Exposure and response
Encyclopedia
Exposure and response prevention (ERP) is a treatment method available from behavioral psychologist
s 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
. The behavioral process is called Pavlovian extinction or respondent extinction
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.
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.
The results of a 2008 study indicate that simultaneous administration of d-cycloserine substantially improves effectiveness of exposure and response prevention.
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
s and cognitive-behavioral therapists for a variety of anxiety disorders, especially Obsessive Compulsive Disorder. It is an example of an Exposure Therapy
Exposure therapy
Exposure therapy is a technique in behavior therapy intended to treat anxiety disorders and involves the exposure to the feared object or context without any danger in order to overcome their anxiety. Procedurally it is similar to the fear extinction paradigm in rodent work...
.
The method is predicated on the idea that a therapeutic
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
effect is achieved as subjects confront their fears and discontinue their escape response
Escape response
Escape response, escape reaction, or escape behaviour is a possible reaction in response to stimuli indicative of danger, in particular, it initiates an escape motion of an animal...
. The behavioral process is called Pavlovian extinction or respondent extinction
Extinction (psychology)
Extinction is the conditioning phenomenon in which a previously learned response to a cue is reduced when the cue is presented in the absence of the previously paired aversive or appetitive stimulus.-Fear conditioning:...
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
Phobia
A phobia is a type of anxiety disorder, usually defined as a persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding, typically disproportional to the actual danger posed, often being recognized as irrational...
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
Habituation
Habituation can be defined as a process or as a procedure. As a process it is defined as a decrease in an elicited behavior resulting from the repeated presentation of an eliciting stimulus...
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.
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.
The results of a 2008 study indicate that simultaneous administration of d-cycloserine substantially improves effectiveness of exposure and response prevention.
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. http://www.baojournal.com/WCBA/WCBA.html Their exam tests knowledge of this technique.Further reading
- Stop Obsessing, by Foa, Edna
- Marks IIsaac MarksIsaac Meyer Marks was born in Cape Town, South Africa. He trained in medicine there, qualifying in 1956. His training as a psychiatrist began in 1960 at the University of London and was completed in 1963...
(1981) Cure and Care of Neuroses John Wiley & Sons Inc 0-471-08808-0 - Marks IIsaac MarksIsaac Meyer Marks was born in Cape Town, South Africa. He trained in medicine there, qualifying in 1956. His training as a psychiatrist began in 1960 at the University of London and was completed in 1963...
. (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