Exposure and Response Prevention Therapy

What is exposure and response prevention therapy?

Exposure and response prevention therapy (ERPT) is a treatment used to change problem behaviors to healthier ones. ERPT helps children to face their fears. ERPT can help with problems such as:

• obsessive-compulsive disorder (OCD)
• panic attacks
• post-traumatic stress disorder (PTSD)
• agoraphobia (fear of being alone in public places)
• social anxiety disorder
• specific phobias such as fear of dogs
• eating disorders such as anorexia and bulimia
• other anxiety disorders such as separation anxiety disorder

What happens during a typical therapy session?

The therapist will meet with you and your child to ask questions about how often the child has the problem, how severe the reaction is, how long it lasts, and what seems to cause it. The therapist will develop a treatment plan and goals for your child. The child must agree with the goals. Goals should not be imposed on a child.

Once the goals are set, then specific steps are taken, such as teaching the child about the particular problem. ERP therapists stress that fear and anxiety are learned and can be unlearned.

For people struggling with OCD, research has shown ERPT to be effective in reducing compulsive rituals. Children are exposed to what they fear and then are prevented from engaging in their usual ritual to reduce that fear. For example, if children wash their hands all the time because they are afraid of being dirty, the therapist might have the child touch something dirty such as a doorknob. Then the two of them might stand at the sink without washing hands until the anxiety goes away. Children learn ways to control their body's response to anxiety, like breathing exercises. The exposure would occur many times over 20 sessions or more, and the child's typical ritual response would be prevented.

How can I find an ERP therapist?

Trained mental health specialists provide ERPT. Ask the therapist if they know ERPT when you make the first appointment. To find a therapist who specializes in working with children and teens, check with:

• your family healthcare provider
• your child's school counselor
• friends or family members who have been in therapy
• local associations of psychologists, social workers, or psychiatrists