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Exposure and Response Prevention

Exposure and Response Prevention

The following article will give you an overview of exposure and response prevention and its uses in behavioral psychology.
PsycholoGenie Staff
One of the most effective methods of Cognitive Behavioral Therapy (CBT) for the treatment of Obsessive Compulsive Disorder (OCD) is Exposure and Response Prevention (ERP). This method of treatment is widely regarded by psychologists as a breakthrough that can help people suffering from OCD, which was previously regarded as an incurable condition. While it isn't so much of a cure, it is an option, which when effectively utilized, can reduce the unwanted behavior to a great extent that OCD routinely gives rise to.
Therapy
Although exposure and response prevention is not used as a therapy for OCD alone, it is most commonly used to treat anxiety disorders. OCD is an anxiety disorder that manifests in the form of unwelcome or involuntary thoughts to the exclusion of all else that give rise to anxiety, and a continuous effort to reduce this anxiety by certain repetitive, compulsive behavioral patterns. Signs of obsessive compulsive disorder manifest in various ways, one of the most common of which is the fear of contamination - leading to, for example, compulsive hand washing. Not performing the compulsive behavior in response to the intrusive thoughts may give rise to panic attacks or extreme anxiety. Cognitive behavioral therapy suggests the use of ERP in order to treat such disorders.

The therapy deals in two steps:
  1. Exposure therapy - Exposure to the stimulus that triggers the compulsive behavior
  2. Response Prevention - Slowly reducing the intensity of the escape reaction to the trigger
The theory behind this method of treatment is that repeated exposure to the stimulus while in therapy, will reduce the anxiety over time that the intrusive thoughts or obsessions give rise to. Through this treatment, the patients are taught to resist the compulsive behavioral patterns that they routinely indulge in.
Techniques
Although the technique that ERP employs will vary considerably according to the degree of OCD and the patient's individual ability to confront the causative agents, the principle behind the treatments remain pretty much the same. Frequently, ERP will involve creating a gradation of the stimuli that lead to compulsive responses in order to understand the degree of anxiety that each grade triggers. For instance, a person who fears contamination, and compulsively washes his hands to rid himself of possible germs, may grade contact with garbage as the trigger that causes maximum anxiety, while touching something dusty, or shaking hands with someone may provoke a less potent response. ERP in such a scenario, would involve repeated exposure to the low-grade trigger, with psychotherapy to slowly resist the response that the stimulus would otherwise cause - in this case, compulsive washing of the hands. This therapy may proceed in multiple ways - the subject may be repeatedly exposed to the trigger, or may be taught to gradually increase the time between the reaction to an exposure. Initial sessions may involve the guidance of a therapist, but as the anxiety response to a low-grade stimulus reduces, exposure continues to the ones higher up on the list.
Should exposure and response prevention therapy prove successful, the patient should experience a marked reduction in both anxiety, and the need to indulge in the compulsive behavior that the trigger causes. ERP has proved to be the most effective method of dealing with anxiety disorders, OCD in particular.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for expert medical advice.