Exposure and response prevention therapy (ERP) for Obsessive-Compulsive Disorder

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.

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.

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.

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.