Exposure Response Prevention (ERP) Counselling in City of London

Photo of Kiran Kalar, Psychotherapist, MSc, MBABCP
Kiran Kalar
Psychotherapist, MSc, MBABCP
3 Endorsed
City of London, London EC2R
It can be daunting entering therapy (whether it's your first experience or returning), and my goal is to create a non-judgmental, safe space where you feel truly heard and valued through evidence-based techniques. I am a Cognitive Behavioural Therapist with over 6 years of experience within the NHS. We will work together to help you overcome your difficulties whether that's day-to-day stress, depression, anxiety, low self-esteem or trauma. In your one-to-one sessions, we will start to build a shared understanding of your difficulties to develop tailor-made coping strategies that suit your needs at a pace that is comfortable for you.
It can be daunting entering therapy (whether it's your first experience or returning), and my goal is to create a non-judgmental, safe space where you feel truly heard and valued through evidence-based techniques. I am a Cognitive Behavioural Therapist with over 6 years of experience within the NHS. We will work together to help you overcome your difficulties whether that's day-to-day stress, depression, anxiety, low self-esteem or trauma. In your one-to-one sessions, we will start to build a shared understanding of your difficulties to develop tailor-made coping strategies that suit your needs at a pace that is comfortable for you.
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Photo of Steven McFarlane, Psychotherapist, MBABCP
Steven McFarlane
Psychotherapist, MBABCP
4 Endorsed
City of London, London EC2R
Sometimes things in life can start to seem overwhelming; the useful strategies of the past may not be as helpful as they used to; we can find ourselves lost and unsure. This can often lead to added, despair, anxiety, and self-criticism. It can often seem hard to see a way out or to ask for help. You may need someone to listen without judgement and provide insights into understanding patterns in your life. You may also desire strategies to change your actions and the way that you think about things. The way to a fulfilling and valued life is available without a life-long commitment to therapy.
Sometimes things in life can start to seem overwhelming; the useful strategies of the past may not be as helpful as they used to; we can find ourselves lost and unsure. This can often lead to added, despair, anxiety, and self-criticism. It can often seem hard to see a way out or to ask for help. You may need someone to listen without judgement and provide insights into understanding patterns in your life. You may also desire strategies to change your actions and the way that you think about things. The way to a fulfilling and valued life is available without a life-long commitment to therapy.
020 3917 4985 View 020 3917 4985
Photo of Dr Shireen Sultana, Psychologist, DCounsPsych, HCPC - Couns. Psych.
Dr Shireen Sultana
Psychologist, DCounsPsych, HCPC - Couns. Psych.
City of London, London EC2M
You may be living with the effects of trauma, anxiety, or long-standing emotional distress, alongside feeling overwhelmed or misunderstood due to ADHD or autistic traits. Past experiences may have involved masking, burnout, or invalidation, leaving you feeling exhausted or unsure of yourself. You might be a busy individual with limited time or feel that weekly therapy hasn’t worked for you. I offer neuroaffirming therapy alongside EMDR intensive therapy to help you process difficult experiences, reduce distress, and gain clarity, supporting you to move forward with greater self-understanding, stability, and confidence.
You may be living with the effects of trauma, anxiety, or long-standing emotional distress, alongside feeling overwhelmed or misunderstood due to ADHD or autistic traits. Past experiences may have involved masking, burnout, or invalidation, leaving you feeling exhausted or unsure of yourself. You might be a busy individual with limited time or feel that weekly therapy hasn’t worked for you. I offer neuroaffirming therapy alongside EMDR intensive therapy to help you process difficult experiences, reduce distress, and gain clarity, supporting you to move forward with greater self-understanding, stability, and confidence.
07588 683393 View 07588 683393
Photo of Jesse Ofori - Motherhood in Mind, Psychologist, PsychD, HCPC - Clin. Psych.
Motherhood in Mind
Psychologist, PsychD, HCPC - Clin. Psych.
City of London, London WC2A
We work with prospective, pregnant, and new parents who are struggling with the emotional challenges of fertility, pregnancy, birth, or early parenthood. They may be experiencing anxiety, low mood, birth trauma, loss, self-criticism, overwhelm, or difficulties adjusting to their new identity and relationship with their baby. We provide compassionate, evidence-based therapy to help parents understand their experiences, process difficult emotions, and build confidence in themselves and their parenting. Our aim is to help clients feel more connected to themselves, their baby, and the kind of parent they want to be.
We work with prospective, pregnant, and new parents who are struggling with the emotional challenges of fertility, pregnancy, birth, or early parenthood. They may be experiencing anxiety, low mood, birth trauma, loss, self-criticism, overwhelm, or difficulties adjusting to their new identity and relationship with their baby. We provide compassionate, evidence-based therapy to help parents understand their experiences, process difficult emotions, and build confidence in themselves and their parenting. Our aim is to help clients feel more connected to themselves, their baby, and the kind of parent they want to be.
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Photo of Dr Obss Alademerin, Psychologist, PsychD, HCPC - Clin. Psych.
Dr Obss Alademerin
Psychologist, PsychD, HCPC - Clin. Psych.
City of London, London CM22
Hi, I’m Obss. I work with adults and young people navigating anxiety, stress, low mood, and questions about their identity shaped by culture, race, religion. Many of my clients start therapy feeling stuck, alone, overwhelmed and disconnected from themselves, or struggling with anxiety that’s become difficult to manage. They’re often looking for a space where they feel understood, where their background and experiences can be held with care. We will work together to understand the patterns keeping you stuck, develop a different relationship with difficult thoughts and emotions help you move towards a life that feels meaningful.
Hi, I’m Obss. I work with adults and young people navigating anxiety, stress, low mood, and questions about their identity shaped by culture, race, religion. Many of my clients start therapy feeling stuck, alone, overwhelmed and disconnected from themselves, or struggling with anxiety that’s become difficult to manage. They’re often looking for a space where they feel understood, where their background and experiences can be held with care. We will work together to understand the patterns keeping you stuck, develop a different relationship with difficult thoughts and emotions help you move towards a life that feels meaningful.
01788 221904 x44 View 01788 221904 x44
Photo of Simon Alexander Lyne, Psychotherapist, MBABCP
Simon Alexander Lyne
Psychotherapist, MBABCP
City of London, London EC4A
Many people I work with are thoughtful, capable individuals who find themselves struggling with anxiety, shame, trauma, or difficulties in relationships or sexuality. Often, they have coped alone for a long time and feel drained by recurring patterns. Therapy offers a space to slow down and understand what has been happening so new possibilities can emerge. My approach is collaborative. Together we explore what’s keeping things stuck and find realistic, meaningful ways forward. I am an accredited Cognitive Behavioural Therapist, Psychosexual Psychotherapist and EMDR practitioner, with particular experience working with shame.
Many people I work with are thoughtful, capable individuals who find themselves struggling with anxiety, shame, trauma, or difficulties in relationships or sexuality. Often, they have coped alone for a long time and feel drained by recurring patterns. Therapy offers a space to slow down and understand what has been happening so new possibilities can emerge. My approach is collaborative. Together we explore what’s keeping things stuck and find realistic, meaningful ways forward. I am an accredited Cognitive Behavioural Therapist, Psychosexual Psychotherapist and EMDR practitioner, with particular experience working with shame.
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Photo of Rosanna Perdoni, Psychotherapist, MBABCP
Rosanna Perdoni
Psychotherapist, MBABCP
1 Endorsed
City of London, London EC2R
Welcome to CBT with Rosanna. As a Cognitive Behavioural Therapist, I am passionate and dedicated in helping you overcome your challenges and in increasing your overall confidence and wellbeing. I provide high intensity personalised cognitive behavioural therapy to address your needs and help empower you to make positive changes in your life, equipping you with lifelong skills to bring about lasting change.
Welcome to CBT with Rosanna. As a Cognitive Behavioural Therapist, I am passionate and dedicated in helping you overcome your challenges and in increasing your overall confidence and wellbeing. I provide high intensity personalised cognitive behavioural therapy to address your needs and help empower you to make positive changes in your life, equipping you with lifelong skills to bring about lasting change.
020 3948 9781 View 020 3948 9781
Photo of Liz White, Psychologist, HCPC - Clin. Psych.
Liz White
Psychologist, HCPC - Clin. Psych.
City of London, London EC2M
I am experienced in Exposure and Response Prevention ( ERP), CBT, ACT & CFT.
Tired of overthinking, feeling anxious or trying to manage OCD on your own? I am a highly qualified and experienced Chartered Consultant Clinical Psychologist who specialises in helping people break free from anxious and obsessive patterns. I have experience of helping people with all types of OCD, particularly relationship OCD, contamination OCD and taboo themes.
I am experienced in Exposure and Response Prevention ( ERP), CBT, ACT & CFT.
Tired of overthinking, feeling anxious or trying to manage OCD on your own? I am a highly qualified and experienced Chartered Consultant Clinical Psychologist who specialises in helping people break free from anxious and obsessive patterns. I have experience of helping people with all types of OCD, particularly relationship OCD, contamination OCD and taboo themes.
01992 351093 View 01992 351093
Photo of Natasha Alexander, Psychotherapist, MBABCP
Natasha Alexander
Psychotherapist, MBABCP
2 Endorsed
City of London, London EC2R
It may be a life event such as a relationship ending, bereavement or life transitions that has bought you to seek help, a lifelong difficulty, such as panic attacks, social anxiety or OCD. For some, an emotion that is harder to pinpoint or stuck in a rut or just feeling not yourself. Whatever it is, we can explore and make sense of it all helping you to find a way out, We will aim to gain an insight into your experiences to understand, work through and find a better way of managing them. I have extensive experience with helping people through their difficulties including working within the NHS as a therapist and supervisor.
It may be a life event such as a relationship ending, bereavement or life transitions that has bought you to seek help, a lifelong difficulty, such as panic attacks, social anxiety or OCD. For some, an emotion that is harder to pinpoint or stuck in a rut or just feeling not yourself. Whatever it is, we can explore and make sense of it all helping you to find a way out, We will aim to gain an insight into your experiences to understand, work through and find a better way of managing them. I have extensive experience with helping people through their difficulties including working within the NHS as a therapist and supervisor.
020 3835 5641 View 020 3835 5641
Photo of Abie Ladepon-Thomas - Joule Therapy with Abie Thomas, Psychotherapist, MBABCP
Joule Therapy with Abie Thomas
Psychotherapist, MBABCP
City of London, London EC2R
We can sometimes feel overwhelmed in life, battling with anxiety, stress, depression, the world or even ourselves. It can be difficult to know what to do or where to turn. I’m here to support you on your journey of breaking free and creating a greater sense of alignment. Together we’ll set goals and intentions that support healing and personal growth. Joule Therapy offers a path to understanding and reducing emotional distress. Therapy combines the practical strategies of Cognitive Behavioural Therapy (CBT) with practices such as gratitude, grounding, the power of manifestation through law of attraction.
We can sometimes feel overwhelmed in life, battling with anxiety, stress, depression, the world or even ourselves. It can be difficult to know what to do or where to turn. I’m here to support you on your journey of breaking free and creating a greater sense of alignment. Together we’ll set goals and intentions that support healing and personal growth. Joule Therapy offers a path to understanding and reducing emotional distress. Therapy combines the practical strategies of Cognitive Behavioural Therapy (CBT) with practices such as gratitude, grounding, the power of manifestation through law of attraction.
020 4538 8372 View 020 4538 8372
Photo of Dr Zheng Zhou, Psychologist, PsychD, HCPC - Clin. Psych.
Dr Zheng Zhou
Psychologist, PsychD, HCPC - Clin. Psych.
City of London, London EC4Y
Hello, I'm Zheng, a Clinical Psychologist of Chinese heritage, trained in the UK, with extensive experience working in the NHS. If you're exploring therapy, I offer a warm, non-judgmental space where we can work together to make sense of what you’re going through. I take a collaborative, holistic approach, influenced by my deep interest in culture, philosophy, and spirituality. I'm mindful of how aspects like ethnicity, gender, sexuality, religion, and cultural background shape someone’s experience of the world. These parts of you are welcome in our work together, and I hold space for them with thoughtfulness and care.
Hello, I'm Zheng, a Clinical Psychologist of Chinese heritage, trained in the UK, with extensive experience working in the NHS. If you're exploring therapy, I offer a warm, non-judgmental space where we can work together to make sense of what you’re going through. I take a collaborative, holistic approach, influenced by my deep interest in culture, philosophy, and spirituality. I'm mindful of how aspects like ethnicity, gender, sexuality, religion, and cultural background shape someone’s experience of the world. These parts of you are welcome in our work together, and I hold space for them with thoughtfulness and care.
020 3376 7842 View 020 3376 7842
Photo of Jason Chan, Psychologist, PsychD, CPsychol
Jason Chan
Psychologist, PsychD, CPsychol
1 Endorsed
City of London, London EC2M
A Principal Clinical Psychologist with 16 years of experience of working in and leading NHS Psychology Services, and an expert in CBT, Psychodynamic psychotherapy, Emotion-focused therapy, EMDR, Acceptance-commitment Therapy and Mindfulness approaches. I offer incisive, experiential, and highly effective treatments designed to help you overcome your distress and effect lasting changes. Seeking help is a major life step. I commit to providing a safe, professional and personalized treatment experience to sensitively support and empower you, deepen your self-understanding and create positive changes for a life that you can truly value.
A Principal Clinical Psychologist with 16 years of experience of working in and leading NHS Psychology Services, and an expert in CBT, Psychodynamic psychotherapy, Emotion-focused therapy, EMDR, Acceptance-commitment Therapy and Mindfulness approaches. I offer incisive, experiential, and highly effective treatments designed to help you overcome your distress and effect lasting changes. Seeking help is a major life step. I commit to providing a safe, professional and personalized treatment experience to sensitively support and empower you, deepen your self-understanding and create positive changes for a life that you can truly value.
020 3962 0919 View 020 3962 0919
Photo of Adriana Kelidi, Psychotherapist, MSc, MBABCP
Adriana Kelidi
Psychotherapist, MSc, MBABCP
2 Endorsed
City of London, London EC2R
I aim to tailor therapy to meet the needs of each person, working collaboratively to understand their challenges from their own perspectives. I am committed to providing high-quality care infused with compassion to support you in overcoming your difficulties, and reach your goals at your pace. As a therapist, my approach is naturally influenced by my passions, both personally and professionally. I have worked with universities in tutoring and mentoring the next generation of therapists, and strongly value passing down knowledge to those completing their training, and enjoy being a part of people's development.
I aim to tailor therapy to meet the needs of each person, working collaboratively to understand their challenges from their own perspectives. I am committed to providing high-quality care infused with compassion to support you in overcoming your difficulties, and reach your goals at your pace. As a therapist, my approach is naturally influenced by my passions, both personally and professionally. I have worked with universities in tutoring and mentoring the next generation of therapists, and strongly value passing down knowledge to those completing their training, and enjoy being a part of people's development.
01702 880010 View 01702 880010
Photo of Dr Bahar Pourghobad, Psychologist, HCPC - Clin. Psych.
Dr Bahar Pourghobad
Psychologist, HCPC - Clin. Psych.
City of London, London SE1
I have 11 years of experience supporting people with a wide range of mental health and relational difficulties. Alongside my private practice, I work in the NHS as a Highly Specialist Clinical Psychologist. I specialise in treating adult mental health conditions and offer evidence-based psychological therapy for anxiety disorders (including OCD, health anxiety, and specific phobias), depression, trauma, low self-esteem, and relationship difficulties. I have a special interest in supporting individuals experiencing work-related stress, anxiety, and burnout. I am also trained and experienced in adult Autism assessments.
I have 11 years of experience supporting people with a wide range of mental health and relational difficulties. Alongside my private practice, I work in the NHS as a Highly Specialist Clinical Psychologist. I specialise in treating adult mental health conditions and offer evidence-based psychological therapy for anxiety disorders (including OCD, health anxiety, and specific phobias), depression, trauma, low self-esteem, and relationship difficulties. I have a special interest in supporting individuals experiencing work-related stress, anxiety, and burnout. I am also trained and experienced in adult Autism assessments.
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Photo of Dr Motchila Innocente, Psychologist, PsychD, HCPC - Clin. Psych.
Dr Motchila Innocente
Psychologist, PsychD, HCPC - Clin. Psych.
City of London, London EC1A
I'm a Clinical Psychologist with over 20 years' NHS and private experience, supporting adults with anxiety, depression, trauma and more. I specialise in supporting neurodivergent adults and people navigating menopause. Seeking therapy can feel daunting, and you might be unsure what to expect, or whether it's the right time. You may have been managing alone for a long time, until something has shifted and those strategies no longer feel enough. You might be carrying something unresolved from the past, or going through a difficult time in the present. Therapy offers a space to make sense of what's happening and find a way forward.
I'm a Clinical Psychologist with over 20 years' NHS and private experience, supporting adults with anxiety, depression, trauma and more. I specialise in supporting neurodivergent adults and people navigating menopause. Seeking therapy can feel daunting, and you might be unsure what to expect, or whether it's the right time. You may have been managing alone for a long time, until something has shifted and those strategies no longer feel enough. You might be carrying something unresolved from the past, or going through a difficult time in the present. Therapy offers a space to make sense of what's happening and find a way forward.
020 4572 1274 View 020 4572 1274
Photo of Fatma Arnavut - The Self-Esteem & Anxiety Therapist , Psychotherapist, MBABCP
The Self-Esteem & Anxiety Therapist
Psychotherapist, MBABCP
City of London, London EC2R
Regulate stress. Manage Anxiety. Boost your self esteem. Build confidence. Do you struggle with overthinking, stress, anxiety, or feeling constantly on edge? Maybe you experience anxiety attacks, intrusive thoughts OR find it hard to relax. Perhaps past experiences still affect you, making it difficult to feel safe or in control? I help burnt out clients break free from cycles of anxiety, depression, self-doubt, and self criticism using CBT, EMDR, and mind-body techniques. Therapy can help you feel calmer, build confidence and regain a sense of balance in your life. You don’t have to navigate this alone—let me help you!
Regulate stress. Manage Anxiety. Boost your self esteem. Build confidence. Do you struggle with overthinking, stress, anxiety, or feeling constantly on edge? Maybe you experience anxiety attacks, intrusive thoughts OR find it hard to relax. Perhaps past experiences still affect you, making it difficult to feel safe or in control? I help burnt out clients break free from cycles of anxiety, depression, self-doubt, and self criticism using CBT, EMDR, and mind-body techniques. Therapy can help you feel calmer, build confidence and regain a sense of balance in your life. You don’t have to navigate this alone—let me help you!
01708 596846 View 01708 596846
Photo of Dr Jessica C Bird, Psychologist, PhD, HCPC - Clin. Psych.
Dr Jessica C Bird
Psychologist, PhD, HCPC - Clin. Psych.
City of London, London EC3V
Hi, I'm Jess - a Clinical Psychologist qualified in EMDR and CBT with 10+ years’ experience in specialist mental health services for teenagers and young adults. My expertise includes assessing and treating trauma/PTSD, paranoia, unusual beliefs and delusions, obsessive compulsive disorder (OCD), and sleep disorders. I also provide specialist support for people struggling with problematic AI chatbot use, including companion relationships, compulsive use, and AI-spirals that disconnect their reality (i.e. AI-associated delusions & psychosis).
Hi, I'm Jess - a Clinical Psychologist qualified in EMDR and CBT with 10+ years’ experience in specialist mental health services for teenagers and young adults. My expertise includes assessing and treating trauma/PTSD, paranoia, unusual beliefs and delusions, obsessive compulsive disorder (OCD), and sleep disorders. I also provide specialist support for people struggling with problematic AI chatbot use, including companion relationships, compulsive use, and AI-spirals that disconnect their reality (i.e. AI-associated delusions & psychosis).
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Photo of Teo Furnadzhieva, Psychotherapist, MBABCP
Teo Furnadzhieva
Psychotherapist, MBABCP
City of London, London SE1
Types of CBT offered include Trauma-Focused CBT, Behavioural Activation, Rumination Focused CBT, Exposure and Response Prevention ( ERP) and disorder specific approaches to anxiety disorders.
Anxiety is a natural part of life, but when it becomes overwhelming, it can stop you from doing what matters most—perhaps spending time with loved ones, trying new experiences, or simply feeling at ease. In an effort to cope, it's easy to fall into patterns that make anxiety worse, leaving you feeling stuck or isolated. You might build walls to protect yourself from disappointing others or feeling embarrassed, but those same walls can push people away, leaving you more disconnected. My approach is centered on creating a compassionate, safe space where we can explore the thoughts, feelings, and behaviors that are holding you back.
Types of CBT offered include Trauma-Focused CBT, Behavioural Activation, Rumination Focused CBT, Exposure and Response Prevention ( ERP) and disorder specific approaches to anxiety disorders.
Anxiety is a natural part of life, but when it becomes overwhelming, it can stop you from doing what matters most—perhaps spending time with loved ones, trying new experiences, or simply feeling at ease. In an effort to cope, it's easy to fall into patterns that make anxiety worse, leaving you feeling stuck or isolated. You might build walls to protect yourself from disappointing others or feeling embarrassed, but those same walls can push people away, leaving you more disconnected. My approach is centered on creating a compassionate, safe space where we can explore the thoughts, feelings, and behaviors that are holding you back.
020 3835 5237 View 020 3835 5237
Photo of Amy Stoddard Ajayi, Psychotherapist, MSc, MBACP
Amy Stoddard Ajayi
Psychotherapist, MSc, MBACP
Serves Area
I am a Cognitive Behavioural Therapist with a background in specialist NHS psychological treatment. I am the Director of Psychological Coaching Ltd, where i deliver a specialist psychological service to Grant Thornton UK LLP's Partners. I am the Mental Health Lead for the Cambridge Medical Academy (Cambridge University), where I train a global network of 800+ doctors and nurses in mental health. My research on improving access to mental health has been published internationally. I sit on a number of international Boards where I advise on mental health service design.
I am a Cognitive Behavioural Therapist with a background in specialist NHS psychological treatment. I am the Director of Psychological Coaching Ltd, where i deliver a specialist psychological service to Grant Thornton UK LLP's Partners. I am the Mental Health Lead for the Cambridge Medical Academy (Cambridge University), where I train a global network of 800+ doctors and nurses in mental health. My research on improving access to mental health has been published internationally. I sit on a number of international Boards where I advise on mental health service design.
01243 957262 View 01243 957262
Photo of David Clifford, Psychotherapist, COSRT Accred
David Clifford
Psychotherapist, COSRT Accred
1 Endorsed
Serves Area
Hello, I'm David, a relationship therapist, clinical sexologist and psychotherapist. I offer a warm, confidential and non-judgemental space where you can talk openly about the difficulties you are facing. I work with individuals and couples experiencing relationship challenges, communication difficulties, loss of intimacy and sexual concerns, including stress, anxiety, sexual anxiety, erectile and ejaculation difficulties, affair and betrayal recovery, desire differences, concerns around porn or sexual behaviours, shame, LGBTQ+ experiences, alternative relationships and chemsex.
Hello, I'm David, a relationship therapist, clinical sexologist and psychotherapist. I offer a warm, confidential and non-judgemental space where you can talk openly about the difficulties you are facing. I work with individuals and couples experiencing relationship challenges, communication difficulties, loss of intimacy and sexual concerns, including stress, anxiety, sexual anxiety, erectile and ejaculation difficulties, affair and betrayal recovery, desire differences, concerns around porn or sexual behaviours, shame, LGBTQ+ experiences, alternative relationships and chemsex.
020 3879 3502 View 020 3879 3502

Nearby Exposure Response Prevention (ERP) Counsellors Searches for City of London, London

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Exposure Response Prevention (ERP) Counsellors
Do I need exposure and response prevention therapy?
Many clients decide to seek help for obsessive thoughts and compulsive behaviours when these symptoms are distressing enough to disrupt everyday life. Any thoughts or behaviours that cause friction in close relationships are also worth addressing. In addition, the client’s symptoms don’t have to be severe for them to benefit from ERP therapy.

Is exposure and response prevention therapy part of cognitive behavioural therapy?
Exposure and response prevention is one specific type of CBT that focuses on behavioural change in response to triggering stimuli. It is related to exposure therapy but adds an additional component of preventing compulsive and harmful responses.

How long does exposure and response prevention therapy take?
While every patient is different, exposure and response prevention therapy typically lasts around 12 sessions, although some treatments can take longer. A therapist will determine if the treatment is complete based on how the client faces their fears, particularly the strongest ones. When a client feels less anxiety about stimuli that once evoked terror or distress, that is generally an indication that they are nearing the end of ERP therapy.

What are the limitations of exposure and response prevention therapy?
The most common pitfalls of exposure and response prevention therapy include not addressing a client’s core fears, allowing the client to avoid their most distressing stimuli, and using imaginary exposure when the client requires real-life exposure (and vice versa). ERP therapy is most effective when the client commits to the full course of treatment; if the client stops early or doesn’t practice what they have learned outside of therapy sessions, they are less likely to have successful outcomes.