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Exposure and Response Prevention (ERP)

Posted Friday, 11 August 2023

Date issued: June 2023

Review date: June 2025

Ref: C-535/EL/Clinical Psychology/Exposure and Response Prevention (ERP)

All CWP interventions are based on CBT. They usually last between 6-8 sessions and progress continues after the end of intervention, especially when new ideas and skills are practised at home
The sessions can be with your child and/or you, face to face or via video and/or telephone call
Attending regular sessions is important for change

ERP is a suitable evidence-based intervention for young people who are experiencing mild to moderate traits of OCD (Obsessive Compulsive Disorder).
ERP is used for children who obsess over bad things that might happen and have compulsions to do certain things to reassure themselves or stop bad thing from happening.
ERP helps break this cycle by encouraging the facing of fears (exposure) and also stopping or reducing the compulsions (response prevention).

Learn about the anxiety cycle and how repetitive behaviours are keeping the young person stuch in the anxiety cycle
Identify any behavioural and thought based rituals, such as mentally saying a list of numbers, checking doors are locked a certain number of times or asking parents a list of questions before they go to bed
Create a plan to stop doing the compulsive actions and learn how to cope with the anxious feelings, until the obsessive thoughts start to reduce
We will set goals with the child and use structured self-help materials to learn the new brave behaviour and stop doing the things that were keeping the anxiety going

As with all our interventions, it is really important that the child or young person practices the techniques at home. As a caregiver, it would be great if you helped facilitate these tasks
Do provide gentle (but not pressured) reminders for the young person to practice reducing the ritualized behaviours
Aiming not to accommodate or enable these behaviours, otherwise this will reinforce rather than weaken the “OCD bully”
Sometimes family members or carers of people with traits of OCD have become involved in the compulsive behaviours, so we will also help to reduce their involvement in order to support the young person. If you are struggling with this, ask your Wellbeing Practitioner for advice.
Do avoid saying “don’t worry” – children with obsessions and compulsions cannot just stop worrying!
Although we understand it can be very tempting, it is important not to ‘rush’. If your child independently chooses to do more, that is fantastic!
Celebrate your young person’s attempts as well as successes, no matter how big or small
Remember it is a journey for the young person and with you beside them, they can achieve great things!

What to do when your brain gets stuck: A kids guide to overcoming OCD by Dawn Huebner
Search on YouTube for “Are you a kid battling with OCD obsessive thoughts?” or “Prevent OCD from getting worse with these OCD tips” and other videos by Natasha Daniels
Scan this QR code to take you straight to our anxiety Padlet or you can visit www.plymouthhospitals.nhs.uk/anxiety-resources

If you have any questions regarding this intervention or the CWP sessions, please do not hesitate to get in touch with your Wellbeing Practitioner!