How does CBT and ERP Therapy works?

With the high-rising statistics related to the issues, we have found a way to treat them along with many other mental and physical health problems.

A Behavior Therapy called CBT or Cognitive Behavioral Therapy that is believed to be a very useful method used for treating OCD. Cognitive Therapy (CT) and Exposure Response Prevention (ERP) are two of the main evidence-based techniques involved in the treatment of CBT.

CBT is based on the concept that with negative feelings and thoughts, you can be trapped in a vicious cycle together with cognitions, emotions and physical sensations.

It is believed that CBT can help you manage your problems by simply changing the way you behave and think. Changing your behaviour together with proper medication is the only effective and scientifically-supported treatment for OCD.

We can help you face overwhelming problems in a more positive manner by means of breaking down your issues into smaller parts as you learn to respond overtime.

CBT is aimed to work in a time-limited manner, meaning if significant symptom relief has been manifested, treatment can be ended making it more generally effective and shorter as compared to traditional talk therapy. But longer treatment will also be provided for those who need additional therapy to create lasting change.

Compared to other talking treatments, CBT finds practical ways that could aid in improving one’s state of mind on a daily basis.

Exposure Response Prevention (ERP) on the other hand is substantiated in the evidence that after pervasive connection with the feared object can cause to decrease anxiety. For example, if you have an anxious fear of germs, a therapist would expose you to a place or thing which you believe is contaminated with germs until your anxiety slowly diminished. Eventually after repeated exposure, your anxiety will decrease until the fear for the object has been extinguished.

It is recommended to combine your exposure to response of ritual prevention (RP) to be most helpful.  In this method, a person’s avoidance or rituals are deterred in a way that the client should only not touch “germy things” but should also avoid the ritual of washing hands to prevent it. This process is called “habituation”, a method in which people learn that when they stop performing rituals, nothing bad actually happens to them.

When exposure to therapeutic are repeated over time, anxiety then decreases until it is no longer noticeable to the point of entirely fading. The individual is then urged to take more challenging exposure until they become manageable like the others. This method will then lead to realization that nothing bad will happen if rituals will be stopped.

Another component of the CBT is Cognitive Therapy (CT) it is often incorporated to E/RP to lessen over thinking and magnified sense of responsibility brought about by OCD. It helps a person modify and identify patterns that cause distress, negative behaviour and anxiety.

By way of explanation, CT enables a patient figure out that the brain is dispatching “error” messages. With the help of Cognitive Therapy, an individual may learn to identify these errors and find new ways to respond to confront the obsessions.

For instance, a wife with OCD may be thinking that her failure to remind her husband to put on his seat belt will cause him to die in car related accident that day. Applying Cognitive Therapy, there is no need to check on the husband regularly to ensure that he has arrived safely.

Strategies like learning to separate oneself from the disarray, self-talk and analyzing the probability of a catastrophe or evaluating the more realistic chances are part of Cognitive Therapy.

Some CBT treatments are conducted on a weekly basis that is composed of sessions with daily exposures to be completed. But in some cases, people may need frequent sessions or even residential treatment.

There are other techniques that could sometimes be helpful but not as effective as CBT such as:

  • Thought stopping and distraction ( Includes concealing or suppressing OCD symptoms)
  • Satiation (With the use of a closed-loop audiotape, prolong listening to obsession will be conducted.)
  • Habit Rehearsal (non-OCD behavior will be used to replace OCD ritual)
  • Contingency Management (Rewards and costs are used as incentive for ritual prevention)


Compared to Traditional Psychotherapy, which focuses on helping an individual to develop insight into their problem rather than deliberately and voluntarily confront the problem.  The specific behaviour therapy approach known as “Exposure and Response Prevention” is more effective to people with OCD.

In this way, the patient is highly encouraged to avoid ritualizing. Perfect example would be an individual who develops a compulsive disorder to wash hands regularly will be then encourage to touch things believed to be contaminated then urged to avoid washing her hands for several hours until a decrease from their anxiety is noticed.

Guided by patient’s ability to control the ritual and tolerate the ability, treatment then proceeds on a successive basis and as the medication progresses, most patients deliberately experience minimal anxiety from their obsessive thoughts they are able to resist their compulsive urges.

Studies conducted to determine the effects of Cognitive-Behavioral Therapy to those who suffer from OCD has proved that almost 76 percent on average has shown to be clinically significantly relief from 3 to 6 years after undoing the treatment. Out of 300 OCD patients, many were successfully treated.  A positive indication that together with positive and highly motivated, attitude OCD is a treatable condition.