ERP Treatment: Therapy that Works for OCD

By Rachel Tombaugh | April 21, 2026

Obsessive Compulsive Disorder (OCD) is a mental health condition that has become recognized by several damaging misconceptions throughout popular culture. Alongside those misconceptions are similar mischaracterizations and dramatizations of one of the most effective, beneficial treatments of OCD, ERP therapy.

Exposure and Response Prevention (ERP) is the gold-standard treatment approach for treating OCD. It is the most effective, evidence-based method for treating the condition. Yet many sufferers of OCD feel hesitant about seeking care from an ERP therapist. Why is that, and how can people overcome fears related to “exposure therapy” as they have seen it on television and in movies?

What research says about ERP treatment therapy

Research indicates that, on average, individuals live with OCD for as many as 13–17 years before receiving the correct diagnosis and treatment. (2) Some research also indicates that for up to 75% of people experiencing symptoms, a clinical diagnosis is never identified, while more than 9 in 10 people with OCD are not receiving the correct treatment. (3) The goal is to drastically reduce the amount of time individuals experience symptoms before diagnosis, and then to further reduce the gap between diagnosis and appropriate therapeutic treatment.

There are a few first line approaches to treating OCD; ERP is the gold standard. Research has shown that when receiving first line treatments for OCD, individuals experience significant reduction in symptoms at a rate of 50–60%. (4, 5)

Additionally, by contrast to treatment with medication, Exposure and Response Prevention (ERP) therapy leads to long-lasting relief from symptoms for many patients. One study found that receiving ERP treatment led to a reduction in OCD symptoms for approximately two-thirds of patients, while almost one-third of patients could be considered recovered. (6)

What is ERP treatment and therapy like?

Despite a tremendous body of evidence of ERP’s efficacy in treating OCD, ERP’s misunderstood reputation can cause prospective clients to feel understandably nervous about seeking care through therapy.

Pop culture often portrays ERP as a torturous experience, implying that treatment forces participants into extreme, overwhelming situations to conquer their OCD.

While some practitioners may employ such techniques, the vast majority of ERP therapists are dedicated to helping their clients regain a sense of confidence and mastery in their lives by providing support that is research-backed and clinically proven.  A therapist should never force someone into exercises they are not ready for. Establishing a caring, trusting therapeutic rapport is essential to foster a sense of safety and confidence during this process.  

ERP therapy will look different for every person, as it is uniquely tailored to each individual’s needs. It can be pursued on an outpatient, inpatient, or intensive option dependent upon a person’s specific needs, symptom severity, and availability for treatment. (1) 

In general, the process of ERP therapy will likely involve your therapist:

  • Working to develop a trusting and caring rapport with you
  • Helping you understand the nature of OCD
  • Educating you on how the condition is functionally maintained
  • Identifying the specific components of your OCD: triggers, obsessions, compulsions, and potential exposure exercises
  • Creating a collaborative plan to support you in regaining a sense of empowerment over your life and your condition

Exposure exercises will be discussed and agreed upon in advance, and your therapist will protect your trust by not forcing or springing exposure exercises upon you. Because OCD robs people of their sense of autonomy, it is essential that the healing process restores autonomy and helps to rebuild a sense of trust in yourself, others, and the world around you.

Vibrant pink flowers on a cactus plant.

Examples of ERP treatment therapy

Understanding the research and process of ERP therapy is a great first step, but many people might wonder what these concepts look like in real life as part of therapy.

Exposure exercises should help you live your life, and they should improve your life and relationships in real and meaningful ways. As we say at Epiphany Center: “Exposure therapy is another way of saying ‘go live your life.’”

Possible exposures a person might work on in ERP include:

  • Dining out and touching utensils and flatware in a restaurant or cafe
  • Hugging your children when they arrive home from school
  • Sitting on your bed with clothing you wore outside your home
  • Cooking a meal using generally accepted cooking utensils and practices 
  • Petting an animal
  • Attending a dance class and dancing with people there
  • Enjoying a picnic with your family 

Next steps

Suppose fears about ERP are preventing you from seeking care. In that case, a wonderful and courageous first step can be to schedule an initial consultation and to talk openly about your fears and concerns with your prospective therapist. Building a warm rapport and learning about the exciting journey that ERP can offer you can help you to feel comfortable and hopeful in taking the next step.

For more information about seeking treatment for OCD, sign up for our free email course.

Sources

  1. Hezel DM, Simpson HB. Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Indian J Psychiatry. 2019 Jan;61(Suppl 1):S85-S92. doi: 10.4103/psychiatry.IndianJPsychiatry_516_18. PMID: 30745681; PMCID: PMC6343408.
  2. Ziegler S, Bednasch K, Baldofski S, Rummel-Kluge C. Long durations from symptom onset to diagnosis and from diagnosis to treatment in obsessive-compulsive disorder: A retrospective self-report study. PLoS One. 2021 Dec 13;16(12):e0261169. doi: 10.1371/journal.pone.0261169. PMID: 34898630; PMCID: PMC8668120.
  3. https://iocdf.org/blog/2026/04/06/the-most-effective-ocd-treatment-reaches-almost-no-one-heres-what-we-can-do-about-it/
  4. Law C, Boisseau CL. Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives. Psychol Res Behav Manag. 2019 Dec 24;12:1167-1174. doi: 10.2147/PRBM.S211117. PMID: 31920413; PMCID: PMC6935308.
  5. https://iocdf.org/about-ocd/ocd-treatment-guide/exposure-response-prevention/
  6. Kamryn T. Eddy, Lissa Dutra, Rebekah Bradley, Drew Westen, A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder, Clinical Psychology Review, Volume 24, Issue 8, 2004, Pages 1011-1030, ISSN 0272-7358, https://doi.org/10.1016/j.cpr.2004.08.004.

Rachel Tombaugh

Rachel Tombaugh

SEE FULL BIO

Rachel has devoted her professional life to helping others heal and reclaim their true potential, working as a psychotherapist and Licensed Professional Counselor in Arizona since 2011. Her therapy approach utilizes a unique combination of compassion, warmth, humor, and clinical excellence. Rachel believes that therapy should feel hopeful and connected, yet maintain focus on clinical sophistication and excellence. Equipped with a Bachelor of Arts degree in Psychology from Arizona State University and earning her Masters of Professional Counseling from Ottawa University, Rachel’s education inspired her to build a career devoted to helping people live with purpose, confidence, and joy. An accomplished writer and editor, Rachel has contributed to several publications devoted to education and advocacy with respect to OCD and anxiety. Rachel has extensive experience working in renowned treatment facilities in both the public and private sectors of healthcare, serving as Primary Therapist at an inpatient treatment facility for eating and anxiety disorders, developing specialty trauma and anxiety programs as a Clinical Director, and training and developing other therapists as Clinical Supervisor. Most recently, Rachel has worked within the private practice setting and has dedicated her efforts exclusively to the treatment of OCD, anxiety disorders, and PTSD. Offering a clinical repertoire that creates change and ensures meaningful results, Rachel has achieved advanced training in Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and Inference-Based Cognitive Behavioral Therapy (ICBT) for the treatment of OCD and anxiety, and extensive training in trauma-focused modalities including Eye Movement Desensitization and Reprocessing (EMDR). Each of these treatment approaches benefits from substantial evidence that it is effective, efficient, and creates positive change that can be trusted. Rachel brings great compassion, warmth, enthusiasm, humor, fun, and innovation to her therapy for each client and is passionate about working with people who have suffered from the traps of anxiety and trauma. Rachel is licensed in both Arizona and New Mexico and offers therapy in person and virtually in Arizona, and via telehealth in New Mexico. When not working with her clients, Rachel loves spending time outdoors with her family, her horse (“Gabriel”), several rescue pets, and a family of screech owls who live at her home in north Phoenix.

Read more Read more
Previous Previous

Will Trauma Therapy Traumatize Me?

Next Next

What to Expect at Your First Therapy Session

READY TO BEGIN YOUR
HEALING JOURNEY?

Taking the first step toward healing is courageous.
We're here to support you every step of the way.

SCHEDULE A CONSULTATION