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Exposure and Response Prevention for Teens: A Guide to Overcoming Anxiety and OCD

Adolescence comes with its share of challenges—from academic pressures and social expectations to the complexities of self-discovery. For some teenagers who develop anxiety and obsessive-compulsive disorder (OCD), these symptoms can become particularly overwhelming. When OCD and anxiety are disrupting their ability to engage fully in daily life, one of the most effective treatments for teens is Exposure and Response Prevention (ERP) therapy. This evidence-based approach empowers adolescents to confront their fears and break free from distressing cycles of behavior, allowing them to regain control and thrive.

What is Exposure and Response Prevention (ERP)?

Exposure and Response Prevention (ERP) is a specialized form of cognitive-behavioral therapy (CBT) and it is considered the gold standard for OCD treatment. ERP is also empirically proven to be effective for other anxiety disorders, such as social anxiety, panic disorder, and phobias. ERP involves two key components: exposure and response prevention.

  1. Exposure: This part of therapy involves gradually and systematically confronting situations, thoughts, or objects that trigger anxiety or fear. For teens with OCD, this could include confronting certain intrusive thoughts or feared situations that typically cause overwhelming anxiety.
  2. Response Prevention: The goal of response prevention is to break the cycle of compulsive behaviors. Teens with OCD often engage in specific rituals or behaviors to reduce anxiety, such as washing their hands repeatedly, checking things, or seeking reassurance. In ERP, the therapist helps teens resist these compulsions, allowing them to experience anxiety without performing the rituals that reinforce it.

Why ERP is Effective for Teens

ERP is especially effective for teens with OCD because it targets the root cause of their anxiety: avoidance and compulsive behaviors. By facing their fears in a controlled, gradual manner, teens learn that their anxiety naturally decreases over time, even without the need for compulsive rituals. This process helps them realize that their worst fears are unlikely to come true and that they can manage anxiety without resorting to avoidance or ritualistic behaviors.

Moreover, ERP empowers teens to take an active role in their healing process. Rather than avoiding their anxiety triggers, they begin to understand that facing those triggers is the key to feeling better. In this sense, ERP builds confidence and resilience, helping teens develop valuable coping skills that can serve them in many areas of life.

How ERP Works for Teens

Therapists use a step-by-step approach when conducting ERP with teens. Here’s how the process typically works:

  1. Assessment and Education: At the beginning of treatment, the therapist works closely with the teen to understand their specific symptoms, triggers, and compulsions. The therapist also educates the teen and their family about the nature of anxiety and OCD, explaining how avoidance and compulsive behaviors perpetuate the cycle of anxiety.
  2. Creating an Exposure Hierarchy: The therapist and teen collaborate to create a list of situations or thoughts that trigger anxiety, ranked from least to most distressing. This list is called an exposure hierarchy. By starting with less anxiety-provoking situations, teens can build confidence as they work their way up the hierarchy.
  3. Gradual Exposure: The teen is gradually exposed to these triggers in a controlled and safe environment. For example, if a teen has a fear of contamination and washes their hands excessively, the therapist might begin with a less challenging task, such as touching an object they perceive as dirty. Over time, the exposures become more challenging as the teen learns to tolerate anxiety without performing compulsive behaviors.
  4. Response Prevention: During each exposure, the teen is encouraged to resist performing any compulsions. This may involve refraining from rituals such as washing hands, checking behaviors, or seeking reassurance. The therapist supports the teen through this process, helping them stay committed to resisting the urge to engage in compulsive behaviors.
  5. Reinforcement: As the teen successfully completes exposures without performing compulsive responses, they gain a sense of accomplishment. This reinforcement encourages continued progress and helps solidify the skills they’ve learned.

Benefits of ERP for Teens

There are many reasons why ERP is a great treatment option for teens with anxiety and OCD:

  • Reduces Anxiety: By confronting feared situations, teens learn that their anxiety decreases over time, even without performing rituals.
  • Improves Confidence: ERP helps teens feel empowered as they take control of their anxiety and learn how to cope with uncomfortable feelings.
  • Long-Term Results: Research shows that ERP can provide long-lasting relief from OCD symptoms, leading to improved quality of life and reduced relapse rates.
  • Family Involvement: ERP often involves the family in treatment, providing them with the tools to support their teen throughout the process.

Conclusion

Exposure and Response Prevention (ERP) therapy is a powerful tool for helping teens manage anxiety and OCD. By facing their fears in a controlled and gradual way, teens can break free from the cycle of compulsive behaviors and build stronger coping mechanisms. If your teen is struggling with OCD or anxiety, consider contacting SunCloud Health about ERP therapy as a potential treatment option. Our expert ERP-trained therapists are dedicated to helping your loved one. With the right support, your teen can overcome their challenges and build a brighter, more confident future.

About SunCloud Health

SunCloud Health offers a comprehensive adolescent treatment program tailored to meet the unique needs of teens and adolescents struggling with various challenges. With three centers in Naperville, Northbrook, and Chicago, IL, we ensure quality care is accessible to families across the region. SunCloud provides two levels of care for teenagers – Intensive Outpatient Program (IOP) and Partial Hospitalization Program (PHP) – along with many individualized treatment modalities for long-term health. 

Rachel Collins, LCSW
Site Director of Northbrook PHP and IOP

Rachel Collins, LCSW, is the Site Director of SunCloud Health’s Northbrook Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs for both adolescents and adults. Rachel earned her bachelor’s degree in psychology and went on to complete her master’s degree in social work from Michigan State University. She has since worked in a wide range of settings, including inpatient treatment, PHP/IOP programs, therapeutic group homes, and private practice. Rachel specializes in treating trauma (using Cognitive Processing Therapy) and anxiety, practicing through a relational, compassionate, and client-centered lens. She is passionate about creating a therapeutic space in which clients feel safe and able to explore various parts of themselves with curiosity as opposed to judgement. In addition to her leadership and clinical work, she is passionate about creating art, and learning about the intersection between creativity and mental health.

Kayla Corirossi, MA, LCSW
Site Director, Naperville PHP/IOP (Adolescents & Adults)

Kayla Corirossi, MA, LCSW, is the Site Director of SunCloud Health’s Naperville Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs for adolescents and adults. She brings extensive experience working with individuals across the lifespan, including adolescents, adults, and geriatric populations, and specializes in the treatment of mood disorders, trauma, substance use, family systems, forensic populations, and individuals in crisis.

Kayla has worked in a wide range of clinical and community settings, including community-based interventions, police crisis response, correctional facilities, inpatient treatment, PHP/IOP programs, and with vulnerable and underserved populations. In addition to her clinical and leadership work, she is passionate about providing mental health education and advocacy within the community.

Kayla earned her Bachelor’s degree with a double major in Psychology and Sociology from Aurora University and went on to complete her Master’s degree in Forensic Social Work, also at Aurora University. Her clinical approach is evidence-based, compassionate, trauma-informed, and integrative, emphasizing collaboration and individualized care.

Driven by a personal mission to meet individuals where they are, Kayla is committed to helping clients feel safe, supported, and understood. She strives to create a natural and empathetic healing environment while ensuring individuals from all backgrounds and identities know they are not alone and have access to meaningful resources and support.

Elizabeth E. Sita, MD
Medical Director of Adult Services
Dr. Elizabeth E. Sita, MD, is a Board Certified psychiatrist specializing in the care of patients with eating disorders. She completed her undergraduate training at the University of Chicago and graduated with Highest Honors. She then earned her medical degree at Northwestern University Feinberg School of Medicine and was recognized with the Chairman’s Award for Excellence in Psychiatry. She subsequently completed residency with the Department of Psychiatry and Behavioral Sciences at McGaw Medical Center of Northwestern University, where she was elected Chief Resident and received the Resident Psychiatrist Leadership & Service Award. Upon completing her training, Dr. Sita came to Ascension Alexian Brothers Behavioral Health Hospital, where she served as Assistant Medical Director of the Center for Eating Disorders and Director of Transcranial Magnetic Stimulation Services before transitioning to lead the new inpatient eating disorder unit as Medical Director of Eating Disorder Services at Ascension Saint Joseph Hospital – Chicago. In these roles, she has cared for a multitude of adolescents and adults struggling with anorexia nervosa, bulimia nervosa, binge eating disorder, and other eating disorders as well as severe, cooccurring mood, trauma, personality, and substance use disorders. Dr. Sita has been recognized throughout her training and practice for a commitment to excellence in patient care and for her ability to engage patients in their most challenging moments. Her passions include the care of treatment-resistant eating and mood disorders as well as questions of medical capacity and end-of-life decision making. She believes that, first and foremost, human connection is key to mental health and well-being and strives to share this philosophy in each and every patient encounter. She is excited to bring her expertise to SunCloud Health as the Medical Director of Adult Services!   VIDEO: Meet Elizabeth E. Sita, MD, Medical Director of Adult Services  
Lacey Lemke, PsyD
Assistant Vice President of Clinical Services

Dr. Lacey Lemke (she/her) is a licensed clinical health psychologist with specialized expertise in the treatment of eating disorders and the practice of medical and health psychology. She completed her doctoral training in clinical psychology with a Primary Care emphasis at the Adler School of Professional Psychology. Dr. Lemke went on to complete both her predoctoral clinical internship and postdoctoral fellowship through Ascension Health, where she gained advanced training working with individuals experiencing eating disorders and self-injurious behaviors, as well as within pediatric subspecialty settings including endocrinology, neurology, and adolescent medicine.

Dr. Lemke is deeply committed to providing evidence-based, compassionate care and collaborates closely with interdisciplinary teams to ensure comprehensive treatment. Her professional mission is to support patients in achieving their fullest potential by guiding them to the most appropriate level of care and empowering them to make meaningful, sustainable progress toward improved health and well-being.

VIDEO: 2. Meet Lacey Lemke, PsyD.