Cognitive Behavioral Therapy (CBT) is a form of psychotherapy commonly employed to treat a large range of psychological disorders. CBT focuses on the idea that our thoughts and emotions trigger our actions and that awareness of these thought processes and behaviors can help us control our reactions to certain situations.
In 1966, British psychologist Victor Meyer took CBT a step further in treating patients with obsessive-compulsive disorder, OCD, and formed a new therapy called exposure and response prevention therapy, or ERP therapy. This type of therapy encourages a person to face their fears, source of anxiety, phobia or addiction, and then change the way they react to them. For example, a person addicted to alcohol may be repeatedly shown a bottle of liquor, inducing their intense cravings and then not be permitted to drink it. Someone with OCD who is afraid of germs and obsessively washes their hands may be forced to touch a dirty object such as a toilet or trash pile and not permitted to wash afterwards.
A person is repeatedly exposed to their triggers and taught coping mechanisms, stress management tools, and ways to effectively handle these situations in a healthier manner.
Exposure and response prevention therapy works to develop a type of conditioned response to situations and events. Over time and with repeated sessions of therapy, a person learns to confront these triggers and not react; for example, the alcoholic may have fewer cravings when shown a liquor bottle, and the OCD individual who is afraid of germs may have less anxiety about germs so there will be fewer obsessive hand washing episodes.
Who Is Best Suited for ERP Therapy?
Exposure and response prevention therapy is often used to successfully treat patients suffering from OCD to manage their symptoms. The Medical Clinic of Pennsylvania and Hahnemann University employed several studies to test how well ERP therapy worked for OCD patients and found that, generally speaking, patients responded in a favorable manner between 70 and 85 percent of the time with the treatment remaining effective for at least two years. Patients had fewer symptoms overall.
ERP is often considered the go-to treatment for OCD. It also seems to be effective in treating other forms of phobias and mental health disorders, including eating disorders and anxiety disorders. ERP can benefit those suffering from many different disorders, including:
- Obsessive-compulsive disorder
- Post-traumatic stress disorder
- Eating disorders
- Anxiety disorders
- Substance abuse disorder
Exposure and response prevention therapy can be very difficult at first and requires patience and diligence. Facing one’s fears or triggers can be very painful and requires the help of a trained professional. Everyone responds differently to therapy, and ERP therapy is no exception. Patients will need to be properly assessed to determine if it is the right type of therapy for them. Therapists will employ many different techniques specific to each individual and situation, and many will require homework.
Sometimes ERP therapy is done as part of a residential treatment plan and other times on an outpatient basis. ERP therapy requires multiple sessions that gradually work to decrease symptoms. It is not a miracle cure that works overnight, but rather takes time and effort to retrain the body and brain in how to act and react accordingly.
Benefits of ERP Therapy in Recovery
Discovering what triggers an anxiety attack, OCD episode, or a desire to abuse substances can be a useful tool in learning how to manage the disorder. Those suffering from a substance use disorder (SUD), for example, may have heightened cravings when in certain places, around specific groups of people, or when feeling a certain way.
Exposure and response prevention therapy works as a two-step process. First, the person is exposed to the trigger either directly, which is called “in vivo,” or if this isn’t plausible then they can be exposed through “imaginal” exposure. In vivo exposure is considered exposing someone to their trigger directly, like showing a crack cocaine user a pipe, while imaginal exposure is when a person is imagining a specific event or trigger. Both forms of exposure serve to bring about the cravings, feelings, and thought processes that typically lead to substance abuse.
The second step of ERP therapy is the responsive prevention part in which the therapist then works to help develop the tools necessary to not give in to their cravings. Preventing the response, in this case abusing substances, through exposure is called habituation. This serves as a form of conditioning where you are training your mind and body not to react to certain stimuli. ERP therapy sessions help patients to not only recognize their triggers but also to learn how to overcome them, enabling a newfound self-confidence and increased self-control. ERP therapy is also likely to help prevent future relapse as patients are not just detoxed and sent back into the world, but rather encouraged to discover the root of their addiction and how to avoid heading down the same destructive path in the future.
Dual Diagnosis Care
Often those suffering from mental health disorders such as eating disorders, OCD, PTSD, and other anxiety disorders may turn to substance abuse as way to cope or self-medicate, which can also lead to addiction and/or substance abuse disorders. Substance abuse exacerbates mental health disorders as well, and the combination of the two is very common. In fact, the National Alliance on Mental Illness postulates that nearly half of those abusing drugs and one-third of those abusing alcohol also suffer from a mental illness of some sort. Addiction is also considered a disorder, and when mental health disorders and substance abuse disorders are present in the same person at the same time, they are referred to as co-occurring disorders and require Dual Diagnosis care. With such care, both disorders are treated simultaneously for the best results. Exposure and response prevention therapy can be a useful tool in treating each separate disorder.
Michael’s House staff members are highly specialized in treating co-occurring disorders and utilize various therapy methods that pertain to the individual’s treatment plan. At our facility, professionals work to teach life skills and healthy coping mechanisms to prevent relapse and provide the necessary tools for a happy and healthy life.
Michael’s House provides a safe environment with skilled therapists intent on treating the whole person and not just the disorders they may suffer from. Our goal is long-term recovery and a brighter, healthier future. We recognize that men and women respond to therapy differently and offer specialized treatment programs that cater to each gender specifically. Call today to speak with an admissions coordinator about how to get started.