Exposure Response Prevention as Treatment for OCD

Exposure Response Prevention (ERP), as proposed by cognitive behavioral therapists, is a unique approach that focuses on the treatment of Obsessive Compulsive Disorder (OCD). Over the course of its existence, ERP has been proven to be the most effective form of cognitive behavioral therapy (CBT) in the intervention and treatment of OCD.

The very core of CBT dwells on the notion that thoughts can greatly affect the behaviors of individuals. Thus, it follows that any unwanted behaviors may possibly be eliminated when thoughts or motivations of such behaviors are reversed.

The Basics of Exposure Response Prevention
ERP therapy targets obsessive-compulsive disorders by focusing on the unwanted behaviors manifested by individuals with OCD. Specific stimuli that trigger compulsive behaviors are identified, and over the course of the therapy, the unwanted responses of these stimuli are gradually reversed and eliminated.

To achieve this goal, the patient is systematically subjected to weak stimuli that are known to trigger the unwanted response. However, the stimulus presented to the OCD patient is weak enough for the subject to be able to feel in control over their reactions. The therapist then encourages the individual to resist the urge to perform the undesired behavior. Often, successful resistance to the unwanted behavior is rewarded by associating such small accomplishments with a more positive feeling.

Specific Examples of ERP Treatment
To start off with the therapy, patients are asked to list the specific obsessive thoughts that result in compulsive behaviors. For example, a patient may list compulsive behaviors such as frequent washing of hands every time they touch a doorknob or engage in a handshake.

The therapist who evaluates the list will then start with the weakest stimulus, and in this example, the touching of doorknobs. The patient is then presented with a doorknob, after which the therapist encourages the patient to resist the urge to wash their hands after touching the knob with just one finger. Once the patient conquers the urge to wash their hands, the therapist subsequently encourages the patient to touch the knob with two, then three fingers, and so on until such time the patient feels in total control.

Imaginal Exposure and ERP
While physical exposure to the stimulus may offer effective results in reversing the unwanted compulsive behavior, presentation of some stimuli may become virtually impossible. For instance, if a patient has the compulsion to avoid a train station for fears of being trapped on the tracks, it would be inconvenient for both the therapist and the patient to continue the therapy at a train station. Thus, imaginal exposure may be a plausible alternative.

Exposure response prevention has shown promising results since it was proposed and established by cognitive behavioral therapists. In fact, self-help among individuals with milder cases has also been proven to be effective. However, more severe cases call for professional help to ensure effective treatment.

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