ERP Has a PR Problem

Written by: Merrisa Little

Source: Kemp et., al. 2023



In the world of OCD treatment, Exposure with Response Prevention (ERP) is often misunderstood and misrepresented, leading to a significant public relations (PR) problem. This article aims to shed light on this issue and provide a detailed analysis based on the research by Kemp et al., 2023.


The Issue at Hand

Exposure with Response Prevention is a powerful therapy that can help individuals overcome OCD when implemented correctly. However, the therapist community experiences difficulty with its utilization due in part to the perceived dangerousness this therapy presents to clients. This negative image has created a PR problem that can hinder the adoption and utilization of ERP by those working with the OCD community, despite its demonstrated efficacy. 


The Root Cause

The root cause of this PR problem can be traced back to a few key issues. First, therapists in graduate school are not trained in helping their clients confront anxiety provolking situations, but rather how to help clients cope with them. This seemingly negligible nuance of the helping profession facilitates the creation of negative beliefs about exposure that can be overwhelming for those unfamiliar with the treatment approach. These negative beliefs lead to misperceptions about the usefulness and applicability of ERP. As such, “exposure is associated with disproportionately low rates of therapist adherence and competence” (Kemp et. Al., 2023, p.02). Secondly, the implementation of ERP brings a practicality element to the minds of therapists: it can be time-consuming and strenuous on the therapist. These factors can deter mental health professionals from using ERP efficaciously, further contributing to client accessibly to effective treatment. 


The Implication

This PR problem is more than just a matter of image; it has real implications for those living with OCD. A lack of understanding and negative beliefs about ERP can prevent individuals living with OCD from realizing the full potential ERP has to promote recovery from the disorder. This, in turn, can impact the shame, stigma and ultimately, the length of time an individual suffers from OCD (already an average of 17 years).


The Solution

Addressing this PR problem requires a multipronged approach. On one hand, there is a need to demystify ERP and make it more accessible to a wider therapy community. This can be achieved through education and awareness campaigns. On the other hand, therapists are likely to encounter OCD in their practice, due to the high prevalence rate. These therapists are not expected to use ERP, but do need another option. Therapists can continuously improve their knowledge about OCD to make their practice more OCD-informed. Finally, therapists practicing ERP for OCD need to be open to the idea of embracing their negative beliefs about exposure, and investing the necessary time to overcome these trained beliefs.



ERP has tremendous potential to change lives, but the PR problem is hindering its widespread adoption. By addressing this issue, we can help more individuals living with OCD overcome the disorder. 



Reference: Kemp, J., Benito, K., Herren., Brown, Z., Frank HE and Freeman, J (2023). Exposure to exposure: A protocol for leveraging exposure principles during training to address therapist-level barriers to exposure implementation. Front. Psychiatry 14:1096259 doi: 10.3389/fpsyt.2023.1096259

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