Exposure and Response Prevention

Exposure and response prevention (ERP) is a treatment method available from behavioral psychologists and cognitive-behavioral therapists for a variety of anxiety disorders, especially obsessive–compulsive disorder and phobias. It is an example of an exposure therapy.

The method is predicated on the idea that a therapeutic effect is achieved as subjects confront their fears and discontinue their escape response. The behavioral process is called Pavlovian extinction or respondent extinction. An example of how this process works: Imagine a person who repeatedly checks light switches to ensure they're in the off position, even when entering a clearly unlit room. The person would be exposed to their feared stimulus (leaving lights switched on), and would refuse to respond with any safety behaviors. It differs from exposure therapy for phobia in that the resolution to refrain from the escape response is to be maintained at all times and not just during specific practice sessions. Thus, not only does the subject experience habituation to the feared stimulus, they also practice a fear-incompatible behavioral response to the stimulus. While this type of therapy typically causes some short-term anxiety, this facilitates long-term reduction in obsessive and compulsive symptoms.

Recent results indicate that ERP can be carried out effectively with minimal face-to-face contact between the therapist and the subject.

The results of a 2008 study indicate that simultaneous administration of d-cycloserine substantially improves effectiveness of exposure and response prevention.