How do you introduce patients with obsessive-compulsive disorder to the concept of exposure and response prevention (ERP) therapy when they may be hesitant to engage in exposure-based work?   

Their hesitancy to engage in a stressful and painful treatment with estimated success rates of around 50%, not a lot higher than placebo, is warranted. So I would acknowledge the reasonableness of hesitancy if I knew what it is based on. In order to do that, I would leave a lot of room for them to l...

I explain step-by-step exactly what’s going to happen. I will begin with teaching techniques to de-escalate anxiety, such as in our breathing, and have them become proficient with this. If it’s a particularly challenging case, I explain very carefully that before we actually go into VIVO...