ERP Therapy Exercises to do with Clients

Posted by Tim Tarks on April 7th, 2023

ERP (Exposure and Response Prevention) therapy is a type of cognitive-behavioral therapy used to treat anxiety disorders, such as OCD (Obsessive-Compulsive Disorder), phobias, and PTSD (Post-Traumatic Stress Disorder). Here are some ERP therapy exercises that can be done with clients:

1. Exposure Hierarchy: Create an exposure hierarchy with your client, listing out the situations or stimuli that trigger their anxiety. Arrange the list from least to most anxiety-provoking. Start with the least anxiety-provoking item on the list and gradually move up to the most anxiety-provoking item.
2. Imaginal Exposure: Have your client imagine the situation or stimulus that triggers their anxiety while in a relaxed state. Guide them through the visualization process while encouraging them to sit with their anxiety and not engage in any compulsive behaviors.
3. In-Vivo Exposure: Have your client confront the situation or stimulus that triggers their anxiety in real life. Encourage them to resist the urge to engage in any compulsive behaviors and to remain in the situation until their anxiety subsides.
4. Delayed Response: Have your client delay their compulsive response to a trigger. Encourage them to wait a few minutes before engaging in their compulsive behavior, then gradually increase the delay time.
5. Scripting: Have your client write a script of a feared situation, detailing their anxiety and how they typically respond to it. Have them read the script aloud and resist the urge to engage in any compulsive behaviors.
6. Interoceptive Exposure: Have your client engage in physical sensations that mimic the sensations they experience during an anxiety attack, such as hyperventilation or holding their breath. Encourage them to resist the urge to engage in any compulsive behaviors and to sit with the sensations until they subside.

It's important to note that ERP therapy should be done under the guidance of a licensed mental health professional who has experience with this type of therapy. A therapist can use ERP therapy worksheets to help facilitate these exercises. These exercises should be tailored to the specific needs of each client and should be done in a safe and supportive environment.