This psychoeducation handout explains what keeps obsessive compulsive disorder (OCD) going and how exposure and response prevention (ERP) can break this cycle.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Obsessive compulsive disorder (OCD) is maintained by a recurring cycle of obsessions, compulsions, and short-term relief. This handout explains why OCD persists and how exposure and response prevention (ERP) is used to address it. It supports psychoeducation, treatment preparation, and motivation enhancement, helping clients make informed decisions about their treatment.
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People experiencing obsessions and compulsions.
Use the handout to explain what keeps OCD going.
Highlight how temporary relief can reinforce obsessions and compulsions.
Compare the OCD maintenance cycle with how ERP works.
Use the resource to explain what clients can expect during ERP.
Revisit the handout when needed during treatment.
People with OCD are trapped in a cycle characterized by repeated obsessions and compulsions. An effective way to break this cycle is exposing individuals to the situations that triggers their obsessions without engaging in compulsions. This facilitates new learning: anxiety declines naturally, feared disasters don’t happen, obsessions reduce, and compulsions are not needed. In this way exposure (facing the feared situation) and response prevention (not doing the compulsion) break the vicious cycle that maintains OCD.
The Why OCD Persists And How ERP Works handout was developed to help clients understand the vicious cycles that keep OCD going and how ERP can help.
A client-facing handout.
An introduction to OCD and ERP for therapists.
Guidance for how to use the resource.
Suggestions for further reading.
This handout provides clients with:
A clear explanation for why OCD persists.
An understanding of ERP and how it works.
A motivating rationale for participating in ERP.
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Jacoby, R. J., & Abramowitz, J. S. (2016). Inhibitory learning approaches to exposure therapy: A critical review and translation to obsessive-compulsive disorder. Clinical Psychology Review, 49, 28-40.
Koran, L. M., Hanna, G. L., Hollander, E., Nestadt, G., & Simpson, H. B. (2007). Practice guideline for the treatment of patients with obsessive-compulsive disorder. American Journal of Psychiatry, 164(7 Suppl.), 5-53.
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Öst, L. G., Enebrink, P., Finnes, A., Ghaderi, A., Havnen, A., Kvale, G., ... & Wergeland, G. J. (2022). Cognitive behavior therapy for obsessive-compulsive disorder in routine clinical care: A systematic review and meta-analysis. Behaviour Research and Therapy, 159, 104170.
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Rachman, S., & de Silva, P. (1978). Abnormal and normal obsessions. Behaviour research and therapy, 16(4), 233-248.
Rachman, S., & Hodgson, R. (1980). Obsessions and Compulsions. Englewood Cliffs, NJ: Prentice-Hall.
Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour research and therapy, 23(5), 571-583.
Stein, D. J., Ruscio, A. M., Altwaijri, Y., Chiu, W. T., Sampson, N. A., Aguilar-Gaxiola, S., ... & Kessler, R. C. (2025). Obsessive-compulsive disorder in the World Mental Health surveys. BMC medicine, 23(1), 416.
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