what does it look like?

Exposure and response prevention (ERP)

We use Exposure with Response Prevention (ERP), an empirically studied treatment, for OCD and BDD. It is now also being used to treat PTSD and eating disorders.  ERP involves encouraging a person to engage in activities which are feared, or completely avoided, without engaging in their compulsive responses.  This requires a systematic and gradual approach for most people; it is not flooding.  The ultimate goal is to learn the rationality behind the therapy rather than to challenge every compulsion or avoidance that one has felt.  We do not try to rationalize with the distorted beliefs, but rather accept the risk and take it anyway.  By doing so the brain is able to relearn a more realistic perspective and fears naturally decrease over time.  This does not necessarily completely eradicate obsessive worry, but people learn that it is just a hyperbolized thought and move on quickly and live normally.  It is the goal, which is commonly accomplished, for a person to successfully implement the principals of this therapy on their own as needed after ending treatment.  However it is also possible that other stressors in one's life would cause a person to "forget" what they have learned and return to treatment for a brief refresher periodically. 

Habit Reversal

Habit Reversal Therapy is utilized in the treatment of what many are now referring to as "body focused repetitive behaviors."  These include hair pulling and skin picking.  It involves first the development of a conscious knowledge of when one is engaging in a habit and then the implementation of stimulus control or a competing response.  It is best if these interventions also are able to serve the same function as the action of negative consequence.  The roots of this disorder vary greatly from person to person and treatment is tailored as a client develops more awareness of the how the behavior plays out as well as the purpose it is serving in their lives. This might be combined with ERP at the end of treatment depending on the reasons why someone is engaging in the behavior.  


This therapy is the treatment of choice for panic attacks.  It aims to remove the fear of such an incident occurring by exposing the person to a stimulus that has become a precursor to the attack along with the physical symptoms associated with it. It can be summarized as eradicating the "fear of fear."  

general cbt

CBT helps you become cognizant of skewed thought patterns so you can perceive difficult situations more clearly and deal with them in a more productive way.  Sometimes the person may be so stuck that they may be causing self-destructive behaviors and beliefs.  CBT often involves homework in between sessions requiring the implementation and reinforcement of what they learned.  Tracking and journaling are often used to measure progress.