How Exposure and Response Prevention (ERP) Therapy Helps You Stop OCD Compulsions and Take Back Control

By Whitney Peters, MS, LPCC
Lindner Center of Hope, Outpatient Therapist

What Is Exposure and Response Prevention (ERP) Therapy for OCD?

Exposure and Response Prevention therapy, or ERP, is widely recognized as the gold standard treatment for Obsessive-Compulsive Disorder (OCD). Backed by decades of research, ERP has consistently proven to be more effective than other therapeutic approaches—especially talk therapy, which can sometimes inadvertently worsen OCD symptoms.

You may have heard of ERP before or had it recommended by a friend or relative. But what exactly is it, and how does it work?

OCD consists of two main components: obsessions and compulsions. ERP mirrors this structure with its two core elements: exposures and response prevention. Exposures are designed to target the obsessive fears, while response prevention aims to reduce or eliminate the compulsive behaviors that reinforce those fears.

OCD is a cycle of distressing thoughts (obsessions) followed by behaviors or mental acts (compulsions) aimed at reducing that distress. Intrusive, obsessive fears often arise spontaneously, while compulsions are deliberate attempts to neutralize or escape those fears. These compulsions keep the OCD cycle going, and a large part of ERP involves learning how to interrupt, reduce, and eventually eliminate them.

How Does ERP Work to Stop Obsessive Thoughts and Compulsions?
ERP specifically addresses the hallmark symptoms of OCD: obsessions and compulsions. Obsessions can cause significant emotional distress, such as anxiety, disgust, guilt, or a feeling of “wrongness.” In response, people may go to great lengths to avoid triggers or perform excessive behaviors—like checking, cleaning, or seeking reassurance—in an attempt to reduce their discomfort. Unfortunately, these avoidance strategies offer only temporary relief and ultimately reinforce the anxiety. ERP helps individuals break free from this cycle.

A helpful way to understand ERP is to compare it to physical therapy. Just as someone might attend physical therapy to rebuild strength and function after an injury, ERP helps individuals strengthen their ability to tolerate distress and reduce the grip OCD has on their lives. With the guidance of a trained therapist, individuals gradually and safely confront their fears while learning to resist the urge to engage in compulsions. Over time, this helps them regain control and participate more fully in daily life.

Example: What an ERP Exercise Looks Like
Let’s say someone is afraid of accidentally harming someone. A therapist might guide them through writing that thought down or imagining it on purpose—without trying to “cancel it out” with a ritual. Over time, this helps the brain learn that the thought isn’t dangerous, and the anxiety fades naturally.

If you or someone you know is struggling with OCD, know that help is available. No one needs to remain trapped by their OCD. With effective treatment like ERP, it is entirely possible to regain control and live a fulfilling life.

Common Questions About ERP Therapy

Is ERP Therapy Hard?
Yes, ERP can feel challenging at first because it involves facing your fears. But with the right support and a step-by-step plan, most people find it gets easier—and even empowering.

Does ERP Work for All Types of OCD?
ERP has been proven effective for many subtypes of OCD, including:

• Contamination fears
• Harm OCD
• Checking or counting rituals
• Religious or moral obsessions (scrupulosity)
• Relationship OCD
• Pure O (obsessive thoughts without obvious compulsions)

How Long Does ERP Take to Work?
Everyone is different, but many people see significant improvements within 12–20 sessions. Some notice changes even sooner. The key is consistency and working with a therapist trained in ERP.

Getting Help: Where to Find ERP Therapy for OCD
If you or someone you love is struggling with OCD symptoms—such as repetitive thoughts, anxiety, or rituals that interfere with life—know that help is available. ERP therapy can offer real relief, even when nothing else has worked.
To find an ERP-trained therapist, contact the Lindner Center of Hope or visit the International OCD Foundation (IOCDF) at iocdf.org.