Exposure and Response Prevention Therapy
evidence-based treatment for obsessive-compulsive disorder
online throughout NC, VA, and FL
in-person in Clemmons, NC
if all your tried and true efforts to get rid of anxiety have worn you out, its time to try something new
You are ready to find calm in the storm of your intrusive thoughts and compulsive behaviors. You are tired of feeling distressed by things that other people don’t seem to think twice about. Your distress has resulted in cycles of overthinking, compulsive behaviors, reassurance seeking, and avoidance. The intensity of your thoughts and feelings can be near constant or come in waves. Despite your best efforts and determination, peace is out of reach while you are stuck in a vicious cycle.
All the distress and the compulsive responses come at a cost. The quality of your life has decreased because your mind is so preoccupied with a particular fear or outcome. You live in a state of hypervigilance and reactivity, and everyday tasks have become burdensome, tedious, or simply avoided.
Have you gone to therapy to address your intrusive thoughts but it only made your symptoms worse?
If you resonate with the experience written above, you might be dealing with Obsessive Compulsive Disorder (OCD). This would explain why you have had limited or no success with other therapies. OCD is a mental health condition that needs a specialized type of therapy, Exposure and Response Prevention (ERP), with someone who is extensively trained in administering ERP with fidelity and flexibility based on each individual’s needs.
WHAT IS EXPOSURE AND RESPONSE PREVENTION?
Exposure and Response Prevention (ERP) is a cognitive-behavioral treatment approach developed in the 1970s that has been well-researched and refined over the years to increase its effectiveness for OCD sufferers. Before this treatment, OCD was considered “untreatable.” Today, ERP is recognized by the International OCD Foundation as the most effective and evidence-based treatment for OCD. It is an effective therapy for 60% of those who suffer from OCD.
ERP first starts with a comprehensive initial assessment with a therapist who specializes in OCD using ERP. The therapist works to understand the OCD cycle, which typically goes like this: trigger (can be internal or external), distressing emotional response, intense urge to do something (internal or external), and slight relief. The therapist and client look for patterns and purpose in these thoughts, feelings, and responses.
This information is then used to determine what the person is afraid of and working so hard to avoid. Sometimes this is obvious, and other times it is less clear.
Once the core fear is identified, the client and therapist will brainstorm a variety of activities and experiences that will become part of an exposure hierarchy, which is the fancy name for a list of activities that cause the unwanted thoughts and feelings.
With the support of the therapist, the client will intentionally complete a variety of activities that trigger their identified fear while actively working to resist doing compulsions or safety behaviors.
Will Doing ERP make me more anxious?
Yes, but it is strategic anxiety. It is similar to the discomfort and tension you feel in your muscles when you are lifting heavy weights. It is uncomfortable, but it is a healthy and beneficial amount of discomfort. The anxiety you are currently living with is like an injured muscle that is torn, it is uncomfortable and interfering with everyday life with no benefit.
ERP aims to help you face your fears without engaging in compulsions. You will learn how to respond differently to your thoughts and feelings and build up tolerance, confidence, and new learning experiences that help you live a full and meaningful life.
Compulsions can only provide short-term relief, while ERP offers long-term relief.
How long does ERP Take?
ERP, in a very manualized form, is completed over 12-20 sessions, with sessions lasting about an hour and completing daily ERP homework outside of the session.
ERP sessions should be completed at a pace that is challenging for you but not overwhelming.
Additionally, more than 20 sessions could be needed due to other factors such as the severity of symptoms, comorbities such as ADHD, depression, or PTSD, difficulty completing homework, etc.
Session frequency and duration will be tailored to meet your individual needs.
How Does ERP Help?
Doing ERP and strategically engaging with your unwanted thoughts, feelings, and feared objects/situations without compulsions provides new information, increased tolerance to distress, increased confidence, and more flexibility with your thoughts, feelings, and behaviors. OCD convinces you that you can’t handle ______________ (fill in the blank with your particular fear). ERP teaches you that you can handle much more than you ever thought possible. Unwanted thoughts and feelings lose their power to keep you from living life on your terms.
What's wrong with doing Compulsions?
If you are asking this question, then it is important to understand the difference between a quirk and a compulsion. We all have “quirks” or routines that we find ourselves doing repeatedly. Quirks are not inherently harmful, and how they impact your life is likely inconsequential. A quirk, or daily routine, falls under the category of a preference and is generally pleasing in some way. For example, let’s say someone follows a bedtime routine with steps they perform in a certain order every night. They find this routine enjoyable. If they have an evening activity that interferes with their bedtime routine, they can be flexible and adjust. Others know this person prioritizes sleep, but there is no negative impact on their overall functioning.
Compulsions, on the other hand, are something a person feels driven to perform out of a distinct urge to find relief from fear of distress. They can become time-consuming, energy-draining, and cause a range of consequences in a person’s life. Let’s look at the same example with someone who has a bedtime routine they follow every evening. Someone who is compulsive about their bedtime routine does not find it enjoyable. They find it essential to prevent something bad from happening, and they likely have very limited flexibility around it. Consequences might include missing out on social activities, relationship conflict, and being mentally preoccupied. There is some “sense of safety” in this routine, but it is distinct from pleasure.
Compulsions are a response to your overestimation of a threat and your underestimation of your ability to handle it. Your brain has cleverly crafted compulsions and rituals to achieve a sense of safety and relieve distress and doubt in the presence of a threat. The compulsions have likely been successful to some degree. As a result, even if they don’t make sense to you, you experience an urge to repeat these compulsions or rituals. Over time, compulsions tend to lose their effectiveness and thereby increase in frequency, duration, and complexity. It is no big deal to wash your hands once after touching something perceived as “dirty.” But when you have to wash for 10 minutes, in a set pattern, until you obtain a certain “feeling” of being clean, small everyday tasks can become tiresome, time-consuming, and cause more problems for you.
WHO DOES ERP HELP?
ERP is designed to help anyone suffering from intrusive, unwanted thoughts or feelings that result in patterns of avoidance or time-consuming compulsions or safety behaviors. ERP is considered the front-line treatment for children, adolescents, and adults who are struggling with:
- OCD
- social anxiety
- phobias
- agoraphobia (fear of leaving the house due to panic attacks)
- emetophobia (fear of vomit)
- panic disorder
- health anxiety (fear of having an illness or getting sick)
WHEN TO SEEK ERP THERAPY
As soon as you recognize that there are areas of your life where you are living life on anxiety’s terms- that is the time to seek out ERP therapy. It is time for you to do ERP if you want to:
- stop letting anxiety and OCD control your life
- get back time and energy that you now spend on compulsions or worrying
- improve the quality of your life and relationships
- feel calmer and more in control
- increase your flexibility and distress tolerance
- gain confidence
No matter what your reasons are for seeking out ERP therapy, know that you are not alone. OCD and anxiety can be very debilitating. But, at Evercare Counseling, Lindsey is here to support you through your journey.
AN ERP THERAPIST CAN HELP YOU FIND RELIEF
Lindsey is licensed to work with people who reside in North Carolina, Virginia, and Florida. She has worked with many people who have felt like they would never be free from their OCD or anxiety. Many of her clients have started ERP therapy thinking it would be too hard or wouldn’t work- like the rest of their therapies they’ve tried. But, with expert support and by taking small steps, her clients have been able to see that change is possible. They were able to shed the heavy weight of fear, responsibility, and shame that OCD can carry- and you can too.
Our Approach to ERP Therapy in Virginia and North Carolina
At Evercare Counseling in Virginia, North Carolina, and Florida, Lindsey offers a very collaborative process for exposure and response prevention therapy. We understand that every person is different and so should the approach they take. Some people may be tired of their OCD and want to go into the exposure part of treatment right away. Others may need time to get to know and understand their diagnosis. We also apply this to identifying all the core of your fear emotional state. Everyone is different and the approach will be too.
Lindsey will work with you to create an exposure hierarchy within your comfort level. We will work at your pace. We want you to feel as comfortable and safe as possible while still challenging yourself to face your fears. The skills you learn during ERP therapy are lifelong and you can use them for years to come. We do this by working to combine good education, humor, and warmth. By doing so, we connect people with the broader OCD community so they know they’re not suffering alone.
We can help strengthen your uncertainty muscle.
Our approach allows you to learn to tolerate discomfort, accept uncertainty, and have more freedom of time and energy. This way, you can live according to your values instead of according to your fear and create a meaningful and fulfilling life. At Evercare Counseling, our caring team strives to help people of faith maintain and strengthen spirituality without obsessions or compulsions of OCD.
Begin ERP Therapy at Evercare Counseling in Virginia and North Carolina
Struggling with OCD and anxiety symptoms can be very difficult and overwhelming. But, you don’t have to suffer any longer. Evercare Counseling is here to support you through this. To start your therapy journey with Evercare Counseling, please follow these simple steps:
- Contact Evercare Counseling
- Meet with a caring OCD therapist
- Start addressing your OCD symptoms
Additional Services Offered At Evercare Counseling
ERP therapy isn’t the only service offered by Evercare Counseling. Our team offers a variety of therapy services to help support your mental health. Mental health services offered include support to individuals experiencing OCD and anxiety. In addition, we are happy to offer Christian counseling, depression treatment, therapy for women, and other services. Please feel free to read our blog or common questions to learn more helpful info!