Exposure Therapy and ERP for OCD: Course Module

What the module teaches

Module 4 of the PsychoPharmRef therapy course is a practical how-to for delivering exposure therapy for anxiety disorders, including exposure and response prevention (ERP) for OCD. It is built on the inhibitory-learning model: exposure does not erase the original fear association but builds a new, competing "safe" association. Each exposure is set up as a test of a specific prediction, and success is defined by what the client learns, not by whether fear came down. The Learn tab covers ten topics:

• From habituation to inhibitory learning, and core strategies: expectancy violation, deepened extinction, variability, removing safety behaviors, multiple contexts and retrieval cues
• Assessment and functional analysis, including SUDS (0–100) ratings
• Types of exposure: in vivo, imaginal, interoceptive and virtual reality
• Step-by-step delivery, from rationale and hierarchy building to processing and between-session practice
• ERP for OCD, including covert mental rituals and reassurance-seeking
• Integrating cognitive techniques, session structure and typical course length
• Managing client distress, dropout risk and therapist anxiety about exposure
• Adaptations for children, PTSD, panic disorder, specific phobia and comorbid depression

Interactive worksheets

• Assess: feared situations with specific predictions and SUDS, avoidance and safety behaviors, and feared body sensations for interoceptive work.
• Hierarchy: a menu of exposure tasks with type, SUDS rating and the safety behavior to drop.
• Exposure Log: prediction and expected likelihood before the task, then peak SUDS, what actually happened and what was learned.
• ERP (OCD): maps each trigger to the obsession, the compulsion (including mental rituals) and a response-prevention plan.
• Goals and Outcomes: a SMART goal builder, Goal Attainment Scaling, and a session-by-session tracker for a repeated measure such as the GAD-7, with change from baseline.

Each worksheet can be copied as plain text for notes or supervision, and blank worksheets are available as a PDF download.

Who it is for

The module is written for trainees and advanced students learning exposure under supervision. The worksheets are practice aids, not validated instruments, and do not replace clinical judgment or supervision. Key references include Abramowitz, Deacon and Whiteside, Exposure Therapy for Anxiety (2nd ed., 2019); Craske and colleagues on the inhibitory-learning approach (Behav Res Ther, 2014); and Foa, Yadin and Lichner's ERP therapist guide (2nd ed., 2012).