At GroundWork in Orlando, we are proud to offer evidence-based Exposure and Response Prevention (ERP) for OCD, and exposure therapy for anxiety disorders. Research has shown that this specific type of CBT therapy is the most effective treatment method for Obsessive Compulsive Disorder (OCD) and anxiety disorders.

Exposure & Response Prevention (ERP) For OCD

Throughout our website, you have likely read about Cognitive Behavioral Therapy (CBT). CBT is a type of mental health therapy that has been shown by research to treat psychological disorders more effectively than other types of therapy. Important advances in the field of CBT have led to an extremely effective treatment for Obsessive Compulsive Disorder (OCD). This treatment is called Exposure and Response Prevention (ERP). Treating OCD with ERP is considered to be one of the single most impressive achievements in the mental health field. Just 20 years ago, the prognosis for persons suffering with OCD has changed from poor to very good due to the development of ERP.

“Exposure” in Exposure and Response Prevention refers to exposing yourself to the situations, images, things and thoughts that make you feel distress or anxious or makes you start your obsessions. “Response Prevention” refers to making a conscious decision not to engage in compulsive behaviors once the anxiety, distress or obsessions have been triggered. It can be initially frightening to clients to learn that part of ERP treatment will be directly facing the thing they fear the most. If you suffer from OCD, you have more than likely tried to confront your obsessions many times, only to have your anxiety rise steeply. We explain to our clients that Exposure and Response Prevention therapy is conducted by gradual exposure to the feared situations, images, things and thoughts while making the commitment to not give in to your anxious feelings and engage in compulsive behaviors. Through gradual exposures, coupled with response prevention, you will eventually experience a drop in your anxiety levels. This process is called “habituation”.

ERP is different from traditional psychotherapy or “talk therapy”. Typical talk therapy hopes to improve a psychological problem by helping the individual to gain “insight” or awareness into their problems. Although talk therapy can be a helpful treatment for some types of disorders and problems, studies have found that it is not effective at all for the treatment of Obsessive Compulsive Disorder (OCD). Extensive research has repeatedly found that ERP is the most effective type of treatment for OCD.

Finding The Right Help 

It is important to interview your prospective therapist to find out if they are trained to do Exposure and Response Prevention (ERP), and where they received their training. Less than 1% of mental health professionals have received the proper training to provide empirically-supported treatment for OCD through ERP.

At The Center for Anxiety & OCD at GroundWork Counseling, our two anxiety and OCD specialists have received ERP training through the Behavioral Therapy Training Institute (BTTI) from The International OCD Foundation, the leading organization in OCD treatment and research.

All clinicians at GroundWork Counseling have received specialized CBT training from leading world institutes including the Beck Institute, the Albert Ellis Institute, The International OCD Foundation, Mclean Hospital (an affiliate of Harvard Medical School), and two of our therapists have earned CBT Diplomate status from the ABCT; there are less than 1,500 diplomats of CBT worldwide.

GroundWork is proud to offer CBT virtually for individuals residing in Florida, and in-office visits for those residing in Central Florida.

What To Look For In An OCD / ERP Therapist 

When interviewing your prospective therapist,  you can begin by asking them about what types of techniques they use to treat OCD/Anxiety in order to determine if they are qualified to treat your OCD. If the therapist doesn’t mention Cognitive Behavioral Therapy (CBT) or Exposure and Response Prevention (ERP), or if they are vague, use caution. When you ask about Exposure and Response Prevention (ERP) to treat OCD, be cautious of therapists who say that they use CBT but who won’t be specific regarding their experience utilizing ERP and what the process entails. A positive sign would be a clinician with active membership in the International OCD Foundation (IOCDF) or a member of the Association of Behavioral and Cognitive Therapists (ABCT). Look for therapists who have sought specialized training offered by the IOCDF. An example would be the IOCDF Behavior Therapy Training Institute (BTTI) and the Annual IOCDF Conference.

Studies have shown that it takes an average of 14-17 years for an individual with OCD to find the right kind of care. Numerous studies have shown that while CBT is the best treatment for OCD, yet many therapists have never received in-depth training in CBT for OCD, even though some therapists have been practicing for decades. This has created a severe shortage of professionals adequately trained in the most effective treatment for OCD and often leads to therapists relying on medications alone or other using other unproven methods that are not likely to be effective.

It is important to interview your prospective therapist to find out if they are trained to do Exposure and Response Prevention (ERP), and where they received their training (visit our list of suggested questions). Some therapists are better at treating OCD than others. Their answers to your questions will be a good guide for you. You can begin by asking them about what types of techniques they use to treat OCD. If the therapist doesn’t mention Cognitive Behavioral Therapy (CBT) or Exposure and Response Prevention (ERP), or if they are vague, use caution. When you ask about Exposure and Response Prevention (ERP) to treat OCD, be cautious of therapists who say that they use CBT but who won’t be specific. Be sure to ask about their training and background in treating OCD. A positive sign would be membership in the International OCD Foundation (IOCDF) or a member of the Association of Behavioral and Cognitive Therapists (ABCT). Look for therapists who have sought specialized training offered by the IOCDF. An example would be the IOCDF Behavior Therapy Training Institute (BTTI) and the Annual IOCDF Conference.

Consider asking the following questions to a perspective OCD therapist:

• Do you have a background in treating adults with OCD?
• How do you treat OCD?
• Are you trained to treat OCD and where did you receive your training?
• How many individuals with OCD have you successfully treated?
• What percentage of your therapeutic practice is working with OCD?
• Will you work with and coordinate with other treatment providers such as physicians and psychiatrists if needed?
• Are you willing to treat OCD in the setting it most frequently occurs, if necessary?
• Do you involve family members (such as parents, spouses, or children) in treatment if needed?
• See Our Full List Of Questions

Exposure Therapy for Anxiety Disorders

Exposure therapy is a type of behavior therapy that helps to uncouple obsessive images, impulses, thoughts and fears from avoided situations or compulsive behaviors (also known as response prevention) by gradually exposing the individual to the thing that most frightens him or her. For example, a person with Social Anxiety might be urged to speak to someone at a party, an individual with Panic Disorder might be encouraged to drive in a car on the highway, or a person with a Phobia of dogs could be repeatedly asked to spend time with dogs.

As an Orlando counseling practice specializing in Cognitive Behavioral Therapy, we often provide exposure therapy to our clients. It can be initially frightening to clients to learn that part of CBT counseling treatment will be directly facing the thing they fear the most through exposure therapy. We explain to clients that CBT exposure therapy is conducted by gradual exposure to a feared situation/object, and through these exposures individuals will eventually begin to fear it less and less. For example, if someone with a fear of spiders is first exposed by seeing pictures of the spider and works up to actually seeing, maybe even touching a spider, eventually this individual’s fear will be reduced so it is tolerable.

The individual receiving exposure therapy will also learn that the feared outcome rarely ever occurs. The person with Social Anxiety learns that she could speak to someone at a party and no one responded negatively to her. The person with Panic Disorder found that she could drive in the car on the highway and although her heart pounded and she couldn’t breathe, her physical symptoms gradually subsided and didn’t result in a heart attack. The individual with a Phobia of dogs realized that he could pet many dogs and did not get bitten.

Why Exposure Works

When clients receive exposure therapy, they also discover that even if they don’t engage in their usual avoidant or compulsive behavior, their anxiety levels do eventually go down and they find that they can be okay with being uncomfortable for some time without something terrible happening. They can, in fact, tolerate the anxious feelings that they have avoided for so long. What they thought would be so terrible and awful, turned out to be not quite as terrible and awful as they imagined. They eventually find that although they may not like the anxious feelings, they could in fact, stand it.

It is a fact that exposure therapy is hard at first. The person is learning to face their fears rather than avoiding it, which is totally different than what they are used to doing. However, we have found that when the client is determined and practices doing what they fear or face what they avoid, the easier it becomes. Research has repeatedly found that exposure therapy is, in fact, one of the very best, fastest and most effective methods to overcoming anxiety.

GroundWork – Why We’re Different

At GroundWork in Orlando, our clinicians specifically trained in the most effective treatment methods for Anxiety and OCD, using research-based approaches such as Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP).

Have You Found Previous Therapy Minimally Effective, or Even Ineffective?

Studies confirm that people often believe that they are receiving Cognitive Behavioral Therapy (CBT) from their mental health professional when in fact they are not. Research repeatedly verifies that other types of therapy are less effective in treating anxiety and OCD and it is widely recognized that CBT is the most effective treatment for anxiety and OCD. OCD and Anxiety disorders are complex and require treatment from clinicians who have been specifically trained in CBT for these issues.

Reclaim Your Life With The Help of An ERP Therapist