Exposure Therapy

What is Exposure Therapy?

Did you know most anxiety disorders could probably be called Avoidance Disorders? That’s why the treatment for anxiety is exposure to the fearful/avoided objects or situations.

Exposure and response prevention (ERP) is a treatment designed to gradually reduce the anxiety that feeds obsessions and compulsions. Over time, individuals will learn that the stimuli, thoughts, and emotions prompting compulsions are more tolerable than anticipated. Individuals will also realize that being exposed to identified fears does not lead to their dreaded outcomes and that they are able to cope with triggers while not acting on compulsions.

The exposure component of ERP refers to the confrontation of stimuli, thoughts, and emotions that lead to anxiety and elicit obsessions. The response prevention component of ERP refers to learning and making the choice to not respond to obsessive thoughts by acting on a compulsion. ERP will include exposures in a variety of environments, depending on the need of the individual, with exposures being done while during and outside of session times.

Exposure with Response Prevention (ERP) Intensive Programming 

The ERP Intensive Program is specially designed for children, adolescents, and adults who would benefit from more targeted treatment of symptoms. The Intensive Program identifies and addresses triggers to emotion dysregulation, rigid thinking, eating difficulties and obsessions and helps patients prevent ineffective mental and behavioral engagements.

Our approaches include Exposure with Response Prevention (ERP), Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Dialectical Behavioral Therapy (DBT). The Intensive program varies in frequency and duration as it is based on the needs of the individual (including homework over the weekend).

Each patient and their family meets one-to-one with a team of at least three providers. Our team includes psychiatrists and therapists. You will have a primary therapist who is part of your treatment team.

Treatment Schedule

1. Phone consultation with Intake Coordinator

  • Goals are to assess level of care recommendations and introduce programming. The Intake Coordinator can also discuss lodging and transportation recommendations.

2. Initial intake and pre-commitment with individual Provider (4-6 weeks of once weekly individual 45-minute sessions)

  • Psychoeducation (including family members)

  • Psychological assessment

  • Structuring the environment

  • Learning non-avoidant coping

  • Treatment planning and case formulation

  • Development of exposure hierarchy

3. Intensive Week

  • Review assigned homework exposures

  • Exposure and skills development protocols

  • Assign homework for the evening

4. Follow-ups

  • 45-minute sessions focused on relapse prevention

  • Typically once weekly for 6 months following the intensive week

What can be treated with exposure & intensive programing?

  • Our anxiety and intensive program addresses anxiety, social anxiety, and phobias, among other anxiety-based disorders. More broadly this category includes:

    • Separation Anxiety

    • Selective Mutism

    • Specific Phobias

    • Social Anxiety Disorder

    • Panic Disorder

    • Agoraphobia

    • Generalized Anxiety Disorder

  • Our program treats obsessive-compulsive and related disorders which may involve obsessions (intrusive thoughts or urges), compulsions (repetitive behaviors or mental acts), and/or recurrent body-focused repetitive behaviors. This category includes: Obsessive-Compulsive Disorder, Hoarding Disorder, Trichotillomania (Hair-pulling) and Excoriation (Skin-Picking).

    Common treatment targets include:

    Compulsions related to:

    • Washing

    • Checking

    • Reassurance seeking

    • Repeating

    • Apologizing

    • Confessing

    • Straightening

    • Counting

    • Perfectionism

    • Prayer

    • Mental checking

    Obsessions/intrusive thoughts related to:

    • Doubt

    • Sex/Sexuality

    • Violence

    • Immortality/blasphemy

    • Contamination

    • Asymmetry

    • Abuse/pedophilia

    • Flaws in appearance

    • Physical symptoms/somatic obsession

    • Figuring it out (eg, "Am I a good person?", "Am I gay?")

    Other Targets:

    • Fear of flying, animals, or other specific phobias

    • Social Anxiety

    • School Avoidance