Exposure Therapy and Exposure and Response Prevention (ERP)

Exposure treatment and Exposure and Response Prevention (ERP) are types of cognitive-behavioral therapies (CBT) that are highly effective in treating anxiety and obsessive-compulsive disorder (OCD) in children and adolescents. Exposure and ERP involve gradually exposing the child to their fears. ERP also includes preventing children from engaging in their compulsions that make them feel better in the short term but worsen their anxiety in the long term.

Exposure and ERP are based on the principle of habituation, which is the process of becoming less sensitive to a stimulus over time. When a child is afraid of something, their body goes into "fight-or-flight" mode, releasing stress hormones such as cortisol. This can cause physical symptoms such as a racing heart, sweating, and shortness of breath. If the child avoids the thing they fear, they never have the opportunity to learn that it is not actually dangerous. Exposure/ERP help children to learn that they can tolerate their anxiety and that it will eventually go away on its own. By gradually exposing them to their fears treatment helps them to become desensitized to their fears and to develop coping skills for managing their anxiety.

ERP for children with OCD

ERP is also often used to treat OCD in children. For example, a child with OCD who has a hand-washing compulsion might be exposed to dirt and grime gradually, starting with touching a dirty doorknob and working their way up to eating a meal with unwashed hands. A child with OCD who has a checking compulsion might be prevented from checking the locks on the door repeatedly before leaving the house.

How Exposure/ERP works

Dr. Bauman will work with the child to develop a treatment plan that is tailored to their fears.. The treatment plan will include a series of exposures around the child’s fears, which are gradually increasing challenges that the child will face. Dr. Bauman will also teach the child coping skills for managing their anxiety.