Exposure and Response Prevention (ERP) in Ventura and Online in California

Compassionate Evidence-Based Therapy for Obsessions, Rituals, and Avoidance

Exposure and Response Prevention (ERP) is the gold standard recommended first line treatment for Obsessive-Compulsive Disorder (OCD). The primary goal of ERP is to stop compulsions and avoidance. This exposure-based cognitive-behavioral therapy helps people develop courage to face their fears, while reducing and learning to tolerate those fears.

ERP strengthens a sense of agency as you learn you have a choice to stop engaging in mental and physical compulsions. Over time anxiety will lose its grip as you use new skills to master it.

ERP has two key components: exposure and response prevention.

  1. Exposure: This aspect of ERP encourages individuals to purposefully face the situations, thoughts, or objects that trigger them. The exposures are carefully planned and start with less challenging scenarios, gradually progressing to more difficult situations with therapeutic support. The gradual exposures are collaboratively planned and consent-based. Clients are never “forced” to engage in an exposure that they haven’t consented to or is against their personal values.

  2. Response Prevention: During exposure, you are asked to refrain from engaging in compulsive behaviors, including avoidance, rumination, and other rituals you would typically use in an attempt to neutralize your anxiety. By resisting these responses or rituals, you learn new skills and begin to change your behavior patters, which ultimately breaks the cycle of OCD.

Throughout ERP treatment, you will receive support and guidance to navigate recovery. The goal is not to eliminate anxiety entirely, because some anxiety is part of the human experience and has an adaptive function, but to help you recognize you can stop ruminating and running away. You can learn to stop engaging in compulsive behavior with compassionate support.

By treating OCD through structured exposure and refraining from avoidance, rumination, and other rituals, you can take your life back from debilitating anxiety and regain a sense of agency. Feeling like you have the ability to choose what you do is the opposite of being enslaved to OCD. Agency contributes to psychosocial well-being and other positive life outcomes.

In therapy sessions, either in person in Ventura or via Telehealth across California, we will tailor your ERP treatment to meet your individual needs and support your particular OCD presentation. You will learn healthy strategies to reduce or manage anxiety, receive encouragement to keep going, and gain tools to act with courage during exposures. The therapy environment is appropriately supportive and challenging to facilitate your growth and healing.

ERP treatment for obsessional fears is journey towards empowerment and resilience.

“The first step of healing is not a step away from the pain, but a step toward it.”

— Henri Nouwen

ERP (Exposure and Response Prevention) for OCD, Anxiety, and Specific Phobias

Learn to Mange Anxiety in Healthy Ways

With ERP for anxiety and OCD you will learn healthy ways to reduce your anxiety instead of engaging in old patterns of compulsive rituals and avoidance. You will get to practice new skills to cope with those times when you are feeling nervous or worried and have the urge to neutralize the discomfort with behavior you find concerning, including passive avoidance. While learning to manage your triggers you will be supported by a therapist who understands the difficulty and who is rooting for your courage to keep moving towards your goals.

Develop belief in your ability to face your fears

With continued practice in not running away from things that trigger obsessive anxiety you will begin to develop a new narrative about your capabilities. You will learn that you can “feel the fear and do it anyway,” and you may experience the fear dissipating in situations where you aren’t actually in danger. The more you practice showing up with courage while in ERP treatment for anxiety or OCD, the sooner you will develop a more confident sense of self. ERP can help you rewrite your story, in which you are brave and capable.

Increase sense of agency

ERP treatment facilitates knowledge that we have choice. Right now it feels as if you are compelled to practice anxious avoidance and neutralizing rituals like you have no choice but with the help of a carefully crafted ERP treatment plan, you reclaim your freedom to choose. The ability to choose how we spend our time, to decide what behavior we want to engage in, is the antithesis to that feeling of being trapped or enslaved to compulsive behavior that is out of alignment with our values.

Tolerate life’s uncertainty with courage & compassion

It’s hard not knowing for certain how things will turn out. We can invest our best efforts in trying to be healthy, trying to keep our kids safe, trying to control the outcome of things deeply important to us, but the reality is we don’t have full control and we can’t know for sure what the future holds. Tolerance for uncertainty is hard for people with vulnerabilities to anxiety disorders and OCD. Avoidance and compulsive behavior are attempts to secure certainty, which is not possible and comes at a great cost to the richness of life’s adventures. Your ERP therapy should include the goal of learning to accept uncertainty to increase your odds of successful treatment.

Be supported in recovery with specialized help

Effective treatment for anxiety disorders and OCD can be counterintuitive. While therapists have good intentions, certain common therapy practices can make anxiety and OCD worse. Some of these practices include a significant amount of reassurance, justification to avoid triggers, hyper-focus on content of thoughts, open-ended talk therapy with no required commitment to action, and not confronting self-defeating behavior in favor of excessive validation. ERP treatment is the right balance of insight, support, authentic care from the therapist, and challenge to grow. I (Teva) receive live bi-weekly consultation from ERP experts in the field of anxiety, phobias, and OCD. Specialized treatment facilitates recovery while the wrong treatment maintains symptoms and wastes precious time and resources.

Amplify Exposure Practice in the Real World

Practicing ERP out in the community may deepen the skills developed in the therapy office and through your homework. Engaging in exposures with response prevention in diverse settings helps the brain integrate new learning better and faster than if you did all exposures in one or two settings. Community-based exposures help generalize your newfound courage to a wide variety of contexts. Clients can engage in exposures in the community with a therapist as part of their treatment for anxious avoidance. Exposure practice outside of the office with the support of a therapist present is completely voluntary.

Ventura County offers numerous opportunities for community-based exposures relevant to your particular obsessional themes. We will take appropriate privacy precautions and select locations likely to provide the most opportunity for growth.

On Location Exposures

Exposures out of the office are a great way to deepen in office learning and expand your capacity to tolerate triggers without engaging in physical or mental compulsions. Locations are chosen based on your clinical needs and appropriateness of setting.

Below are a few ideas for local ERP practice. Community exposures are selected to intensify and generalize your learning to broader settings. Ideas include:

  • Ventura Harbor Village

  • Downtown Ventura

  • The Collection in Oxnard

  • Ventura County farms

  • Ventura, Oxnard, or Carpinteria beaches

  • Ventura College campus

  • Starbucks or local restaurants

Picture of horses in Ventura County

  • Exposure and Response Prevention therapy can take place in person in the office, over Zoom, and outside in the broader community. We can visit relevant locations to practice exposures based on your particular obsessions. For example, we can confront contamination obsessions at a local beach or farm while encouraging openness to new experiences and tolerance of uncertainty. This type of psychological flexibility promotes recovery.

    We can approach your triggers with courage and creativity so you take your life back from OCD and specific phobias.

Beach in Ventura California with image of lifeguard tower, blue skies, and sand.


  • Ventura and Santa Barbara County beaches offer many opportunities to practice exposure and response prevention related to your particular OCD themes and goals for recovery. Exposures are planned collaboratively with consideration for privacy. Beaches are great places for social exposures and for contamination obsessions. Beaches are ideal locations to practice not ruminating on your obsessions and returning to the present moment.

Exposure Therapy FAQs

If I have contamination OCD will I be forced to touch gross things?

No, ERP treatment doesn’t force clients to do anything. Therapy is voluntary and consent-based. What you do or don’t do in therapy is entirely up to you. Exposure exercises are planned collaboratively between us and you can veto any suggestions I may have.

That being said, ERP is a modality where you confront things you fear and confront things you have been avoiding. If your obsessions are about contamination, then yes, treatment with ERP requires intentionally exposing yourself to what you fear and this could be approached any number of ways.

I have ‘Pure O’ OCD. How will ERP work?

‘Pure O’ OCD is a bit of a misnomer, as to quality for an OCD diagnosis compulsions must be present. In other words, if someone only has obsessions and no compulsions they don’t have OCD.

What some refer to as ‘Pure O’ is unwanted thoughts followed by a mental process of rumination, which is a compulsion not visible to others like physical compulsions are. To treat the mental loop of rumination, I use Rumination-Focused ERP (RF-ERP) and teach you how to stop mental compulsions while you confront triggers that normally cause you to spiral with thoughts that feel out of control.

How often will I have to do exposure homework with ERP?

ERP is a commitment both in session and outside of session. I recommend 5-7 days of exposure practice. As one of my teachers, Dr. Jon Grayson says, “OCD never rests, why should treatment?”

Clients who practice exposure homework in a disciplined fashion most days of the week see faster results. Recovery from OCD with ERP is a lot like getting strong in the gym—active participation is required for results. Each time you practice you are moving closer to your goals.

How many ERP sessions will I need?

Recovery is a highly individualized process. The length of time for a successful course of Exposure and Response Prevention treatment depends on variables like severity of symptoms, cooccurring mental health conditions (eg. depression), environmental stressors (eg. financial challenges), your commitment to practicing between sessions, and our working alliance. It is not possible for me to give an exact number of sessions, however, from experience, most clients experience significant relief in about 6 months but each person’s timeframe is unique.