What is Exposure and response prevention therapy (ERP)?

Exposure and Response Prevention Therapy (ERP) is a type of cognitive-behavioral therapy (CBT) that is commonly used to treat anxiety disorders, particularly Obsessive-Compulsive Disorder (OCD)

ERP involves gradually exposing a person to situations or objects that trigger their anxiety or compulsive behaviors, while preventing them from engaging in the compulsive behaviors or rituals that they typically use to reduce their anxiety. This process helps the person to learn that they can tolerate the anxiety triggered by the situations or objects without having to engage in compulsive behaviors.

How could ERP work?

For example, a person with contamination-related OCD may be gradually exposed to situations involving dirt or germs, while being prevented from washing their hands or engaging in other cleaning rituals. The person might start with a relatively mild exposure, such as touching a doorknob, and then gradually work up to more challenging exposures, such as touching a public restroom sink or shaking hands with someone who has a cold.

ERP is typically conducted with the guidance of a therapist who helps the person to develop an exposure hierarchy and provides support and guidance throughout the process. The goal of ERP is to help the person learn to manage their anxiety and reduce their reliance on compulsive behaviors.

How could ERP help with eating disorders?

Exposure and Response Prevention Therapy (ERP) can be adapted to address specific symptoms and behaviors associated with eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder.

In the case of anorexia nervosa, ERP would focus on gradually exposing the individual to foods and situations that trigger anxiety or fear, such as high-calorie foods, social events involving food, and situations where the person may feel pressured to eat. The therapist would then help the individual to resist the urge to engage in behaviors such as restricting food intake, over-exercising, or purging.

For bulimia nervosa, ERP would focus on exposing the individual to situations or stimuli that trigger binge-purge episodes, such as specific foods or negative emotions. The therapist would then help the individual to resist the urge to engage in the binge-purge cycle and develop alternative coping strategies for managing distress.

For binge eating disorder, ERP would focus on exposing the individual to situations that trigger binge episodes, such as certain foods or emotional triggers, and then help them to resist the urge to engage in binging behaviors while developing alternative coping strategies.

The ultimate goal of ERP for eating disorders is to help individuals with eating disorders learn to manage their emotions and develop healthy coping mechanisms for managing anxiety or distress, without relying on disordered eating behaviors. ERP is typically conducted with the guidance of a therapist who specializes in treating eating disorders.