Exposure & Response Prevention (ERP)

What is Exposure and Response Prevention (ERP)?


Exposure and Response Prevention is a type of Cognitive -Behavioral therapy that is used to help client's confront and move past the fears that are disrupting their lives.  Specifically, the therapeutic technique called "exposure" means to confront one's fears repeatedly until the fear subsides (a process which is referred to as habituation). The term "Response Prevention" means to refrain from any avoidance behaviors or compulsions that a client might engage in when attempting to face their fear. 


What is ERP like at Vantage Point?


At Vantage Point, we understand that the idea of getting exposed to your fear without being able to engage in avoidance behaviors can be intimidating or terrifying for some clients.   Therefore, we offer a gradual, supportive, and collaborative approach to  Exposure and Response Prevention driven by the client's own willingness to approach each fear and the therapist's encouragement.  We work closely with our client's to develop comprehensive personal fear hierarchies that accurately pinpoint the client's fears and their associated level of anxiety.   We have found a collaborative approach to be most effective as it often improves the client's overall experience and commitment to the recovery process. 


What type of Exposures can I expect?


Your therapist will work with you to determine which exposure variation that will work best for you.  Keep in mind that your exposures will be graduated meaning that every step along the way from minor fears to major fears will become more manageable.  The idea is to dip your toes in the water rather than jump off of the high dive at the pool.  The following are examples of the variations of exposures that a client might experience in therapy in order to reduce a client's fear.


Imaginal Exposure: Your therapist might guide you in vividly imagining one of your fears.


Interoceptive Exposure:  Your therapist might guide you through re-creating the physical sensations associated with your fear. 


In Vivo Exposure:  Your therapist would encourage you to directly face your fear.



What is the research on Exposure and Response Prevention?


Over the last few decades, Exposure and Response Prevention has been proven to be the treatment of choice for Obsessive-Compulsive Disorder (click here for Dr. Jonathan S. Abramowitz's review of treatment outcome literature for ERP and OCD).  ERP is also an evidenced-based treatment for  PTSD and is shown to be effective Phobias and Anxiety  Disorders (click the National Alliance on Mental Illness at for further information).