Exposure and Response Prevention

Obsessions are unwanted thoughts

and images that pop into your mind How could this tool help me?
that you find unacceptable, or that

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make you feel anxious. Compulsions You might feel anxious about exposing yourself to something that you are
are things that you do in response

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afraid of, but ERP has been proven across multiple research studies to be an
to your obsessions, whether it’s to effective way of helping people overcome their symptoms of OCD.

wit nlo r:
stop harm from occurring, or to make

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With practice, many people find that ERP means they’re less bothered by
yourself feel better. If your obsessions

ng dow n fo
intrusive thoughts, feel less anxious, and are more free to live their life

h y ad
and compulsions interfere significantly

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without OCD.
with your life, you might have obsessive
compulsive disorder (OCD).
Exposure and response prevention
How should I use it?

a
(ERP) is an evidence-based treatment
for OCD. It involves exposing yourself to
a situation that triggers your obsession
(the ‘exposure’ part of ERP) and resisting
the urge to perform the compulsion (the
sh free pl Fill in the Exposure and Response Prevention form whenever you conduct a
session of ERP.
for rk- aid
Start by describing the obsessions and compulsions that arise in the
‘response prevention’ part of ERP). situation you’ve chosen to face:
• Situation / trigger: Choose the situation that you will expose yourself to
with ERP.
ed ma a p

Exposure And Response Prevention

• Obsessions: Describe your typical obsessive thoughts and fears in this

Exposure and Response Prevention is about exposing yourself to a situation that triggers your obsessions
or compulsions (exposure), and then deliberately resisting the urge to carry out the compulsion that would
normally relieve your anxiety (response prevention).

situation.
Situation / Trigger Obsession Compulsion
What situations trigger my obsession? What is the thought, image, urge or What do I do to make myself feel better
impulse that bothers me? when I get the obsession?

• Compulsions: Describe what you typically do to prevent an unwanted

outcome when you have these obsessions.
o

EX/RP Instructions
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1. Expose yourself to the trigger.

2. Resist performing the compulsion.
3. Record how distressed you feel over time using the graph below.

To carry out exposure and response prevention:

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4. If you do perform the compulsion, expose yourself to the trigger again.

1. Expose yourself to the triggering situation.

e

As bad as it can get 100

80

Subjective

2. Resist performing your compulsions.

60
Units Of
Distress
d

(SUDS) 40

20

No distress at all 0
0 10 20 30 40 50 60 70 80 90 100 3. Use the graph to record how distressed you feel as time passes.
- L - W gra

Time (minutes)
ns ter

PSYCHOLOGYT LS
®
Copyright © 2020 Psychology Tools Limited. All rights reserved.

Helpful tips
Up
a

• Practise completing some ERP in session with your therapist at least once
before practising on your own.
• Keep your record nearby so you can rate your distress throughout the
session. Try to do this every 10 minutes.
• You will need to do ERP long enough for your distress to decrease.
A helpful rule is to do each exposure for around 1 hour, or until your
ice

distress has dropped by 50%.

• Repetition is one of the most important parts of ERP. Aim to do it every
day for 1–2 hours. Your therapist might have recommendations around
how you should use it.
• Hold on to your ERP records – it may be helpful to review them if your
obsessions or compulsions return in the future.

Copyright © 2023 Psychology Tools Limited. All rights reserved.

Exposure And Response Prevention
Exposure and Response Prevention is about exposing yourself to a situation that triggers your obsessions
or compulsions (exposure), and then deliberately resisting the urge to carry out the compulsion that would
normally relieve your anxiety (response prevention).

ts
Situation / Trigger Obsession Compulsion
What situations trigger my obsession? What is the thought, image, urge or What do I do to make myself feel better
impulse that bothers me? when I get the obsession?

lien
wit nlo r:
ou s
ng dow n fo
h y ad
rc
a
EX/RP Instructions sh free pl
for rk- aid
1. Expose yourself to the trigger.
2. Resist performing the compulsion.
3. Record how distressed you feel over time using the graph below.
ed ma a p

4. If you do perform the compulsion, expose yourself to the trigger again.

o

ari
t

As bad as it can get 100

d e

80
- L - W gra

Subjective 60
ns ter

Units Of
Distress
(SUDS) 40
Up
a

20

No distress at all 0
0 10 20 30 40 50 60 70 80 90 100
Time (minutes)
ice

PSYCHOLOGYT LS
®
Copyright © 2020 Psychology Tools Limited. All rights reserved.
Exposure And Response Prevention
Exposure and Response Prevention is about exposing yourself to a situation that triggers your obsessions
or compulsions (exposure), and then deliberately resisting the urge to carry out the compulsion that would
normally relieve your anxiety (response prevention).

ts
Situation / Trigger Obsession Compulsion
What situations trigger my obsession? What is the thought, image, urge or What do I do to make myself feel better
impulse that bothers me? when I get the obsession?

lien
Seeing dirty things – Image of my family Clean myself and

wit nlo r:
worst things are used

ou s
getting ill – it would be anything my family
nappies or plasters.

ng dow n fo
h y ad
my fault. might touch.

rc
a
EX/RP Instructions sh free pl
for rk- aid
1. Expose yourself to the trigger. – Hold a used nappy.
2. Resist performing the compulsion. – Not wash my hands.
3. Record how distressed you feel over time using the graph below.
ed ma a p

4. If you do perform the compulsion, expose yourself to the trigger again.

o

ari
t

As bad as it can get 100

d e

80
- L - W gra

Subjective 60
ns ter

Units Of
Distress
(SUDS) 40
Up
a

20

No distress at all 0
0 10 20 30 40 50 60 70 80 90 100
Time (minutes)
ice

PSYCHOLOGYT LS
®
Copyright © 2020 Psychology Tools Limited. All rights reserved.