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?

This is a fantastic question, and I agree with the others who responded! I like to first validate their thoughts and feelings about ERP and explore their reluctance, noting that it is very reasonable. There are a few steps that can be helpful in introducing ERP to the patient.

Metaphors can be very ...

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, we’re just...