Pros And Cons Of Erp For Clinical Practice

Implications and Recommendations for Clinical Practice After reviewing the extant literature, it is apparent that there are potent treatments, which have been logically derived from supported theoretical models, available to treat OCD, a disorder that was initially believed to be intractable. Of these treatments, exposure-based treatments, such as ERP, have the most empirical support for their efficacy in reducing OCD symptoms, although there is promising evidence that cognitive-based treatments are also quite effective—perhaps just as effective, especially if they incorporate behavioral components such as exposure. As did the APA (2007) and NICE (2006), it is recommended that the CBT variant ERP be used as the first-line psychological treatment

Moreover, it is recommended that exposure be conducted in real life (i.e., in vivo exposure) and through imagination (i.e., imaginal exposure), because it has been shown that combining in vivo exposure with imaginal exposure is more efficacious than either exposure alone (Abramowitz, 1996; Sánchez-Meca, Gómez-Conesa, & Méndez, 2003), and that all exposure be guided by a competent therapist, who is intensively trained and supervised (Sholomskas et al., 2005), because it has been shown that therapist-guided exposure is more efficacious than therapist-assisted self-exposure (Abramowitz, 1996; Sánchez-Meca et al., 2003). Since there is great evidence that both group and individual exposure treatments are equally efficacious (Arumugham & Reddy, 2014; Öst et al., 2015), it is recommended that either be used. It has been proposed, however, that group approaches to treating emotional disorders such as OCD are the most cost-effective forms of treatment (Fisher & Wells, 2005). And, lastly,

The first requirement is that physiological arousal and fear be evoked during exposure sessions. The second requirement is that within-session habituation occur—that is, fear and arousal should gradually diminish during the exposure sessions while the individual refrains from engaging in compulsive behavior. The third requirement is that between-session habituation occur—that is, initial arousal and fear responses at the beginning of each new exposure session should decline over