Exposure-Response Prevention

What Is ERP?

Exposure-Response Prevention (ERP) is a type of Cognitive Behavior Therapy used in the treatment of OCD and anxiety. The Exposure in ERP refers to exposing patients to their anxiety triggers while welcoming the intrusive thoughts, images, and fears, that start their obsessions.

While the Response Prevention refers to committing to not engage in compulsive behaviors once the obsessions are triggered. At CalmOCD the therapist will do ERP exercises with patients in an office setting, in the community, or in their homes while providing support until they feel confident in doing exposures on their own. Often, OCD sufferers have tried to confront their anxiety triggers before, only to leave with debilitating anxiety and feelings of hopelessness. The difference is with ERP patients learn both the E and RP are crucial in exposure success. They learn they can face their fear, feel uncomfortable emotions, and not give in to their ritual. Exposure therapy is about learning they CAN face their OCD triggers (and resist their compulsions) and do far more than they ever thought possible!

At CalmOCD, therapists use an exposure approach referred to as inhibitory learning.

This approach focuses on helping patients with ‘distress tolerance’ rather than the traditional habituation model of exposure. The habituation model focuses on exposure to a trigger while the main goal is to lower anxiety and feel neutral about an anxiety trigger. With the habituation approach, there is an emphasis on rating/scoring anxiety levels (commonly known as a subjective units of distress scale) and creating a specific hierarchy of exposures. However, at CalmOCD we do not believe patients need to reach habituation to be successful during exposure work, nor does it matter for overall healing from OCD. Instead, we teach people to tolerate these difficult emotions and allow the anxiety to be there while focusing less on anxiety levels and more on what they are learning.

A great outcome we see when using inhibitory learning at our office is the confidence and willingness in our patients with this approach.


At CalmOCD, we do not find rating anxiety levels particularly helpful, as it keeps patients more in tune with how poorly they are feeling. Instead, we want people to focus on what they are learning through the exposure process and what compulsions they are resisting.

When we have patients record their exposures for homework, we ask them to record what they have learned, what compulsions they resisted, and their future goals for the exposure. We also do not believe exposure work means we have to go in a set order using a specific hierarchy from the lowest to the highest fears. The reason for this is when we only address low-level anxiety triggers it communicates to the OCD/anxiety brain that there is a problem with a higher level of anxiety, and they can not tolerate that level of distress when they can. In addition, another reason we do not use hierarchies is the real world does not give OCD sufferers anxiety triggers at a certain low level. Unfortunately, OCD sufferers get all types of triggers at different levels at CalmOCD we like for patients to gain confidence in facing a variety of triggers at different levels of anxiety because this is how OCD and anxiety operate!

Ready to Start Your Healing Journey?

If interested, please follow the steps below! Due to the high volume of inquiries please allow 48 hours for a response.


Submit an online inquiry


You will receive a response from CalmOCD within 48 hours and a 15 minute complimentary consultation will be scheduled

Intake Session

If CalmOCD seems to be a good fit based on your individual needs, an intake session will be scheduled.