ANXIETY AND DEPRESSION IS OVERCOME BY LEARNING THAT ONE CAN COPE WITH UNCERTAINTY, DISTRESS, AND FEAR
What is Exposure & Response Prevention (ERP) / Exposure Therapy?
Exposure & response prevention (ERP), aka exposure therapy, is the most effective psychological treatment for obsessive compulsive disorder (OCD), anxiety disorders, and posttraumatic stress disorder (PTSD). In ERP, the therapist helps the patient systematically confront 1) situations (e.g., public speaking) and objects (e.g., spider) through in vivo exposure; 2) thoughts (e.g., "I might accidentally harm my baby") through imaginal exposure; and/or 3) bodily sensations (e.g., rapid heart beat, lightheadedness) through interoceptive exposure, that trigger irrational fear without engaging in unhelpful safety behaviors (e.g., avoidance).
What is Behavioral Activation?
In behavioral activation (BA), the experience of major depression is considered a consequence of avoiding or escaping from uncomfortable and negative thoughts or feelings (called ‘experiential avoidance’). As such, in behavioral activation, the therapist helps the patient face the uncomfortable and negative thoughts or feelings and increase contact with sources of reward by helping him/her get more active and, in so doing, improve one’s life.
What Do You Learn?
When exposure is practiced over and over again, patients begin to learn that 1) the feared outcome is often much less likely to happen (or less 'bad') than one might think, and 2) he/she is able to cope even with their worst fear, without using his/her unhealthy/safety behaviors. Exposure therapy helps people learn new safety information about a situation/object/thought/bodily sensation that will inhibit existing fear. In behavioral activation, depressed patients are taught how to recognize the unintended consequences of their ways of coping, including inactivity, social withdrawal, and rumination (e.g. trying to find reasons for the past or attempting to solve insoluble problems), and establish new activities that counter this avoidance. In both exposure therapy and behavioral activation, patients are taught to engage in everyday activities that are in line with their values (i.e., what is important to them in their life). Furthermore, patients learn various coping skills relevant to their symptoms, including appropriate exercise and healthy eating, problem solving skills, sleep management, and mindfulness practice.
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