Successes and Pitfalls of ERP: Houston conference covers the of basics of “facing your fears” in OCD treatment

“Facing your Fears: the Basics of ERP,” was the theme of the OCD TEXAS quarterly meeting and conference in Houston on Saturday, May 19, 2012. The conference introduced OCD sufferers, their families, students and professionals to the treatment method deemed most effective for obsessive compulsive disorder. Exposure Response and Prevention therapy challenges patients to face their fears, ultimately to lower their anxiety and learn to weaken the demands of obsessive compulsive disorder.

ERP is an effective therapy for OCD. It is also challenging for the therapist to administer and takes hard work and dedication from the patient. Conference speakers and panelists with OCD shared their experiences with ERP. Professional treatment providers spoke on ERP therapy as the evidence-based “treatment of choice” for OCD. A web-assisted ERP program and an iPhone app for ERP were introduced.

Medication treatment was also discussed, as an adjunct to ERP. Participants also spoke of the importance of support from family, friends and other OCD sufferers as essential on the path to recovery from the debilitating symptoms of OCD.

Keynote Speaker: Shay Mooney – “Successes & Pitfalls of ERP”Shay mooney

During her third year in college, Shay Mooney became overrun with fears and anxiety. Her mind was consumed with questions that led to checking and rechecking rituals. Did I lock the door? Did I hit a pedestrian today? If I think about something bad, will it come true?
These thoughts paralyzed her. She stopped driving her car and would check the door multiple times to make sure it was locked. Shay Mooney was suffering from obsessive compulsive disorder.

Mooney, now 23, a Houston native attending social work graduate school in Austin, shared her journey from diagnosis to intensive treatment to recovery, encouraging and inspiring attendees to regain control of their lives.

“My OCD was absolutely exhausting,” said Mooney. “I felt like I was deteriorating with each passing day. During treatment, I learned that facing the situations I feared made my anxiety go down. I have learned to accept that doubt is all around us.”
Mooney’s treatment included driving her car in areas full of pedestrians and purposely leaving lights on or doors unlocked.

Although Shay has largely overcome her OCD to the extent that it no longer significantly impacts her functioning, she continues to do ERP exercises to maintain her gains and to continue to make progress on her symptoms. “I feel blessed to have had support from family, friends and therapists along the difficult journey of recovery,” she said.

“I am so grateful for the opportunity to speak with others who struggle with the same challenges I struggle with.”


Throstur pink elephantIn an introductory “OCD 101” talk, Thröstur Björgvinsson, PhD, director of the Houston OCD Program, described obsessions as intrusive, unwanted thoughts. When someone tries to stop having those thoughts, however, he said, it’s like saying “Don’t think of a pink elephant!” — the thoughts then actually start flooding into the mind. People with OCD often perform compulsions, actions taken in attempt to stop or neutralize unwanted thoughts. In ERP therapy, the person resists doing compulsions in response to obsessive thoughts, and the intensity and frequency of the obsessive thoughts diminishes over time.

Joyce Davidson, MD, from The Menninger Clinic , spoke on medication treatment options for OCD. Medication is typically helpful as an adjuct to ERP therapy.
Two technology-assisted ways of doing ERP were presented at the conference.

OCD Challenge is an online, interactive, behavioral program, built by leading psychologists in the field of behavior therapy, that uses the principles of ERP to help users confront and challenge their OCD using an interactive website.

Live OCD Free, an iPhone app, available in versions for children and adults, interactively helps users set up an exposure hierarchy, set practice goals and rewards, and provides tools to help users fight OCD symptoms at any place or any time.


Both adults and youth panelists with OCD spoke about their experiences with ERP therapy, describing both challenges and successes. The encouraged others who had not yet tried ERP treatment, and urged those in treatment to trust that it works and to keep at it.

Professional treatment providers — John Hart, PhD, Michael Soderstrom, MA, LPC, Emily Anderson, PhD, Constantina Boudouvas, LCSW, and Sarah A. Webb, PhD — also spoke on a panel, describing ERP in their practices. They offered examples of exposure exercises that had been successful in helping their clients overcome significant OCD symptoms.

Research posters:

Researchers from the University of Houston – Clear Lake, students in the laboratory of Chad Wetterneck, PhD, presented posters of recent studies of OCD phenomenology and treatment of obsessive compulsive spectrum disorders with an emphasis on OCD, trichotillomania, and Tourette’s syndrome. The 10 research posters presented were:

Steinberg, D. S., Wetterneck, C. T., Hart, J., & Smith, A. H. (May, 2012). Experiential avoidance in obsessive-compulsive symptom dimensions.

Wetterneck, C.T., Little, T.E., Hart, J.M., & Smith, A.H. (May, 2012). An Exploration of Relationship Satisfaction and Caretaker Burden in OCD Sufferers and Caregivers.

Wetterneck, C.T., Little, T.E., Daniel, J.C., Smith, A.H., & Baker, A. (May, 2012). Exploring the Links Between Sexual Trauma, Intrusive Thoughts, and OCD Symptomology.

Wetterneck, C.T., Little, T.E., Hart, J.M., & Smith, A.H. (May, 2012). The Relationship Between Self-Compassion and OCD Subtype Severity.

Little, T.E., Wetterneck, C.T., Chasson, G. S., & Bjorgvinsson, T. (May, 2012). The Relationships Between Personality Disorder Dimensions and OCD Severity.

Smith, A.H., Wetterneck, C. T., Hart, J.M., Little, T.E., & Short, M.B. (May, 2012). Predictors of Distress in the Obsessive Compulsive Disorder Subtypes.

DePue, S., Blandon, J., Smith, A., & Wetterneck, C.T. (May, 2012). Trauma vs. Obsessions: Distress and Beliefs about Sexually Intrusive Thoughts.

Burgess, A.J., Smith, A.H., Cervantes, M.E., & Wetterneck, C.T. (May, 2012). Variations in the report of Obsessive-Compulsive symptomology and mental health beliefs across ethnicities.

Manos, R. C., Cahill, S. P., Wetterneck, C. T., Conelea, C. A., Ross, A. R., & Riemann, B. C. (May, 2012). The impact of experiential avoidance and obsessive beliefs on obsessive-compulsive symptoms in a severe clinical sample.

Burgess, A.J., Smith, A.H., Cervantes, M.E., Wetterneck, C.T. (May, 2012). Variations in Obsessive-Compulsive Symptoms by Ethnicity: The Importance of Cross-Cultural Examination of OCD Symptomology.

Support Groups: In the late afternoon, several special support groups met, giving participants an opportunity to meet others with OCD, exchange information and offer support to each other.

Networking for Treatment Professionals: In the late afternoon treatment providers also met for peer consultation on using ERP in OCD treatment, as well as for networking.

Location: The event was held at The Houston Council on Alcohol & Drugs, 303 Jackson Hill St., in Houston.

Attendees: The conference had 91 attendees.

Photos: Photos by Claire Jordan and Irene Tobis. More photos. Photos on this page can also be viewed here. Photos are available for download, but please respect confidentiality — do not tag or repost without permission. Thanks.

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