behavioural therapy (ERP) exposure responce prevention

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  • behavioural therapy (ERP) exposure responce prevention
    • ERP thearpy aims to provide oppertunities for recondtioning
    • first component is EXPOSURE
      • patient is repeatedly presented with the feared stimulus until anxiety subsides
      • exposure may just start with them imagining the feared stimulus and later experieng the real feared stimulus such as touching dirt for a contamination OCD stufferer
      • exposure moves from least threatening to most threatening similar to systematic desestitiations
      • if the pace is to slow patients may get demotivated
    • the second component is RESPONCE PREVENTION
      • at the same time as the exposure the patient is prohibited from carrying out the compulsion
        • this is important  as it make the patient realise that the anxiety can be reduced without the compulsive ritual
      • in an institutional setting staff may work out a strict routine to restrict patients compulsive behaviours such as allowing them to only flush the toilet twice  instead of ten times like they normally would
    • mode of action
      • 1) the  psychiatrist work out a list of target areas using the y-boc test
      • 2) the paitient ranks them from least to  most anxiety provoking
      • it normally consists of 13-20 weeks worth of sessions
      • once treatment is complete patients are encouraged to continue to use the ERP techniques
      • monthly booster sessions are often given up to six months afterwards
    • effectiveness
      • albucher etal reported that between 60-90% of adult with OCD have improved considerablly using ERP
      • research has found that the effectiveness of ERP was improved when intergrated with discussions of feared consequences and dysfunctional beleifs
      • for people with mild OCD self directed ERP may be realitively effective
    • appropriateness
      • ERP alone is not effective for people who also suffer from depression and are serverally depressed nor with patients who have specific types of ocd such as hording
      • the sucess of ERP relies on the effort made by the patient

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