EXPOSURE & RESPONSE PREVENTION
WHAT IS ERP?
Exposure and Response Prevention is the gold standard treatment for many different anxiety disorders, including Panic Disorder, Agoraphobia, Phobias, OCD, and Social Anxiety. During ERP, your therapist helps you overcome your anxiety through gentle and gradual exposure to what you fear. As you are gradually exposed to what causes you anxiety, you learn how to tolerate the uncomfortable feelings that come with this fear. This allows you to be increasingly more able to move past your fears with minimal anxiety or distress. During the exposure exercises, your therapist also guides you in identifying behaviors you may engage in to reduce your anxiety, and develop a plan to refrain from using those behaviors (response prevention) so that the exposure treatment is most effective.
ERP is a heavily researched treatment that has been found to be effective for many different types of anxiety disorders. ERP is a cognitive-behavioral treatment, and its effectiveness has been studied extensively. Typically, people who complete ERP experience significant reductions in their anxiety immediately after treatment. These improvements made for people who complete ERP are robust in that they are long-lasting, often extending for many years.
HOW DOES IT WORK?
During the first 1-2 appointments, your therapist will meet with you and conduct a comprehensive assessment of your fears, beliefs about what you fear and stuck points that may be maintaining your fears. Your therapist will then educate you about anxiety and exposure therapy so that you have a firm understanding of how ERP works and why exposure is effective in treating anxiety. Then, collaboratively with your therapist, you will work on constructing the exposure hierarchy which serves as the “roadmap” that guides the specific exposure exercises you engage in. The bulk of treatment will then focus on completing the planned exposure exercises.
WHAT CAN I EXPECT WITH ERP?
The overwhelming majority of people who complete ERP experience substantial reduction of their anxiety. After completing ERP, you can expect that your symptoms of anxiety will be minimal and that you will feel more in control of and substantially less impacted by your phobia. Most importantly, you will likely experience a significant improvement in how your anxiety impacts your quality of life. Ultimately, the goal of this treatment is to overcome your anxiety, learn skills and tools to manage your anxiety during flareups, and live your life the way you want to with minimal impact from what you fear.
NOTES ABOUT ERP
Relationship between you and your therapist: Our therapists are uniquely trained to build rapport and establish a meaningful connection with you so that you are able to get the most benefit out of this treatment. We believe that the therapeutic bond is important regardless of treatment, but especially so for ERP. We strive to serve as anchors for clients while they engage in exposures; our job is to guide clients through their exposure hierarchies, while simultaneously providing our clients with support and encouragement to effectively move through their hierarchies. When you are participating in ERP, it is essential that you never feel “forced” to participate in any exposure exercise, no matter how easy or difficult the exercise feels.
Therapists are “in the trenches”: During exposure work, we believe it is important that our clients know that our therapists are willing to engage in any exposure exercises alongside them that we suggest. This approach has been found to be most effective in ERP for a number of reasons: first, when clients understand that their therapists are willing to engage in any recommended exposures, the therapeutic bond and sense of trust between client and therapist strengthens. Second, a client may need a “boost” in order to complete some of their exposure exercises, and watching someone else engage in these activities may allow clients to increase their willingness to do the same. Finally, we believe this practice allows clients to further undergo modification in the thoughts and beliefs that maintain their fears, which is an essential mechanism of exposure therapy.