Exposure and response prevention
Exposure and response prevention (ERP) is a treatment method available from behavioral psychologists and cognitive-behavioral therapists for a variety of anxiety disorders, especially Obsessive Compulsive Disorder. It is an example of an Exposure Therapy.
The method is predicated on the idea that a therapeutic effect is achieved as subjects confront their fears and discontinue their escape response.[1] The behavioral process is called Pavlovian extinction or respondent extinction [2] An example would be of a person who repeatedly checks light switches to make sure they're turned off. They would carry out a program of exposure to their feared stimulus (leaving lights switched on) while refusing to engage in any safety behaviors. It differs from Exposure Therapy for phobia in that the resolution to refrain from the avoidance response is to be maintained at all times and not just during specific practice sessions. Thus, not only does the subject experience habituation to the feared stimulus, they also practice a fear-incompatible behavioral response to the stimulus. While this type of therapy typically causes some short-term anxiety, this facilitates long-term reduction in obsessive and compulsive symptoms.[3]
Recent results (Lovell et al., see below) indicate that ERP can be carried out effectively with minimal face-to-face contact between the therapist and the subject.[4]
The results of a 2008 study indicate that simultaneous administration of d-cycloserine substantially improves effectiveness of exposure and response prevention.[5]
Please refer to the Obsessive Compulsive Disorder article for elaboration on ERP and its effectiveness.
Organizations
Exposure and response prevention is a behavior therapy technique. Many organizations exist for behavior therapists around the world. The World Association for Behavior Analysis offers a certification in behavior therapy. [1] Their exam tests knowledge of this technique.
References
- ↑ Huppert & Roth: (2003) Treating Obsessive-Compulsive Disorder with Exposure and Response Prevention. The Behavior Analyst Today, 4 (1), 66 - 70 BAO
- ↑ Michael P. Twohig, Maureen L. Whittal, Jared M. Cox & Raymond Gunter (2010)An initial investigation into the processes of change in ACT, CT, and ERP for OCD. International Journal of Behavioral Consultation and Therapy, 6(1), 67- 81 BAO
- ↑ Audio-taped exposure therapy in a case of obsessional neurosis By Thyer, Bruce A. 9-1985
- ↑ Lovell K, Cox D, Haddock G, Jones C, Raines D, Garvey R, Roberts C, Hadley S. (2006) Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: randomised controlled non-inferiority trial. BMJ. Oct 28;333(7574):883
- ↑ Wilhelm, Sabine; Ulrike Buhlmann, David F Tolin, Suzanne A Meunier, Godfrey D Pearlson, Hannah E Reese, Paul Cannistraro, Michael A Jenike, Scott L Rauch (2008-03). "Augmentation of behavior therapy with D-cycloserine for obsessive-compulsive disorder". The American Journal of Psychiatry 165 (3): 335–41. doi:10.1176/appi.ajp.2007.07050776. PMID 18245177.
Further reading
- Stop Obsessing, by Foa, Edna
- Marks I (1981) Cure and Care of Neuroses John Wiley & Sons Inc 0-471-08808-0
- Marks I. (1997) Behaviour therapy for obsessive-compulsive disorder: a decade of progress. Can J Psychiatry. Dec;42(10):1021-7.
- Lovell K, Cox D, Haddock G, Jones C, Raines D, Garvey R, Roberts C, Hadley S. (2006) Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: randomised controlled non-inferiority trial. BMJ. Oct 28;333(7574):883
