- Get back to normal life and routines
- Improve relationships, work, and quality of life in general
Many people experience dramatic improvement that lasts long after the end of therapy with regular practice.
What Can ERP Do?
Exposure and Response Prevention is often used to help people with:
- Obsessive-Compulsive Disorder (OCD)
- Anxiety disorders
- Panic disorder
- Social phobia
- Health Anxiety
- Particular phobias
- Intrusive thinking
ERP can also be incorporated into comprehensive treatment regimens for trauma, depression, perfectionism, and other mental health issues when clinically indicated.
Exposure and Response Prevention Therapy at No Fear Counselling
At No Fear Counselling, we offer bespoke ERP treatment by our skilled therapists who can help you get the right treatment for OCD, anxiety disorders, and other similar issues.
Your specific treatment program will be designed to meet your needs, comfort zone, and personal experiences. You and your therapist will work together to manage your fears, minimize compulsions, and develop useful coping strategies.
We also have therapists who will assist you with problems like depression, trauma, relationships, stress, perfectionism, and many more. Your therapist can combine ERP therapy with other evidence-based therapies depending on your individual needs. Such therapies may include CBT, ACT, Mindfulness Therapy, and EMDR Therapy.
Whether you need in-person counseling or online counseling in Canada, we will assist you in achieving what you aim to achieve.
Start Your Recovery with ERP Therapy
Suffering from OCD and anxiety is tough work, but there is good news. Therapy has worked for countless people to alleviate symptoms. Exposure and Response Prevention Therapy is one such method that has proven itself to be quite effective for decreasing obsessions and reducing anxiety.
At No Fear Counselling, our experienced therapists will assist you along every step of the way in receiving effective, customized care.
We provide in-person therapy sessions in Vancouver, Surrey, Burnaby, Richmond, Coquitlam, Langley, Abbotsford, and Chilliwack, and many other areas within British Columbia, as well as online therapy sessions in all regions of Canada.
Contact us now to schedule your free session. Meet your ideal therapist who will assist you along the way towards a more confident and liberated life.
References
Foa, E. B., Yadin, E., & Lichner, T. K. (2012). Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder: Therapist Guide. Oxford University Press.
Abramowitz, J. S. (2013). The Practice of Exposure Therapy: Relevance of Cognitive-Behavioral Theory and Extinction Theory. Behaviour Therapy.
ERP can feel uncomfortable at times, but you are never pushed into an exposure you have not agreed to. Your counsellor goes at your pace, starts with easier steps and helps you feel steady before any harder exposure, and you can pause or change the plan at any point. If you are in crisis or thinking about suicide, call or text 9-8-8, call 1-800-SUICIDE (1-800-784-2433), or call 911 if you are in danger.
Yes, many parts of ERP can be done by video from anywhere in BC. Some exposures may even be easier to practise at home, where rituals often happen. You can also meet in person if you prefer, and our intake team suggests counsellors who fit what you need, your language, your budget and where you want to meet.
It may be, depending on your plan and the counsellor you see. Many extended health plans cover Registered Clinical Counsellors and Canadian Certified Counsellors (RCC/CCC), so it helps to check your own plan. We also offer sliding scale rates for eligible people, and our fees and funding page has more detail.