[10] The exposure therapist identifies the cognitions, emotions and physiological arousal that accompany a fear-inducing stimulus and then tries to break the pattern of escape that maintains the fear.
[21][26] A 2024 systamtic review found that ERP is highly effective in treating pediatric OCD using both in-person and telehealth-based modailites.
[38] This model posits that additional associative learning processes, such as counterconditioning and novelty-enhanced extinction may contribute to exposure therapy.
At a post-treatment follow-up four years later 90% of people retained a considerable reduction in fear, avoidance, and overall level of impairment, while 65% no longer experienced any symptoms of a specific phobia.
The preliminary results concluded improvement post-treatment across all measures of PTSD and maintenance of the gains at the six-month follow up.
[47][48] This method was also tested on several active duty Army soldiers, using an immersive computer simulation of military settings over six sessions.
In the area of PTSD, historic barriers to the use of exposure therapy include that clinicians may not understand it, are not confident in their own ability to use it, or more commonly, see significant contraindications for their client.
[25][52] ERP is predicated on the idea that a therapeutic effect is achieved as subjects confront their fears, but refrain from engaging in the escape response or ritual that delays or eliminates distress.
Over repeated practice of ERP, patients with OCD expect to find that they can have obsessive thoughts and images but not have the need to engage in compulsive rituals to decrease distress.
[56] Exposure therapy has been posited as potentially helpful for other uses, including substance abuse disorders,[57] overeating, binge eating, and obesity,[58][59][60] and depression.
South African psychologists and psychiatrists first used exposure as a way to reduce pathological fears, such as phobias and anxiety-related problems, and they brought their methods to England in the Maudsley Hospital training program.
He sought consultation with other behavioral psychologists, among them James G. Taylor (1897–1973), who worked in the psychology department of the University of Cape Town in South Africa.
[22] Exposure and response prevention (ERP) traces its roots back to the work of psychologist Vic Meyer in the 1960s.
Meyer devised this treatment from his analysis of fear extinguishment in animals via flooding and applied it to human cases in the psychiatric setting that, at the time, were considered intractable.
[65] The success of ERP clinically and scientifically has been summarized as "spectacular" by prominent OCD researcher Stanley Rachman decades following Meyer's creation of the method.