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When & Why ERP Isn't Working
“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.
When you have OCD, a very specific set of tools are usually required for success.
Here are some ways to get you connected outside of therapy.
Effective Treatment
In case you missed it on the home page, here's a primer on OCD.
We all have an alarm system in our brain. "False alarms" regularly occur in OCD, making it very difficult at times to function. Find out more how it's treated in this video.
We all have an alarm system in our brain. "False alarms" regularly occur in OCD, making it very difficult at times to function. Find out more how it's treated in this video.
What is Exposure Therapy &
How Do You Do It?
Sounds strange? Find out the basics on exposure therapy, how it is applied, and the disorders that are treated.
The 4 Types of Exposure Therapy
Check out the video to learn the 4 types of exposure therapy and examples.
Supporting Your Loved One With OCD
This entirely FREE guide helps walk loved ones who support someone with OCD through what to expect, helpful tools, and encouragement for the journey. Covering topics such as the significance and impact of OCD, Research, and Boundaries, this guide will hopefully assist you in staying grounded.
ERP for OCD Brochure
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ERP for OCD- The Basics and Beyond
Presented by Justin Hughes, MA, LPC Multiple times in different locations.
Mindfulness [Exposure-Friendly]
Mindfulness. Contact with the present moment. Simple, isn't it? It takes a lot of practice, though. This video accompanies the full guide (get it free here).
This one's a bit different from the average mindfulness practice you might be familiar with. The reason it's called "Exposure-Friendly" is that it is specially designed to help a person be mindful of whatever they are experiencing, not just attempting to feel better. This is a hallmark of exposure therapy: being able to tolerate distress without engaging in pathological responses (rituals, safety behaviors) that negatively reinforce fear. Distractions and relaxation when facing our fears can backfire (see the research at the end). So if we need a different set of tools to face fear, here's one of them. I hope it helps.
Music: As Leaves Fall
Musician: @iksonofficial
This one's a bit different from the average mindfulness practice you might be familiar with. The reason it's called "Exposure-Friendly" is that it is specially designed to help a person be mindful of whatever they are experiencing, not just attempting to feel better. This is a hallmark of exposure therapy: being able to tolerate distress without engaging in pathological responses (rituals, safety behaviors) that negatively reinforce fear. Distractions and relaxation when facing our fears can backfire (see the research at the end). So if we need a different set of tools to face fear, here's one of them. I hope it helps.
Music: As Leaves Fall
Musician: @iksonofficial
10 Tips for Effective ERP
Quick tips for effective ERP. Though Exposure and Response Prevention can be straightforward, doing it well is crucial for best outcomes.
OCD Log (Tracking/Monitoring)
Here's a form I encouraged clients to use in therapy to monitor ongoing obsessions and compulsions. It's yours, free!
Specially curated outside resources.
General OCD Education
The A2A Alliance
Anxiety BC's Home Help for Children/Teens
A Short History of OCD
Beyond the Doubt: Thriving Through Uncertainty
Disabling Nature of Untreated OCD (OCD-UK)
Drug Treatment of OCD in Adults (Dr. Jenike)
Example of OCD Therapy with a Child (Dr. Eric Storch)
Existential and Philosophical Obsessions (Dr. Fred Penzel)
Exposure and Response Prevention (ERP) research
Getting Your Insurance Company To Pay For OCD Treatment
International OCD Foundation (IOCDF)
International OCD Foundation (IOCDF) Youtube Channel
Intrusive Thoughts
IOCDF "What You Need To Know"
OCD Texas
OCD U.K.
Peace of Mind Foundation
Scrupulosity and Christians (Dr. Ted Witzig)
Anxiety BC's Home Help for Children/Teens
A Short History of OCD
Beyond the Doubt: Thriving Through Uncertainty
Disabling Nature of Untreated OCD (OCD-UK)
Drug Treatment of OCD in Adults (Dr. Jenike)
Example of OCD Therapy with a Child (Dr. Eric Storch)
Existential and Philosophical Obsessions (Dr. Fred Penzel)
Exposure and Response Prevention (ERP) research
Getting Your Insurance Company To Pay For OCD Treatment
International OCD Foundation (IOCDF)
International OCD Foundation (IOCDF) Youtube Channel
Intrusive Thoughts
IOCDF "What You Need To Know"
OCD Texas
OCD U.K.
Peace of Mind Foundation
Scrupulosity and Christians (Dr. Ted Witzig)
Exposure and Response Prevention (ERP) and Other types of Exposure
Common Pitfalls in ERP for OCD Presentation (Justin Hughes, MA, LPC and Dr. Molly Martinez)
Exposure and Response Prevention (IOCDF with Thröstur Björgvinsson)
Exposure Therapy for OCD (Anxiety BC)
Imaginal Exposure Nuts and Bolts (CCT)
Imaginal Exposure for OCD & Anxiety (OCD Center of L.A.)
Imaginal Exposure Research (Science Direct)
OCD Treatment (video) by Michael Jenike, MD
Treating OCD: What Is ERP? (Child Mind Institute)- Video
"The Practice of Exposure Therapy: Relevance of Cognitive-Behavioral Theory and Extinction Theory" (Dr. Jonathan Abramowitz)
What is ERP? (Shala Nicely, LPC)
Exposure and Response Prevention (IOCDF with Thröstur Björgvinsson)
Exposure Therapy for OCD (Anxiety BC)
Imaginal Exposure Nuts and Bolts (CCT)
Imaginal Exposure for OCD & Anxiety (OCD Center of L.A.)
Imaginal Exposure Research (Science Direct)
OCD Treatment (video) by Michael Jenike, MD
Treating OCD: What Is ERP? (Child Mind Institute)- Video
"The Practice of Exposure Therapy: Relevance of Cognitive-Behavioral Theory and Extinction Theory" (Dr. Jonathan Abramowitz)
What is ERP? (Shala Nicely, LPC)
Psychopharmacology and Treatment Refractory Options
CBT and Psychopharmacology for OCD (Audio) by Peggy Richter, MD
IOCDF's "Medications for OCD" by Michael Jenike, MD
Transcranial Magnetic Stimulation (TMS) by IOCDF
IOCDF's "Medications for OCD" by Michael Jenike, MD
Transcranial Magnetic Stimulation (TMS) by IOCDF
Personal Stories
Beyond the Doubt Blog (Jeff Bell / Shala Nicely)
Chrissie Hodges "Pure O" OCD
Clint Malarchuk (A2A Alliance)
Corey Hirsch, Retired NHL [adult language]
Historical Figures (from Martin Luther to Audrey Hepburn)
Howie Mandel Talks About Living With OCD (ABC's 20/20 with David Muir)- Video
NPR's "Dark Thoughts"
"Soooo OCD" by Terrible, Thanks for Asking
The Mighty Blog
The OCD Stories
Chrissie Hodges "Pure O" OCD
Clint Malarchuk (A2A Alliance)
Corey Hirsch, Retired NHL [adult language]
Historical Figures (from Martin Luther to Audrey Hepburn)
Howie Mandel Talks About Living With OCD (ABC's 20/20 with David Muir)- Video
NPR's "Dark Thoughts"
"Soooo OCD" by Terrible, Thanks for Asking
The Mighty Blog
The OCD Stories
Subtypes (common presentations)
Contamination
Overview by IOCDF
Common manifestations by OCD Types
Harm
Overview by OCD L.A.
Common manifestations by Beyond OCD
Incompleteness / "(Not) Just Right" / Perfectionism
Overview by Peace of Mind
Common manifestations by Beyond OCD
Intrusions / Unacceptable Thoughts / Scrupulosity
Common manifestations by Intrusive Thoughts
Existential and Philosophical OCD (IOCDF)
Living with Religious OCD (Made of Millions)
Scrupulosity: Blackmailed by OCD in the Name of God (Beyond OCD)
Unacceptable thoughts overview (Houston OCD Program)
Overview by IOCDF
Common manifestations by OCD Types
Harm
Overview by OCD L.A.
Common manifestations by Beyond OCD
Incompleteness / "(Not) Just Right" / Perfectionism
Overview by Peace of Mind
Common manifestations by Beyond OCD
Intrusions / Unacceptable Thoughts / Scrupulosity
Common manifestations by Intrusive Thoughts
Existential and Philosophical OCD (IOCDF)
Living with Religious OCD (Made of Millions)
Scrupulosity: Blackmailed by OCD in the Name of God (Beyond OCD)
Unacceptable thoughts overview (Houston OCD Program)
Clinical Tools
Cognitive Defusion- 7 Metaphors
Cognitive Defusion in practice (ACBS)
Cognitive Defusion in practice (WCCT)
Distinguishing Information-Seeking from Reassurance (IOCDF/SLBMI)
Exposure and Desensitization (U of Michigan)
Exposure Therapy quick guide (Anxiety Canada)
Exposure Therapy Practice Form- IL (Dr. Abramowitz)
Exposure Therapy Practice Form- IL with Expectancy Tracking (Dr. Abramowitz)
Relapse Prevention (Shala Nicely, LPC)
Cognitive Defusion in practice (ACBS)
Cognitive Defusion in practice (WCCT)
Distinguishing Information-Seeking from Reassurance (IOCDF/SLBMI)
Exposure and Desensitization (U of Michigan)
Exposure Therapy quick guide (Anxiety Canada)
Exposure Therapy Practice Form- IL (Dr. Abramowitz)
Exposure Therapy Practice Form- IL with Expectancy Tracking (Dr. Abramowitz)
Relapse Prevention (Shala Nicely, LPC)
Online Apps, Support, Connection
Anxiety Coach by Mayo Clinic (iOS App)
At Parenting Community (online support)
CBT Tools for Youth (iOS App)
Chrissie Hodges Peer Support
Goal Group- FREE (Peace of Mind)
My OCD Community (Health Unlocked with IOCDF)
nOCD (iOS App)
OCD Peers (Peer Support Groups)
OCD Support Group Led by Wendy Mueller
PatientsLikeMe
At Parenting Community (online support)
CBT Tools for Youth (iOS App)
Chrissie Hodges Peer Support
Goal Group- FREE (Peace of Mind)
My OCD Community (Health Unlocked with IOCDF)
nOCD (iOS App)
OCD Peers (Peer Support Groups)
OCD Support Group Led by Wendy Mueller
PatientsLikeMe
Parents / Family Members
Christians with OCD
Coping Statements for Christians with OCD (ACC)
OCD and the Death of the Christian (Desiring God)
Religious and Moral OCD in Christians (Ted Witzig / ACC)
OCD and the Death of the Christian (Desiring God)
Religious and Moral OCD in Christians (Ted Witzig / ACC)
Low Cost / FREE Options in DFW
DFW area IOCDF Listings (add/remove filters that apply to you)
Free/Low Fee Support Groups in DFW
"Getting Insurance to Pay for an OCD Specialist" (Fred Penzel, PhD)**
Subscribe to my newsletter, select "OCD" to stay apprised of FREE events and options
Free/Low Fee Support Groups in DFW
"Getting Insurance to Pay for an OCD Specialist" (Fred Penzel, PhD)**
Subscribe to my newsletter, select "OCD" to stay apprised of FREE events and options
"Common Pitfalls in ERP for OCD"
10.12.19 Presentation
My therapy hallmarks:
I will offer you attentive, careful treatment in 3 ways:
1) Strong adherence to the evidence-base
2) Expertise, personableness, & creativity applied to you, personally
3) My best recommendations (even when it doesn't include me, seriously)
*General Disclaimer:
All Content on this Site, www.justinkhughes.com, was created for informational purposes only, whether images, text, videos, or other formats. Content is not intended as a substitute for professional advice, treatment, advice, 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 this Site. 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 www.justinkhughes.com. The Site and its Content are provided on an "as is" basis. Links to external educational content are taken at your own risk. Justin K. Hughes, MA, LPC is not responsible for the claims of external content.
Affiliate Disclaimer:
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.
**This article is provided for helpful negotiation strategies with your insurance. Please note, in my practice you must negotiate with your insurance separately as I do not do "single case agreements" that are dependent on ongoing communication and oversight by out-of-network insurance companies.
All Content on this Site, www.justinkhughes.com, was created for informational purposes only, whether images, text, videos, or other formats. Content is not intended as a substitute for professional advice, treatment, advice, 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 this Site. 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 www.justinkhughes.com. The Site and its Content are provided on an "as is" basis. Links to external educational content are taken at your own risk. Justin K. Hughes, MA, LPC is not responsible for the claims of external content.
Affiliate Disclaimer:
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.
**This article is provided for helpful negotiation strategies with your insurance. Please note, in my practice you must negotiate with your insurance separately as I do not do "single case agreements" that are dependent on ongoing communication and oversight by out-of-network insurance companies.