Exposure and Response (Ritual) Prevention (ERP)

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Exposure and Response (Ritual) Prevention (ERP)

Exposure and Response (Ritual) Prevention (ERP) is the leading effective treatment for people who exhibit behaviors and thoughts related to an anxiety disorder such as OCD, Social Anxiety, Panic Disorder, Phobias, and some forms of PTSD. All of these issues manifest themselves in anxiety provoking thoughts and specific forms of behavioral avoidance.

In a safe and empathetic environment, our practitioners help people gradually expose themselves to situations that invoke distress. Over time, and with guidance from the therapist, this process allows the person to learn a different response, rather than reinforcing their existing fears and ruminations.

The ultimate goal of ERP is that a person will be able to live the life they want without anxiety interfering with their choices and decisions. ERP also increases people's likelihood that they will use the same tools and mindset they learn in ERP sessions to expose themselves to challenges in other areas of life. Instead of spending time avoiding the things they found distressing, they might try going back to school, getting a new job, dating, or starting a new hobby.

We use ERP to help with a wide variety of issues related to anxiety:

Obsessive Compulsive Disorder

Social Anxiety Disorder

Panic Disorder

Some forms of Trauma and PTSD

Phobias:

Flying
Public speaking
Animals, Insects, Spiders, Etc.
Foods
Unique and specific phobias

What is ERP and How Does it Work?

ERP is a form of Cognitive Behavioral Therapy, a type of therapy that helps people recognize unhelpful thought and behavioral patterns and to learn new and more helpful ones.

With ERP, a person is exposed to images, videos, objects, specific thoughts or situations that make them anxious. Once the anxiety has been induced, the person can then practice making a different behavioral choice instead of the one attempting to neutralize the distress (e.g. avoidance).

The intent of ERP is not to eliminate a person’s distress by repeatedly doing exposures or activating their fear system, but that is regularly an outcome. One of the main goals is for a person to realize that the distress they experience is tolerable, manageable, temporary and does not need to inhibit them. When this type of new learning occurs, a person can make the choices in their lives that they normally would have avoided or ruminate over.

Most people start to see improvements in their lives rather quickly, from just a few sessions to a few months, depending on severity. Within a year of ERP, many clients see a reduction of 80% - 90% of their rituals and unwanted behaviors.

What to Expect During ERP at CBT Central Florida

With many years of practice and ongoing training in best the most current practices, our practitioners are experts in ERP and have helped people successfully cope with their anxiety, phobia, and trauma-related issues to reduce or eliminate their unwanted behaviors.

If you’re thinking of trying ERP, congratulations - the first step is wanting to address your distress, which is why you're here.

Together, we’ll create a comprehensive assessment and list the main things that you’re distressed about, anxious over, or avoiding. Then, we’ll start to address those barriers in a gradual way.

ERP includes guidance through either the actual situation (In Vivo) or through the use of your imagination (Imaginal) to make yourself vulnerable to distress without resorting to protective behaviors.

You’re in the driver’s seat the entire time. We don’t flood or overwhelm you to the point that you would want to leave your session or avoid coming back to treatment.

This teaches you how to tolerate the distress you experience, work through it, and ultimately lower your distress when you encounter an activating situation in daily life.

Most people can benefit from ERP, even if they:

Have tried CBT or ERP before and it didn't work long term, or it didn’t work at all

Have had success in the past but their anxiety, phobia, or symptoms have changed over time
Have never been in therapy before
Have tried other forms of therapy in the past to varying degrees of success
Use alcohol, drugs, and other substances
Want to try medication in addition to ERP - or don’t
Are afraid of being judged or shamed by a therapist

Exposure and Response Prevention FAQ

We offer both in person and virtual appointments. Our in person appointments currently take place at our Orlando, FL office.
Most clients pay for our services out-of-pocket. Please contact our office to verify your coverage. Even if we can’t see you at our practice, we are happy to connect you with additional resources. We feel it is our job and responsibility to help you find the help you need.
We generally schedule weekly, 45 minute appointments for therapy.
If you are interested in more intensive therapy we offer several options, which can include multiple sessions per week and can range from 60 to 90 minutes or longer.
Oftentimes, medication can be extremely helpful for some people. If a person feels stuck and unable to do the exposures or finds them too distressing, or the distress is not going away fast enough, we can refer them for medication with a psychiatrist or psychiatric nurse practitioner.
Yes. As CBT clinicians we have a specific way of helping people, but we recognize that it's not the only way. If we feel another form of therapy outside of our scope of practice is helpful, we will refer you to our best resources.
If you want to incorporate other methods of helping or healing, we'll integrate that into your treatment or provide a referral to another provider.

Therapy Delivered With Respect, Empathy, and Compassion

We view all people as unique individuals who are doing the best they can to cope with the circumstances they are presented with. Although we are CBT specialists that help people manage their anxiety using the most current and effective treatments, we also recognize how privilege, power, unequal access to resources, prejudice, racism, and other systemic issues affect a person’s lived experience. We approach each relationship with the respect, empathy, and compassion that all people deserve.

Our practitioners have also received additional training and supervision in culturally competent practices, and continue to do so as part of participating in our group.