Exposure and Response Prevention (ERP): The Most Effective OCD Treatment Explained
When you’re living with OCD, it can feel like your mind is working against you, generating intrusive thoughts and irrational rules that drive fear, shame, or uncertainty. Obsessive-compulsive disorder (OCD) and related anxiety disorders often interfere with the ways in which individuals respond to everyday situations, making even simple tasks feel overwhelming.
The good news: there’s an evidence-based treatment that works.
Exposure and Response Prevention (ERP) is the gold standard for OCD care. Backed by clinical research and real-world outcomes, ERP is a powerful therapy model designed to help individuals face their fears, reduce compulsions, and reclaim meaningful parts of their lives.
ERP is at the core of our specialized OCD and Anxiety Treatment Programs at Compass Health Center, offered daily (5x a week) and available in both in-person and virtual settings for children, adolescents, young adults, and adults.
Why Exposure and Response Prevention Works for OCD
ERP helps individuals change their relationship with anxiety, not by eliminating distressing thoughts or sensations, but by learning to tolerate them and continue living in alignment with their values.
Here’s how ERP works:
- Exposure: Repeatedly confronting feared thoughts, situations, or sensations.
- Response Prevention: Resisting the urge to use compulsions or avoidance strategies to reduce anxiety.
Over time, this process builds what’s known as inhibitory learning, the idea that individuals can learn new, more accurate associations with anxiety triggers. Rather than reinforcing fear-based responses, ERP helps individuals discover that their feared outcomes are unlikely, manageable, or less threatening than they believed.
Clinical Benefits of ERP
Research shows ERP is highly effective for treating:
- Obsessive-Compulsive Disorder (OCD)
- Panic Disorder
- Social Anxiety
- Illness Anxiety
- Generalized Anxiety Disorder (GAD)
- Specific Phobias
Through ERP, individuals often learn:
- Their anxiety overestimates threat and underestimates their ability to cope
- Unwanted outcomes can be navigated more effectively than expected
- It’s possible to live a values-driven life even with the presence of anxiety
How ERP Works at Compass
ERP is woven into our broader treatment model in our OCD & Anxiety Programs. Patients work with their care team to build a personalized exposure hierarchy, a list of anxiety-provoking situations ranked from least to most distressing. This hierarchy guides treatment and ensures that exposures are introduced gradually, thoughtfully, and in a way that builds confidence.
No one is pushed to do anything unreasonable or for which they are not ready. Instead, progress happens at a pace that balances safety with growth.
Types of Exposures Used in ERP
ERP therapy can include different types of exposures, depending on the specific fears or compulsions being treated:
- In Vivo Exposures: Direct confrontation of feared objects or situations
Example: Touching a doorknob without washing hands afterward - Interoceptive Exposures: Deliberate exposure to physical sensations associated with anxiety
Example: Spinning in a chair to trigger dizziness - Imaginal Exposures: Written or recorded scripts that explore feared outcomes
Example: Narrating the fear of being fired or causing harm
By practicing these exposures in different contexts and settings, individuals develop lasting change; not just symptom relief, but new ways of engaging with life.
ERP vs. Traditional Talk Therapy
While talk therapy can be helpful for many mental health conditions, it often falls short for those with moderate to severe OCD. ERP provides a more structured, action-oriented approach that targets the core mechanisms of OCD, such as obsessions and compulsions, head-on.
At Compass, we integrate ERP with complementary therapies such as ACT (Acceptance and Commitment Therapy), CBT (Cognitive Behavioral Therapy), DBT (Dialectical Behavior Therapy), and psychiatric care. This whole-person approach supports not only symptom reduction but long-term growth and functioning.
When ERP in a Higher Level of Care Is Recommended
If OCD or anxiety symptoms are significantly interfering with your ability to function at work, in school, or in daily life, weekly outpatient therapy might not be enough. Compass offers:
Treatment duration is tailored based on individual needs and collaborative goals between patients and providers. Whether you start in PHP or IOP, our goal is always the same: effective, compassionate, evidence-based care that helps you move forward.
Whether you’ve just received a diagnosis or have been struggling for years, our outcomes show what’s possible when treatment is both evidence-based and compassionate. Patients experience meaningful shifts, from severe or moderate to mild or subclinical, across anxiety and depression.
Recent Patient Treatment Outcomes from our OCD & Anxiety Programs
(January 2024 – June 2025*)
| 40% reduction in OCD symptoms Y-BOCS | Relative size: Large | Effect size: 1.85 | 55% reduction in depressive symptoms PHQ-9 | Relative size: Large | Effect size: 1.93 |
| 52% reduction in generalized anxiety GAD-7 | Relative size: Large | Effect size: 2.10 | 31% reduction in experiential avoidance BEAQ | Relative size: Large | Effect size: 1.75 |
*Effect size is a measure of differences between two groups, in this case, the severity of symptoms at the start of treatment compared to the end. A small (difference) effect = .2; A medium = .5; and a large = .8 or higher.
Why ERP at Compass Works
Our specialized OCD and Complex Anxiety programs are available at Compass Health Center’s Illinois, Maryland, Virginia, Washington, D.C., and Wisconsin locations, and virtually across Illinois. Every patient receives:
- Daily ERP (5x a week) from specialized, ERP-trained therapists
- Immediate, integrated psychiatric support
- Specialty groups based on subtype (e.g., contamination, harm OCD, perfectionism)
- ACT-based skill building and values clarification
- Family therapy and psychoeducation
“The best part about being an exposure therapist is teaching people the tools they need to start relating to their anxiety in a different way and seeing things ‘click’ as they develop an exposure mindset approach to living. They begin to take on new challenges and build confidence in their abilities in real-time. They stop letting their anxiety dictate what they do and start living more by their values – it’s inspiring!”
– Talia Stoehr, LCSW, Director, OCD and Anxiety Program
Contact Compass to See If ERP Is Right for You
Our latest outcomes reflect the impact of personalized care and daily ERP (5x a week). With our recent program enhancements, we’re seeing even stronger results. OCD and anxiety are powerful, but you are stronger. With the right treatment and support, real change is possible.
If OCD or anxiety is interfering with your ability to live the life you want, Compass can help. Our clinical team can walk you through a same- or next-day assessment to determine whether ERP in a higher level of care is the right fit.
Ready to disrupt the cycle? Contact us today to learn more or schedule an assessment.
