What is Exposure and Response Prevention (ERP)?

What is Exposure and Response Prevention (ERP)?


Hi, my name is Rixi Abrahamsson, and I’m a psychologist with the Therapy Centre. I’d like to talk to you today about a treatment approach that has been proven effective for anxiety disorders. I’ve really found it to be effective for my clients. It’s called Exposure and Response Prevention or ERP for short.

Exposure and response prevention is a Cognitive Behavioural Therapy treatment that works on the idea that when people are afraid of something, they often avoid it. But that this avoidance actually ends up reinforcing their anxiety and making things worse.

In ERP, you are gradually exposed to those things that you’ve been afraid of and avoiding, and that you’ve been asked to do them without doing those things you normally do to reduce your anxiety.

I want you to think of your anxiety as like a fire alarm system. In your house, if the fire alarm goes off, it’s trying to get your attention. So you can look around, see if there’s danger and then get to safety. In an anxiety disorder, though, that fire alarm has become hypersensitive, and starts going off for really small things, treating them as if they are catastrophic. So in other words, if you have an anxiety disorder, your fire alarm is going off for things like a birthday candle, or burnt toast. This is where ERP comes in.

The idea behind ERP is that you by going towards anxiety, and doing things differently, can learn that anxiety is not as bad as you thought and that you can tolerate or work through your anxiety in a very different way.

ERP helps to break that cycle of avoidance and reinforces new learning, learning in the situation that it is not as dangerous as it seems, and that you are more capable of dealing with it than you thought. I want to take an example, let’s say that you are really afraid of contamination, and that this leads you to avoid touching a lot of things, or washing your hands multiple times a day to try and keep yourself from getting contaminated.

With exposure and response prevention, you would work with the therapist towards creating an exposure and exposure might look like in this case touching something you consider dirty, let’s say a doorknob, and that you would touch this doorknob, and then refrain from doing those things you normally do to bring down your anxiety, which might include washing your hands or using sanitizer. exposures are done gradually and repeatedly. You would work with your therapist to create a hierarchy of increasingly challenging situations to face.

ERP is usually done in a structured and supportive way, with a trained therapist guiding the process. The therapist provides education about anxiety and helps you to navigate any issues that might arise that could interfere with your learning during exposures. It’s important to note that the goal of ERP is not to eliminate anxiety. Anxiety can be really helpful in some situations. But the goal is to learn that you can deal with anxiety differently, and to right size, some of those things that you’ve been avoiding.

ERP has been found to be effective for a range of anxiety disorders, including OCD, social anxiety and specific phobias.

If you’re struggling with an anxiety disorder, consider reaching out to the Therapy Centre. We have psychologists, social workers and psychotherapist who are trained in ERP for anxiety disorders and are ready to help.


What is Exposure and Response Prevention (ERP)? VLOG by Dr. Rixi Abrahamsson