General Description

Exposure and Response Prevention is the most widely practiced behabiour therapy for OCD. The exposure part of this treatment involves directly or imagined exposure to objects that trigger obsessions and anxiety. The exposure over time will lessen the anxiety and cause habituation. The response aspect of this treatment refers to the stopped the ritualistic behaviours carried out to lessen the anxiety. The patients learn to resist the compulsion to perform rituals.

Before treatment

Patients make a list, hierachy, of situations which trigger obsessional fears.

Treatment

Treatment starts with exposure to situations which cause low/mild anxiety. Once the patient habituates to this trigger they move up to situations which cause greater anxiety. Exposure tasks are usually performed with a therapist and last between 45 minutes and 3 hours. Patients are also asked to practice exposure tasks between sessions.

How to track the progress

To mark the progress during exposure tasks patients are trained to rate their anxiety levels. The patients are asked to use the skills when new situations arise. A typical course of ERP treatment is between 14 and 16 weeks.

Abramowitz et al, 1999

15 OCD patients comorbid with major depressive disorder and 33 OCD patients without MDD were examined with their treatment outcome. All the patients received ERP. Improved in both groups occurred and the treatment gains were maintained at follow-up. However those patients without MDD showed significantly lower post-treatment and follow up OCD severity scores. It was therefore concluded that ERP is sucessful for the treatment of OCD however is more effective in patients who do not have depression.

Abramowitz et al, 1999 - Evaluation

This study has high reliability as a control group was used which means that the results can be applied not only to OCD patients comorbid with MDD but all patients with OCD which increases the reliability and