ERP Therapy in NYC

Learn to overcome distressing thoughts and behaviors with exposure and response prevention (ERP) therapy.

Exposure and Response Prevention (ERP) Therapy

What Is Exposure and Response Prevention (ERP)?

Exposure and response prevention therapy is a form of cognitive behavioral therapy (CBT) used to treat obsessive-compulsive disorder (OCD), phobias, panic attacks, and situational anxiety. It is named after its two main components:

  • Exposure: A person is gradually exposed to the feared situation or object they wish to avoid.
  • Response prevention: Once exposed, the person learns to tolerate their fears and refrain from engaging in compulsive behaviors. They can employ healthy coping strategies to ease the distress of the exposure.
What Is ERP Therapy

How Does ERP Therapy Work?

ERP therapy works by building skills a person needs to choose healthy behaviors over rituals and obsessions. Individuals are exposed to their fears and learn to tolerate them without engaging in their compulsions such as checking behaviors, hand washing, compulsive rituals, or seeking reassurance. Over time with repeated exposures, people learn they can tolerate the anxiety or discomfort that occurs when they refrain from doing their typical compulsions. Once they gain the skill of distress tolerance, they can choose healthy behaviors consistent with their true values. For many people, this leads to a reduction in fear, anxiety, and finally a sense of freedom from their OCD.

What Does ERP Therapy Treat?

ERP threats OCD

Obsessive Compulsive Disorder (OCD)

OCD is the main disorder for which ERP therapy is utilized. People with OCD engage in specific, compulsive behaviors or rituals in order to lessen the distress they experience from their obsessive thoughts. This is a condition that can begin to take over daily life if left untreated.


Pure O (Pure Obsessional OCD)

People with ‘Pure O’ have obsessive thoughts without outwardly engaging in compulsive behaviors. Their thoughts are often very upsetting and distracting, causing them to continually try to “think their way out” of the distress by mental compulsions such as repeatedly reviewing the situation, repeating certain words, or mentally undoing or redoing certain actions. Seeking reassurance repeatedly from others is also common.


While for many, the thought of purposefully being exposed to a phobia sounds daunting, ERP therapy is often used in treatment. By gradually being exposed to your phobia in a controlled, supportive setting with a professional, you’ll learn to cope with the feared object or situation. The stress response of your mind and body will decrease over time, leading to less fear.


ERP can be very effective for people who have anxiety when confronted with certain situations, such as air travel, public speaking, or interactions with superiors at work. ERP in combination with other CBT techniques is also effective for many people with social anxiety.

Panic Attacks

Over time, ERP therapy can reduce the number of panic attacks you face daily until they’re a rare occasion. Whatever the panic attacks stem from, exposure and response prevention can help you manage reactions and mitigate symptoms.

What Does Exposure and Response Prevention Help With?

There are a range of symptoms and scenarios that ERP therapy can help with.

  • Intrusive thoughts: By exposing yourself to intrusive thoughts in the company of a trained therapist, you can work together to tolerate the discomfort that comes with the thoughts and learn to refrain from compulsive behaviors that may arise. By sticking with ERP, your thoughts become less intrusive and have less impact on your life. For many people, thoughts that were once intrusive become merely passing thoughts. 
  • Anxiety attacks: ERP therapy is often used in treating anxiety disorders. It can lessen the frequency of anxiety attacks by helping patients manage their response to triggers.
  • Compulsions: One of the main goals of ERP therapy is to reduce compulsions in OCD cases. If you feel compelled to engage in certain rituals to relieve distress, ERP therapy can help.

What's It Like Doing ERP Therapy?

When doing Exposure & Response Prevention, therapists intentionally expose clients to things which trigger their anxiety or provoke their obsessions. Exposure to feared objects, activities, or situations are then gradually increased with intensity in a process called exposure hierarchies. During this process you’re encouraged to avoid compulsive behaviors in response to the anxiety triggered, learning how to “sit with the uncertainty.” With enough exposure exercises performed under the guidance of your clinician, healthier responses can be habituated and more productive behaviors initiated.

What is like to do ERP

Common Techniques

There are three main types of exposure used in ERP therapy:

  • Imaginal exposure: Often the first step in ERP therapy, imaginal exposure is a technique based on a person imagining exposure to their fear. For example, an ERP therapist might guide a person with contamination OCD through imagining what it would be like to put their hand in a trash can.
  • In vivo exposure: In vivo exposure is the type of exposure most commonly associated with ERP therapy. This is the real exposure to the fear or trigger itself, conducted under the guidance of an ERP therapist. 
  • Virtual reality (VR) exposure: With the help of virtual reality technology, ERP therapists can expose their clients to their fears or triggers in a life-like way. VR exposure is particularly popular for phobias that may be impossible to be exposed to in a therapy setting, such as flying on a plane.


happy couple walking in nyc

Benefits of ERP Therapy

ERP therapy brings many benefits to a patient’s life.

  • Improved quality of life: Instead of having your entire life revolve around your disorder, you can conduct your daily life without being controlled by your fears. 
  • Lessened anxiety: You’ll no longer be so focused on compulsions which will naturally reduce your anxiety.
  • New coping skills: You’ll learn new skills from ERP therapy that you can use long after therapy is completed.

ERP Therapy at Behavioral Health of New York

1. Contact Our Office

The first step of your ERP therapy is to give us a call or fill-out                          our online form. 

2. Speak with Dr. Levy 

Each new client has an initial consultation with Dr. Levy, the director          of our practice at Behavioral Health of New York. 

3. Fill Out Forms

Fill out the necessary forms so that we have all the information we need    to get you started.

4. Start Your Sessions 

Behavioral Health of New York will set up sessions at times that are most convenient to your schedule.

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Feel Better with ERP Therapy

Schedule a consultation for ERP therapy at Behavioral Health of New York

Find BHNY ERP Therapy Near You

Serving NYC, Westchester, and Long Island

Frequently Asked Questions

Is Exposure Response Prevention Therapy Effective?

Response improvement after ERP therapy tends to persist in the long-term in comparison to other treatment methods. The exact results are always going to be dependent on each case and a client’s personal goals.

How Does ERP Therapy Treat OCD?

ERP therapy treats OCD by gradually exposing a patient to their feared situation or object.  By learning to tolerate the fear or anxiety (distress tolerance), the patient then can refrain from doing compulsive behaviors. 

Can You Do ERP Therapy at Home?

Your ERP therapist works with you in the office on exposure and response prevention skills and exercises. They will often provide guidance on ERP homework between sessions.

How Long Does ERP Therapy Take?

Your BHNY therapist will work with you to decide on a timeline for your OCD ERP therapy. The length of each session will vary based on what best fits your unique circumstances. The number of sessions before results are seen also varies based on the severity of your case and the goals you wish to achieve.