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Exposure And Response (Ritual) Prevention For Obsessive Compulsive Disorder: Therapist Guide

Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the Client Workbook.

Cognitive behavioral therapy (CBT), including Exposure and Response Prevention (ERP), is an effective treatment for Obsessive-Compulsive Disorder (OCD). It is recommended by the American Psychiatric Association (APA) and the UK National Institute for Health and Care Excellence (NICE). The Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder (Second Edition) is written by Edna B. Foa, Elna Yadin, and Tracey K. Lichner,  and provides therapists with all the tools they need to deliver effective, evidence-based psychological treatment for OCD. Part of the Treatments That Work® series, it provides step-by-step instructions for helping clients manage and overcome their OCD, as well as the challenges that can arise during treatment.

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  • English (US)

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Chapter 1: Introductory Information for Therapists

Chapter 2: Assessment

Chapter 3: Treatment Components of Exposure and Ritual Prevention

Chapter 4: Session 1: Treatment Planning Part 1

Chapter 5: Session 2: Treatment Planning Part 2

Chapter 6: Session 3: Exposure and Ritual Prevention – Introducing In Vivo Exposure

Chapter 7: Session 4: Exposure and Ritual Prevention – Introducing Imaginal Exposure

Chapter 8: Intermediate Sessions: Continuing Exposure and Ritual Prevention

Chapter 9: Final Session

Chapter 10: Problems Commonly Encountered During Exposure And Ritual Prevention

Appendix

Front Matter

References

Description

OCD can be one of the most debilitating mental health conditions (Mathers & Loncar, 2006) and affects approximately 1% of individuals during their lifetime (Fawcett et al., 2020). Symptoms of OCD include obsessions (repetitive and distressing thoughts, images, or urges) and compulsions (repetitive behaviors, including mental acts, that are performed in response to obsessions). Obsessions and compulsions are often time consuming and can have a significant impact on people’s relationships, work, and ability to function.

Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder is a comprehensive program which assists clinicians in delivering effective ERP for OCD. The program includes two books:

  • Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder: Therapist Guide details the step-by-step treatment of OCD using ERP, including common obstacles.
  • Treating Your OCD with Exposure and Response Prevention: Workbook is the companion to this therapist guide. It will help your patients to become active participants in their treatment and learn how to implement ERP independently and with the support of a therapist.

About Treatments That Work®
Authored by leading psychologists including David Barlow, Michelle Craske and Edna Foa, Treatments That Work® is a series of manuals and workbooks based on the principles of cognitive behavioral therapy (CBT). Each pair of books – therapist guide and workbook – contains step by step procedures for delivering evidence-based psychological interventions and will help you to provide the best possible care for your clients.

At Psychology Tools, we are proud to make many of the Treatments That Work® titles available to our members. Each book is available to download chapter-by-chapter, and Psychology Tools members with a currently active subscription to our ‘Complete’ plan are licensed to share copies with their clients.

How effective is this treatment?
Addressing OCD using ERP is seen as one of the great success stories in the field of mental health and has led to dramatic improvements in how OCD is understood and treated (Abramowitz, 2006).

Over the last 40 years, an impressive and substantial body of evidence supporting the use of ERP for treating OCD has accumulated. It is recommended for treating depression in clinical practice guidelines developed by the American Psychiatric Association (APA) and the National Institute for Health and Care Excellence (NICE), which produces guidelines for the National Health Service in the United Kingdom (APA, 2007; NICE, 2005). A recent, comprehensive review of studies identified ERP-based CBT as being an effective treatment for OCD and more effective than other forms of therapy (Ferrando & Selai, 2021).

Chapters in Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder: Therapist Guide:

  • Chapter 1: Introductory Information for Therapists
  • Chapter 2: Assessment
  • Chapter 3: Treatment Components of Exposure and Ritual Prevention
  • Chapter 4: Session 1: Treatment Planning Part I
  • Chapter 5: Session 2: Treatment Planning Part II
  • Chapter 6: Session 3: Exposure and Ritual Prevention – Introducing In Vivo Exposure
  • Chapter 7: Exposure and Ritual Prevention – Introducing Imaginal Exposure
  • Chapter 8: Intermediate Sessions: Continuing Exposure and Ritual Prevention
  • Chapter 9: Final Session
  • Chapter 10: Problems Commonly Encountered During Exposure And Ritual Prevention
  • References
  • Appendix

About the authors
Edna B. Foa, Ph.D., is a Professor of Clinical Psychology in Psychiatry at the University of Pennsylvania and Director of the Center for the Treatment and Study of Anxiety. She received her Ph.D. in Personality and Clinical Psychology from University of Missouri at Columbia in 1970. Dr. Foa devoted her academic career to study the psychopathology and treatment of anxiety disorders, primarily obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Her research aiming at delineating theoretical frameworks, targeted treatments, and treatment mechanisms of pathological anxiety has been highly influential and she is currently one of the world leading experts in the areas of PTSD and OCD. The treatment program she has developed for PTSD sufferers has received the most evidence for its efficacy and has been disseminated in the US and around the world. Dr. Foa has published 18 books and over 350 articles and book chapters, has lectured extensively around the world, and her work has been recognized with numerous awards and honors, among them the Distinguished Scientific Contributions to Clinical Psychology Award from the American Psychological Association; Lifetime Achievement Award presented by the International Society for Traumatic Stress Studies; Lifetime Achievement Award presented by the Association for Behavior and Cognitive Therapies; TIME 100 most influential people of the world; 2010 Lifetime Achievement in the Field of Trauma Psychology Award from the American Psychological Association; and the Inaugural International Obsessive Compulsive Disorder Foundation Outstanding Career Achievement Award.

Elna Yadin, Ph.D., is a psychologist and director of the OCD clinic at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. Dr. Yadin received her Ph.D. in Physiological and Experimental Psychology from Bryn Mawr College in 1979 and respecialized in clinical psychology in 1995. Her neuroscience and clinical interests focus on the study and treatment of anxiety disorders, with an emphasis on OCD and PTSD. She has also published scientific articles on brain mechanisms of anxiety and relief from fear, and on treatment of anxiety disorders in children, adolescents, and adults. Dr. Yadin has been invited to speak nationally and internationally and has taught workshops on the use of evidence-based treatments for anxiety disorders.

Tracey K. Lichner, Ph.D., is a psychologist and director of supervision at the University of Pennsylvania’s Center for the Treatment and Study of Anxiety. Dr. Lichner received her Ph.D. in clinical psychology from the Catholic University of America in Washington, D.C., in 2002. Previously at Johns Hopkins University School of Medicine, she participated in research investigating the genetics of OCD. She has conducted comprehensive clinical interviews, nationally and internationally, with hundreds of family members with OCD. At the Center for the Treatment and Study of Anxiety, she has taught in numerous workshops for mental health professionals on the treatment of OCD, PTSD, and grief. Dr. Lichner’s professional interests include psychotherapy and the dissemination of evidence-based treatment for OCD, PTSD, and prolonged grief disorder.

Instructions

Each Treatments That Work® title is published in two volumes:

  • Clients use the Workbooks which contain elements of psychoeducation, skills development, self-assessment quizzes, homework exercises, and record forms.
  • Therapists use the Therapist Guides which contain step-by-step instructions for teaching clients’ skills, overcoming common difficulties.

Although written for the client, the exercises in the workbook are intended to be carried out under the supervision of a mental health professional. The authors suggest that the most effective implementation of these exercises requires an understanding of the principles underlying the different procedures, and that mental health professionals should be familiar with both the Treating Your OCD with Exposure and Response Prevention: Workbook, as well as this therapist guide.

Therapists with an active subscription to a Psychology Tools ‘Complete’ plan are licensed to use Treatments That Work® titles, and to download and share chapters with their clients.

References

  • Abramowitz, J. S. (2006). The psychological treatment of obsessive—compulsive disorder. The Canadian Journal of Psychiatry, 51, 407-416. DOI: 1177/070674370605100702.
  • American Psychiatric Association (2007). Practice guideline for the treatment of patients with obsessive-compulsive disorder. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/ocd.pdf.
  • Fawcett, E. J., Power, H., & Fawcett, J. M. (2020). Women are at greater risk of OCD than men: a meta-analytic review of OCD prevalence worldwide. The Journal of Clinical Psychiatry, 81, 19r13085. Doi:10.4088/JCP.19r13085.
  • Ferrando, C., & Selai, C. (2021). A systematic review and meta-analysis on the effectiveness of exposure and response prevention therapy in the treatment of Obsessive-Compulsive Disorder. Journal of Obsessive-Compulsive and Related Disorders, 31, 100684. DOI: 1016/j.jocrd.2021.100684.
  • Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3, e442. Doi:10.1371/journal.pmed.0030442
  • National Institute for Clinical Excellence (2005). Obsessive-compulsive disorder: Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder (Clinical guideline CG31). https://www.nice.org.uk/guidance/cg31.