What is ERP?

Helping you face fears without letting anxiety take over

Exposure and Response Prevention (ERP) is an evidence-based form of Cognitive Behavioral Therapy (CBT) and one of the most effective treatments for OCD and anxiety disorders.

When we feel anxious, it’s natural to want to avoid whatever is making us uncomfortable. We may seek reassurance, check things repeatedly, avoid certain situations, or perform rituals to feel safer. These strategies can bring relief in the short term, but over time they can keep anxiety and OCD going.

ERP helps change that cycle.

How does ERP work?

In ERP, you gradually practice approaching the thoughts, situations, sensations, or experiences that trigger anxiety while learning to reduce the avoidance, reassurance, rituals, and other behaviors you typically use to feel safe.

This is done collaboratively and at a pace that feels challenging but manageable. ERP is not about throwing you into your biggest fear or forcing you to do something before you’re ready.

Instead, you and your therapist develop a personalized plan for practicing new ways of responding to anxiety. Over time, you learn:

  • I can experience anxiety without immediately trying to make it go away.

  • I can tolerate uncertainty and discomfort.

  • I don’t have to believe or respond to every anxious thought.

  • I can do difficult things even when anxiety is present.

  • Anxiety doesn’t have to determine the choices I make.

What can ERP treat?

ERP can be helpful for children, teens, and adults experiencing:

  • Obsessive-Compulsive Disorder (OCD)

  • Social anxiety

  • Panic disorder

  • Specific phobias

  • Health anxiety

  • Emetophobia (fear of vomiting)

  • Separation anxiety

  • Perfectionism and anxiety

  • School avoidance related to anxiety

What does exposure actually look like?

Exposure therapy is individualized based on what someone fears and what anxiety is getting in the way of.

For someone with social anxiety, an exposure might involve asking a question in a group or intentionally allowing an awkward moment.

For someone with contamination OCD, it might mean touching something that feels “contaminated” and resisting the urge to wash or seek reassurance.

For someone with panic, it might involve intentionally practicing uncomfortable physical sensations and learning that they can experience those sensations without escaping or trying to control them.

For a child with anxiety, exposure might look like gradually practicing separation from a parent, speaking to someone new, or doing something independently.

The goal isn’t to eliminate anxiety. The goal is to help you become more confident in your ability to handle anxiety, uncertainty, and discomfort so you can get back to doing the things that matter to you.

Response Prevention: The Other Half of ERP

Exposure is only one part of ERP. Response Prevention involves changing the behaviors that keep the anxiety cycle going.

Depending on the person, this might mean practicing:

  • Asking for less reassurance

  • Checking less

  • Resisting compulsions or rituals

  • Spending less time researching feared outcomes

  • Reducing avoidance

  • Allowing uncertainty instead of trying to find a definite answer

With practice, people can learn that they don’t need these strategies to manage anxiety—and that they are capable of handling much more than anxiety tells them they can.

ERP at Maryland CBT Center

Our therapists use evidence-based exposure therapy in a collaborative, individualized way. We work with children, teens, and adults to understand what anxiety or OCD has been getting in the way of and develop practical exposures that translate into everyday life.

Exposure work may take place in the therapy office or, when appropriate, in real-world settings where anxiety actually happens.

Our goal isn’t simply to help you feel less anxious. It’s to help you become less limited by anxiety.