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Justin K. Hughes, MA, LPC

Get Unstuck From Fear

10 Tips for Effective ERP (Exposure & Response Prevention)

Posted in Anxiety, CBT, Exposure Therapy, Mental Health, OCD

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Exposure and Response Prevention (ERP), the gold standard treatment for OCD, can be fairly straightforward once understood.  However, certain nuances are crucial for facilitating learning, growth, and maximal fear disconfirmation (fancy terms for successfully overcoming fearful responses).  Here are 10 tips- click on the picture for a downloadable version:
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  1. Be prepared to feel uncomfortable- a healthy mind is not made in comfort.
  2. Structure- it’s important to know how OCD functions, all the clever ways it can sneak past you, and specific strategies that confront the heart of compulsions, which drive obsessional anxiety and disruption to life. Prepare and have a back-up plan.
  3. Repeat in mixed contexts. The strongest training requires going beyond one practice or context.
  4. Varied- challenge yourself to face varying levels of anxiety- and multiple situations.
  5. Track your anxiety level and urges to ritualize.
  6. Attempt to not fight fear- it only reinforces it.
  7. Avoid subtle avoidance strategies. These also reinforce fear.
  8. Test negative predictions. Real-life ERP experiments inhibit faulty/erroneous misappraisals when you experimentally reveal you CAN face your fears. How did you do? Did the worst thing happen?
  9. Stick with exposures until your prediction has been tested experientially. You are rewiring your brain for resiliency!
  10. Practice alone! Develop strength on your own, not just with others (therapist).

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Adapted from: Abramowitz, J. S., & Jacoby, R. J. (2015). Obsessive-compulsive disorder in adults. Boston, MA: Hogrefe Publishing.

 

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