Exposure and response prevention therapy (ERP)

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Explore for Obsessive-Compulsive Disorder

Summary

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

Published Aug 24, 2026Revision 1 · EveryOptionEnglish (United States)

Published Need uses

Select an exact Need to inspect its scoped research. These are the uses currently published on EveryOption; they do not establish every use of Exposure and response prevention therapy (ERP) or a personal recommendation.

1 published use

Exposure and response prevention therapy (ERP) for Obsessive-Compulsive Disorder
Published assessmentPublished Oct 7, 2026 · revision 4

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

The research answer belongs to this exact Need and its published scope. It does not establish benefit for other uses of Exposure and response prevention therapy (ERP).

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 source

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 source

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 source

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 source

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 source

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 source

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

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