Exposure and Response Prevention

Exposure and Response Prevention (ERP) is the gold standard approach for the treatment of OCD. It has the largest evidence base demonstrating its effectiveness in the reduction of OCD symptoms.

Exposure and Response Prevention (ERP) involves gradually learning to tolerate obsessive or intrusive thoughts and images, as well as the accompanying feelings that arise (eg. anxiety, uncertainty, discomfort, disgust) without engaging with them and without doing compulsions (response prevention component). Clients will then practice gradually exposing themselves to previously avoided triggers and situations while continuing to resist compulsions (exposure component). Over time this allows people to learn to respond to intrusive thoughts/images differently and not engage with them, instead treating them as irrelevant 'false alarms'.

Therapy approaches for the treatment of OCD are continuing to be developed and refined by clinicians and research is ongoing. Other adjunctive approaches that can enhance the effectiveness of treatment include:

• Acceptance and Commitment Therapy (ACT)

• Dialectical Behaviour Therapy (DBT)

• Schema Therapy

• Imagery rescripting techniques

• Addressing emotional avoidance and relational patterns, and relationship issues.

• Coping strategies that help people to reduce their stress levels and relax may also be beneficial in the long-term management of anxiety.

Mental compulsions such as overthinking, rumination, worry and mental checking are common with OCD, and are the primary compulsions that occur with what is known as 'pure' OCD. A Rumination-Focused ERP approach can be beneficial in identifying and addressing mental compulsions from the initial stages of therapy. Clients are encouraged to engage in daily practice of resisting mental (and all other) compulsions whenever urges arise, with the goal of retraining the brain so that it will become easier overtime, with anxiety and urges to do compulsions gradually lessening.