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Patricia Escudero Rotman, Ph. D., LCSW, Clinical Psychologist (Arg.)

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Exposure and Response Prevention (ERP)

Exposure and Response Prevention (ERP) is the treatment of choice for Obsessive Compulsive Disorder (OCD). ERP is a research based clinical intervention that significantly helps approximately 80% of OCD sufferers.

Research has shown that most people (non OCD sufferers) have intrusive thoughts, impulses, and images. The difference is that these people do not take them seriously as they can easily dismiss them. These intrusions do not interfere with their lives.

The goal of Exposure and Response Prevention (ERP) is to decrease the frequency, and intensity of the obsessions, but not to totally eliminate them. The goal is also for patients to have as much as a stress free life as possible. Other general clinical interventions derived from Cognitive Behavioral Psychology (CBT) will be used during treatment to attain this goal (e.g. time management, relaxation training, and cognitive restructuring).

Exposure and Response Prevention (ERP) is based on gradually exposing patients to their feared obsessions while helping them to decrease their rituals and avoidance behaviors. This intervention is carefully tailored to the patient based on their subjective level of discomfort.

As an ERP expert, I will not be pushing you to do some exposure work if your anxiety is overly high. We will choose a less anxiety provoking intervention until you feel more ready to address the next step in your hierarchy of feared situations (from the least to the highest level of anxiety producing item in your list).

Exposure and Response Prevention (ERP) may include not only in vivo components but also imaginal exposure to your feared outcomes. The latter intervention is especially helpful when in vivo exposure is not feasible (e.g. feared accident happening to a loved one). Endless loop tapes will be used in between sessions for homework assignments.

Cognitive interventions as well as family sessions may also be used to maximize your treatment progress. Booster sessions after treatment has ended have also been shown to be helpful, mainly during times of significant life stressors as these may increase the likelihood of a temporary relapse of your obsessions and/or compulsions.