Who Can Benefit From Exposure and Response Prevention (ERP)?

Exposure and Response Prevention (ERP), is a highly effective treatment for people with obsessive-compulsive disorder (OCD). But what some people don’t know when the first come for therapy is that not all models of therapy are right for your issue, and not all people are suited to the particular types of therapy. I’ve been working as a psychologist for over two decades now and want to take time today to discuss your suitability for ERP, if it is something you have been thinking about.

Is ERP The Right Choice For You?

ERP is designed for individuals whose OCD is their primary issue. That simply means you do not have another diagnosis, as sometimes people can be diagnosed with more than one mental health condition which is called a co-occurring condition. If this is you, ERP may not be a good fit as different conditions need different types of treatment; in this case I recommend meeting with a licensed mental health professional face-to-face who shall conduct a complete assessment and based on this be able to suggest the best way forward.

However, if OCD is your only diagnosis ERP could be a good fit if you are motivated and ready to put the work in.

ERP is challenging. It requires facing situations that trigger your anxiety without resorting to compulsive behaviours to find relief. Many people with OCD have heard unhelpful advice like, “Just stop doing that,” or “Why not ignore it?” The truth is, compulsions feel impossible to resist because they temporarily relieve overwhelming distress. ERP doesn’t minimise this difficulty but provides a clear, supportive framework for change.

Here’s how you and your therapist can boost your motivation for treatment:

1. Build a Team Effort

ERP is a collaborative journey. Your therapist acts as a guide and ally, supporting you as you confront OCD head-on. You’re the leader of this effort, but it’s not a solo battle—you’ll have the guidance, encouragement, and tools to succeed.

2. Visualise Your Goals

Think about specific ways your life could improve if OCD became less dominant. For example, imagine being able to leave the house on time without checking the door multiple times, spending more quality time with loved ones without interruptions from rituals, or going back to work without avoiding tasks that trigger your anxiety. Identifying these tangible goals can drive your commitment to treatment.

3. Practice Makes Progress

The cornerstone of ERP is doing exposures—intentionally facing the situations that trigger your obsessions without engaging in compulsions. Talking about exposures isn’t enough; regular, consistent practice helps make them more manageable over time. It’s like learning to swim. The first few times in the water might feel overwhelming, but as you keep practicing, your confidence and skills grow. Here are some examples of exposures for different types of OCD:

• Checking: Leaving the house without checking the stove, sending an email without rereading it multiple times.
• Contamination: Using a public restroom, eating food prepared by someone else, touching the floor of a public space.
• Intrusive Thoughts: Listening to a song with triggering lyrics, watching a movie with a disturbing scene, holding a knife.

4. Embrace Gradual Progress

ERP follows a step-by-step hierarchy, starting with manageable challenges and gradually working up to more difficult exposures. For instance, if you have contamination fears, you might start by touching a doorknob and then gradually move toward touching a sink or using public restrooms. For a more detailed guide on creating hierarchies and tackling intrusive thoughts, visit my Step-by-Step ERP Guide, which includes step-by-step instructions and examples to help you confidently navigate ERP. It’s natural to feel that some situations are “impossible” to confront, but as you build confidence, what once seemed unattainable becomes achievable

5. Address All Rituals

Compulsions can feel minor or trivial, but even small rituals reinforce the OCD cycle. For example, you might think, “I only need to check the stove once or twice, so it’s not a big deal.” However, this reinforces the habit and makes it harder to stop. By tackling even these “smaller” compulsions, you’re creating a stronger foundation for long-term relief.

6. Learn From Success Stories

From my clinical practice, I’ve seen inspiring examples of individuals who have overcome significant OCD challenges through ERP. For instance, one client with contamination fears was eventually able to hug their family again after gradually working through exposures. Another client, who struggled with contamination-related cleaning rituals, learned to allow visitors in their home without cleaning surfaces they had touched, such as wiping counters or cleaning toilet seats. This breakthrough not only freed up their time but also reduced the stress and exhaustion caused by their compulsions. Another individual who feared harming others was able to confidently drive again, reclaiming their independence. These real-life transformations demonstrate that change is possible and that even daunting challenges can be overcome with persistence.

How ERP Can Change Your Life

ERP offers a path to freedom from the constraints of OCD. By reducing the time and energy spent on obsessions and compulsions, you can regain control over your life. Imagine being able to:

• Spend quality time with loved ones without intrusive thoughts.
• Engage in work or school activities without debilitating rituals.
• Enjoy hobbies and interests without avoidance behaviours.

ERP doesn’t promise a life free from all anxiety—but it teaches you how to respond to anxiety in a healthier, more constructive way. Over time, obsessions lose their grip, and compulsions no longer feel necessary.

Next Steps

If you think ERP might be right for you, consult a therapist trained in OCD treatment. They can assess your situation, help you build a treatment plan, and guide you through the process with empathy and expertise.

Finding a therapist with specialised training in ERP can sometimes be challenging, but it’s worth the effort. Here are some resources that can help:

• International OCD Foundation (IOCDF): https://iocdf.org/
• Anxiety & Depression Association of America (ADAA): https://adaa.org/

About Dr. Elaine Ryan

Dr. Elaine Ryan is a psychologist with over 20 years of experience specialising in OCD and anxiety disorders. Discover how her online therapy programs can help you overcome OCD. . Through her website, MoodSmith.com, she offers online structured therapy programs tailored to help individuals overcome their struggles with intrusive thoughts and compulsions. Her self-directed programs are designed to provide practical, evidence-based tools that empower clients to manage their OCD effectively from the comfort of their own homes. Dr. Ryan’s approach combines professional expertise with a deep understanding of the unique challenges OCD presents.