Skip to main content

Anxiety Treatment: Exposure & Response Prevention

Anxiety counseling incorporates similar elements to general counseling, but also includes specific exposure + response treatment that targets obsessive worry and anxious thoughts. ERP includes psychoeducation regarding how anxiety works and how behavioral interventions for anxiety work.

Therapy Goals + Preferred Outcomes

Treatment for specific anxiety and obsessive compulsive disorder varies from general counseling in that it follows specific steps and interventions. General counseling tends to focus on overarching themes, interpersonal interactions, sense of being, etc. Anxiety counseling uses exposure and response prevention, which is a type of behavior therapy. ERP is evidence-based and structured. Sometimes, we use ERP as part of general counseling. However, it always follows a specific treatment plan and goals.

Examples of Goals

  1. Learn about the obsession / compulsion cycle (the relationship between anxious, intrusive thoughts + repetitive behaviors to relieve anxiety).
  2. Decrease instances of compulsive behaviors.
  3. Increase coping skills and mindfulness, in order to increase tolerance of anxiety.
  4. Decrease influence of intrusive thoughts and reactivity to intrusive thoughts.
  5. Understand influence of obsessive thoughts & compulsive behaviors on daily life and activities, and recognize importance for change.
  6. Develop skills in recognizing obsessions and compulsions, behaviors that relieve anxiety only short term, and be able to independently identify and implement opportunities for exposure therapy.
  7. Practice exposures outside of session for at least 15 minutes a day, and keep track of behavior in provided logs or in a journal.

Phases of Treatment

These phases may be incorporated into general counseling, or be implemented on their own.

  1. Education regarding anxiety and behavior interventions.
  2. Identify obsessions + compulsions and rank them from least distressing to most distressing.
  3. Identify + develop mindfulness + coping skills to help tolerate anxiety during exposure.
  4. Explore what exposure looks like for each compulsion, and develop a plan to practice exposure in and out of session.
  5. Track exposure progress and levels of distress.
  6. Continually re-assess to ensure treatment is working; re-adjust as needed.

Location Options


In person


*For outdoors anxiety counseling, specifically with exposure + response prevention (ERP) treatment, we will need to meet in office or online and establish an ERP plan prior to outdoors sessions.