“ERP (Exposure and Response Prevention) is not working.” “I’ve tried ERP before- it doesn’t work for me.” I have many current and past clients who said this once. You might think, given my practice focus, that I would simply respond by offering more ERP. Not necessarily. Let me say what I don’t do, first. I don’t automatically say, "MORE ERP!" What I do is dig deep in assessment, first. Your outcomes are highly connected to whether you have done a few crucial things in your Exposure and Response Prevention for OCD. Here are common reasons you aren’t getting the most benefit you could.
#1: You haven’t given ERP a real chance.
Let’s just start with the obvious- you can’t get the benefit of a treatment if you haven't tried it. Have you tried another approach instead that is NOT ERP?
Please note that at any given point, all of the approaches listed above (EMDR, talk therapy, etc.) can be useful for a variety of things; they are just not the clinical first option for OCD!!!
Hear me loud and clear, because it needs to be said: if you're serious about getting better and have access to it- go for the gold standard Exposure and Response Prevention. The rationale and research is extensive- you can find it in my ERP for OCD presentation and ERP for OCD Brochure.
#2: You tried and “failed.” You might need to increase the quality of your ERP or attempt another trial.
If we sit down in assessment, and you say anything like the following, the quality of ERP may have been lacking, and we need to “up your game.”
Use this handy checklist ✅:
Though this is a very thorough list, it’s not even cumulative. There are even more! All of this to say, ERP is a very deep and powerful tool. Don’t give up too soon.
#3: You gave up without considering many viable OTHER treatments.
Now that we’ve covered many reasons that ERP quality may have been lacking, there are certainly those who receive solid treatment from a trained clinician, but they still are having problems. It happens in my practice; it happens with the world’s foremost experts, too. OCD is a formidable foe, and we are complex as human beings- no one size fits all. OTHER OPTIONS EXIST!!! As you consider with your clinician what’s not working, consider the following:
#4: Though it's uncommon, you may have tried many options above. Keep pressing on.
This is part of the uncertainty we have to accept- and work towards. A generation ago the tools we have today didn't exist as they do (ERP got full steam in the 80’s and wasn’t available in your average practice until later)!!! OCD, especially severe cases, was seen as largely difficult to treat or untreatable by many providers for most of the 20th century.
I have seen personally- and the experts attest- there is usually hope for those who keep pressing on, even in the most severe of cases. Check out Dr. Liz McIngvale’s personal story to to be encouraged.
So if you have doubts and fears about ERP, have tried it and it hasn’t worked for you- or have avoided it, I have good news- there likely exists options for you. And even those who seem to run out of options can typically find many if they keep persevering. You are valuable and significant, no matter how you feel today. I hope to be an encouragement in your journey.
A Psychotherapists' thoughts on healthy living.
All Content on this Site, justinkhughes.com, was created for informational purposes only. Content is not intended as a substitute for professional advice, treatment, or diagnosis. Always seek the advice of your own personal health provider who is qualified to treat you, along with asking them any questions you may have regarding medical or other conditions. Never disregard professional medical advice or delay in seeking it because of something you have viewed on justinkhughes.com. Also, due to the sensitive nature of topics and material covered through this Site, which contains very descriptive and/or advanced content, you may not want to use justinkhughes.com. The Site and its Content are provided on an "as is" basis. Some posts are written for specific populations (OCD, Christians, Professionals)- with the intent to remain respectful to all- some content may not fit or go counter to your beliefs, perspectives, and what is explored for you in a professional counseling session with Justin K. Hughes, MA, LPC. The posts are intended solely for the population they are written to and can be designated by their titles and tags.
Links to external educational content are taken at your own risk. Justin K. Hughes, MA, LPC is not responsible for external content.
Justin K. Hughes, MA, LPC of Dallas Counseling, PLLC participates in the Amazon Services LLC Associates Program. This means that some links on this site will produce a small commission from Amazon.com and affiliated sites. I NEVER link products I don't use or clinically find benefit in. Many of them have been recommended for years inside and outside therapy sessions. You are under no obligation to purchase any book, product or service recommended on this site. However, they are provided on this site only educationally and are not meant to be interpreted as treatment or therapy in any way. I am not responsible for the quality or experience of any items purchased through affiliate links, as they are entities completely separate of myself.