Exposure & Response Prevention
What is Exposure and Response Prevention (ERP)?
Exposure and Response Prevention is the gold-standard treatment for many different anxiety disorders, including panic disorder, agoraphobia, phobias, obsessive-compulsive disorder (OCD), and social anxiety. During ERP, your therapist helps you overcome your anxiety through gentle and gradual exposure to what you fear. During the exposure exercises, your therapist also guides you in identifying behaviors you may engage in to reduce your anxiety, and in developing a plan to refrain from using those behaviors (response prevention) so that the exposure treatment is most effective.
Typically, people who complete ERP experience significant reductions in their anxiety immediately after treatment. These improvements for people who complete ERP are robust and long-lasting, often extending for many years. With your therapist, you move at a pace you agree on together, starting with situations that feel manageable and building from there. The goal is not to make anxiety disappear completely, but to learn that you can tolerate it and live more freely.
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.
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 fears. 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 flare-ups, and live your life the way you want to with minimal impact from what you fear.
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
Your Relationship With Your Therapist
Your therapist builds a strong bond with you and supports you through each step of your exposure plan. You will never be forced into any exposure exercise, no matter how easy or difficult it feels.
Therapists Are “In The Trenches”
Your therapist is willing to do any exposure they suggest right alongside you. Knowing they will do it too builds trust, and watching them can make your next step feel more doable.