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OCD vs. Exposure & Response Prevention Therapy

Managing Obsessive-Compulsive Disorder with Exposure & Response Prevention Therapy

What is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder (OCD) is a psychological condition that is characterized by uneasiness, excessive worry, anxiety, obsessions, compulsions and the need to eliminate the triggers that are causing your angst. Obsessions are described as troubling beliefs, feelings, images and/or impulses that cause unwanted anguish and do not subside on their own, while compulsions, also known as “rituals,” are the coping mechanisms that you use to ease your anxiety and reduce your obsessive impulses.

It is important to remember that compulsions only relieve your obsessions temporarily. In fact, compulsive behaviors can actually increase your risk of experiencing re-occurring obsessions and compulsions. In other words, your compulsive behaviors reinforce your obsessions in a positive feedback loop sequence.

What is Exposure & Response Prevention Therapy?

Exposure & response prevention therapy is a type of cognitive-behavioral therapy that is often used in the treatment of obsessive compulsive disorder (OCD). This type of therapy gradually exposes you to the source of your obsession and encourages you to refrain from the compulsive behavior associated with it. For instance: during exposure & response prevention therapy, your therapist may help you determine why you are obsessed with making sure the door is locked and encourage you not to check the door 15 times before you go to work.

The first thing you will do during therapy is confront your minor obsessions and compulsions. Once you have successfully worked through these issues, you will then advance to more challenging obsessions and compulsions. Research suggests that this approach to OCD treatment is highly beneficial for relieving OCD symptoms. Exposure & response prevention therapy is typically combined with medication, family therapy and educational instruction.

How Can Exposure & Response Prevention Therapy Help You Manage OCD?

Exposure & response prevention therapy is considered the most effective OCD treatment because it not only helps you identify, understand and confront the triggers that are causing your obsessions; it also teaches you how to refrain from committing the compulsive behaviors associated with them. Response prevention is needed to help you stop the positive feedback loop sequence commonly associated with OCD. In order for this treatment approach to be successful, you must expose yourself to situations that trigger your obsessions and refrain from behaving compulsively in response to them.

During exposure & response prevention therapy, you will begin to notice a decrease in your OCD symptoms. This approach to OCD treatment consists of counseling sessions and outside homework, which is beneficial for helping you confront and conquer you OCD both in session and in the real world. As your anxiety decreases, your urge to perform compulsive behaviors will also decrease.

For instance: if you normally check the door 15 times before you leave for work, your therapist will be assign you outside homework (a weaning schedule), in which you only check the door 14 times for the first month, 13 times the next month and so on until you are only checking the door once before you leave for work. The purpose of exposure & response prevention therapy is to retrain your brain so that you no longer have obsessions and compulsions. This treatment approach teaches you how to trust your instincts and conquer your fears.

Once you finish exposure & response prevention therapy, your obsessions will decrease in frequency and strength because they will no longer be reinforced by your compulsive behaviors. In addition, when you expose yourself to the things you fear, your obsessions will weaken until you no longer experience anxiety when you are confronted with challenging situations. Furthermore, with time, practice and therapy, you will no longer be triggered by the same stimulus that you once were and you will be able to better manage your OCD symptoms.


Foa, E. B., Yadin, E. & Lichner, T. K. (2012). Exposure and response (ritual) prevention for obsessive-compulsive disorder: Therapist guide (treatments that work). New York, NY: Oxford University Press.

Shoenfelt, J. L. & Weston, C. G. (2007). Managing obsessive compulsive disorder in children and adolescents. Psychiatry, 4 (5), 47-53.


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