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Exposure Response Prevention: Common Questions & Beliefs

Updated: 6 days ago

By Victoria Washburn, LMFT | Adolescent, Young Adult & Couples Therapist

Exposure therapy is an evidence-based practice for the treatment of Obsessive Compulsive Disorder (OCD) (Ferrando & Selai, 2021). OCD treatment involves facing anxiety, fear, or intrusive thoughts in a therapeutic setting rather than avoiding, compulsing, or investigating.

The following are common questions for individuals seeking therapeutic support:

What should I expect with exposure therapy?
What if I don't want to do an exposure?
Does talk therapy work for OCD?

In the initial assessment period, one can expect an investigation of presenting symptoms and identification of current therapeutic struggles and needs. The therapist will gather personal history details and create a treatment plan for your individual needs. An integral part of treatment is psycho-education on OCD, the cycle of anxiety and the mechanism of exposure response prevention (ERP) (International OCD Foundation, 2023). ERP exercises involve gradually and willingly exposing yourself to feared scenarios while monitoring anxiety response levels. A common fear is being forced to engage in unwanted exposures; when in fact your therapist will support your terms of readiness to confront your fears.

Exposure therapy can bring about initial spikes of anxiety, which are mitigated by a gradual decrease in obsessional thoughts and compulsive behavior, and higher anxiety tolerance. One will also learn to manage common worries and develop self confidence (International OCD Foundation, 2023). By increasing awareness around the rules your OCD has created to help you cope with anxiety, you and your therapist will identify a rules hierarchy. From this list you will collaborate on which rules to challenge and at what pace.

By increasing awareness around the rules your OCD has created to help you cope with anxiety, you and your therapist will identify a rules hierarchy.

Talk therapy has not been found to be the gold standard for OCD treatment, however talk therapy can be very beneficial for other mental health disorders (International OCD Foundation, 2023).

It is important to remember that each individual has their own unique needs and preferences. We encourage you to ask your provider questions to make sure your specific needs are addressed. West Coast Integrative Mental Health therapist Tori Washburn, LMFT is accepting new clients who are seeking OCD treatment options.

To connect with Tori Washburn, LMFT, please complete this consultation form. Our team will get back to you within 2 business days.


Melchior, K., van der Heiden, C., Deen, M., Mayer, B., & Franken, I. H. (2023). The effectiveness of metacognitive therapy in comparison to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial. Journal of Obsessive-Compulsive and Related Disorders, 36, 100780.

Ferrando, C., & Selai, C. (2021). A systematic review and meta-analysis on the effectiveness of exposure and response prevention therapy in the treatment of Obsessive-Compulsive Disorder. Journal of Obsessive-Compulsive and Related Disorders, 31, 100684.

International OCD Foundation, 2023, National Collaborating Centre for Mental Health, 2006, Abramowitz, Deacon, & Whiteside 2019

National Collaborating Centre for Mental Health (UK. (2006). USE OF HEALTH SERVICE RESOURCES. In Obsessive-Compulsive Disorder: Core Interventions in the Treatment of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder. British Psychological Society (UK).

Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. (2019). Exposure therapy for anxiety: Principles and practice. Guilford Publications.

International OCD Foundation. (2023). About the IOCDF. Retrieved July 6, 2023, from


Victoria (Tori) Washburn, LMFT is an adolescent, young adult, and couples therapist at West Coast Integrative Mental Health.

She offers clinical support for interpersonal challenges, relationship issues, stress, career transitions, obsessive compulsive disorder, anxiety, and substance use issues. Tori specializes in the following interventions: CBT, Acceptance Commitment Therapy, Exposure Response Prevention, and Psychodynamic Therapy. She also uses the Havening Technique for individuals with stress, trauma and anxiety. She is currently accepting new clients for virtual therapy in California, USA.

More about Victoria Washburn, LMFT


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