Exposure and response prevention therapy (ERP)
What it is
Exposure and response prevention (ERP) is a form of CBT that NICE includes among treatment options for adults with OCD, within the scope of its guideline recommendation.
Official guideline documents · checked Aug 24, 2026
Relationship: supports
Statement scope
- Document
CG31
- Jurisdiction
United Kingdom
- Population
adults with OCD
Source collection coverage: global
Pointer: /document/recommendation
Source: Official guideline documents. Checked Aug 24, 2026. Scope: global.
Why it is on this page
People: niños y adolescentes con TOC
GuíaSalud GPC 634: TOC en niños y adolescentes · checked Oct 16, 2026
Relationship: recomendado para población pediátrica con TOC
Statement scope
- Jurisdiction
Sistema Nacional de Salud de España
- Population
niños y adolescentes con TOC
Source collection coverage: country:ES
Pointer: /recommendations/0
Open sourceSource: GuíaSalud GPC 634: TOC en niños y adolescentes. Checked Oct 16, 2026. Scope: country:ES. Link: https://portal.guiasalud.es/wp-content/uploads/2025/02/gpc_634_toc_nino_adolescente_compl.pdf
Why it is on this page
People: adults with OCD
Official guideline documents · checked Aug 24, 2026
Relationship: guideline recommendation
Statement scope
- Document
CG31
- Jurisdiction
United Kingdom
- Population
adults with OCD
Source collection coverage: global
Pointer: /document/recommendation
Source: Official guideline documents. Checked Aug 24, 2026. Scope: global.
Research for Obsessive-Compulsive Disorder
Research suggests benefit in this exact scope
Published Oct 7, 2026 · revision 4
What research says
NICE CG31, recommendation 1.5.1.1, identifies psychological treatment that includes ERP as a low-intensity initial option for adults with OCD when impairment in everyday functioning is mild, when they prefer a low-intensity approach, or both. This is an attributed guideline recommendation for that adult group.
Official guideline documents · checked Oct 3, 2026
Relationship: supports the attributed adult initial-treatment recommendation and its delivery qualifiers
Statement scope
- Formulation or format
brief individual cognitive behavioural therapy (CBT; including ERP) using structured self‑help materials; brief individual CBT (including ERP) by telephone; group CBT (including ERP)
- Guideline
CG31
- Indication
obsessive-compulsive disorder
- Intensity
up to 10 therapist hours per patient; group CBT (including ERP) may exceed 10 hours
- Treatment phase
initial treatment
- Population
Adults with OCD whose functional impairment is mild and/or who prefer a low-intensity approach
- Recommendation
1.5.1.1
Source collection coverage: global
Pointer: /document/recommendation
Open sourceSource: Official guideline documents. Checked Oct 3, 2026. Scope: global. Link: https://www.nice.org.uk/guidance/cg31/chapter/Recommendations
Delivery and time commitment
For this initial-treatment pathway, NICE CG31 describes low-intensity care as using up to 10 hours of therapist time per patient. Its listed formats include brief individual CBT with ERP supported by structured self-help materials, brief individual CBT with ERP by telephone, and group CBT with ERP. In the group format, a patient may receive more than 10 hours of therapy.
Official guideline documents · checked Oct 3, 2026
Relationship: supports the attributed adult initial-treatment recommendation and its delivery qualifiers
Statement scope
- Formulation or format
brief individual cognitive behavioural therapy (CBT; including ERP) using structured self‑help materials; brief individual CBT (including ERP) by telephone; group CBT (including ERP)
- Guideline
CG31
- Indication
obsessive-compulsive disorder
- Intensity
up to 10 therapist hours per patient; group CBT (including ERP) may exceed 10 hours
- Treatment phase
initial treatment
- Population
Adults with OCD whose functional impairment is mild and/or who prefer a low-intensity approach
- Recommendation
1.5.1.1
Source collection coverage: global
Pointer: /document/recommendation
Open sourceSource: Official guideline documents. Checked Oct 3, 2026. Scope: global. Link: https://www.nice.org.uk/guidance/cg31/chapter/Recommendations
More intensive option
For adults with OCD whose day-to-day functioning is moderately impaired, England’s NICE guideline CG31 (recommendation 1.5.1.3) says they should be offered a choice between a course of an SSRI medicine and more intensive CBT that includes ERP, meaning more than 10 hours of therapist time, because the two appear to be comparably effective. This describes a guideline pathway; a local provider’s approach and an individual’s needs may differ.
Official guideline documents · checked Oct 7, 2026
Relationship: supports the attributed moderate-impairment choice and intensive therapist time
Statement scope
- Alternative
a course of an SSRI
- Delivery
more intensive CBT (including ERP; more than 10 therapist hours per patient)
- Guideline
CG31
- Indication
Obsessive-compulsive disorder
- Population
Adults with OCD with moderate functional impairment covered by NICE CG31
- Recommendation
1.5.1.3
- Section
1.5.1 Initial treatment options: Adults
Source collection coverage: global
Pointer: /document/recommendation
Open sourceSource: Official guideline documents. Checked Oct 7, 2026. Scope: global. Link: https://www.nice.org.uk/guidance/cg31/chapter/Recommendations
Severe impairment option
For adults with OCD whose day-to-day functioning is severely impaired, England’s NICE guideline CG31 (recommendation 1.5.1.4) says they should be offered combined treatment: an SSRI medicine together with CBT that includes ERP. This describes a guideline pathway; a local provider’s approach and an individual’s needs may differ.
Official guideline documents · checked Oct 7, 2026
Relationship: supports the attributed severe-impairment combined treatment
Statement scope
- Delivery
combined treatment with an SSRI and CBT (including ERP)
- Guideline
CG31
- Indication
OCD
- Population
Adults with OCD with severe functional impairment
- Recommendation
1.5.1.4
- Section
1.5.1 Initial treatment options: Adults
Source collection coverage: global
Pointer: /document/recommendation
Open sourceSource: Official guideline documents. Checked Oct 7, 2026. Scope: global. Link: https://www.nice.org.uk/guidance/cg31/chapter/Recommendations
Children and young people
For children and young people with OCD whose functioning is moderately to severely impaired, or mildly impaired when guided self-help has not worked or was declined, NICE CG31 (recommendation 1.5.1.9) names CBT that includes ERP as the treatment of choice, involving the family or carers and adapted to the child’s developmental age. This describes a guideline pathway in England; a local provider’s approach and an individual’s needs may differ.
Official guideline documents · checked Oct 7, 2026
Relationship: supports the attributed young-people treatment of choice and its family and age adaptations
Statement scope
- Delivery
CBT (including ERP) that involves the family or carers and is adapted to suit the developmental age of the child
- Format
Group or individual formats depending upon the preference of the child or young person and their family or carers
- Guideline
CG31
- Indication
OCD
- Issuer
National Institute for Health and Care Excellence
- Population
Children and young people with OCD with moderate to severe functional impairment, and those with OCD with mild functional impairment for whom guided self-help has been ineffective or refused
- Recommendation
1.5.1.9
- Section
1.5.1 Initial treatment options: Children and young people
Source collection coverage: global
Pointer: /document/recommendation
Open sourceSource: Official guideline documents. Checked Oct 7, 2026. Scope: global. Link: https://www.nice.org.uk/guidance/cg31/chapter/Recommendations
Compared with the others: Not directly compared. We show each option’s own research.