Exposure and Response Prevention (ERP) for Children, Teens, and Young Adults in Portland, OR

What Is Exposure and Response Prevention (ERP)?

Exposure and Response Prevention (ERP) is the gold-standard treatment for Obsessive-Compulsive Disorder (OCD) and is one of the most effective evidence-based therapies for helping children, teens, and young adults overcome anxiety-driven avoidance and compulsive behaviors.

ERP helps individuals gradually face situations, thoughts, feelings, images, or sensations that trigger anxiety while learning to resist rituals, avoidance, reassurance-seeking, or other behaviors that keep anxiety and OCD going. Over time, young people learn that they can tolerate uncertainty, experience anxiety without being controlled by it, and build confidence in their ability to cope.

What Difficulties Can ERP Help With?

As an ERP therapist, OCD therapist, and child and adolescent psychologist in Portland, OR, I use ERP to help children, teens, and young adults with difficulties like anxiety, OCD, perfectionism, reassurance-seeking, panic symptoms, specific phobia, school avoidance.

ERP can be helpful whenever fear, anxiety, uncertainty, or unwanted thoughts begin limiting a young person's ability to participate in school, relationships, family life, or valued activities.

What Does ERP Look Like?

Many people hear the word "exposure" and worry that therapy will be overwhelming. In reality, ERP is gradual, collaborative, and tailored to each person's developmental level and goals.

Together, we create a personalized plan to help your child or teen face fears in manageable steps. Exposures may involve:

• Touching objects that feel "contaminated"

• Making small mistakes on purpose

• Resisting the urge to check

• Sleeping independently

• Practicing social situations

• Tolerating uncertainty

• Facing feared thoughts without seeking reassurance

• Approaching situations that have been avoided because of anxiety

The goal is not to force children to face their worst fears immediately. Instead, ERP helps young people build confidence through repeated practice and successful experiences.

What to Expect During Therapy

Treatment begins with a comprehensive assessment to understand your child or teen's symptoms, triggers, compulsions, avoidance patterns, strengths, and goals.

Together, we will:

• Learn how anxiety and OCD operate

• Identify rituals, compulsions, and avoidance behaviors

• Create an exposure hierarchy

• Practice exposures both in and outside of session

• Build tolerance for uncertainty and discomfort

• Reduce reliance on rituals and reassurance

• Increase participation in meaningful activities

• Celebrate progress and build confidence

Parents are often actively involved in treatment. They learn how to support ERP at home and reduce accommodations that may unintentionally reinforce anxiety or OCD.

ERP and ACT

I frequently integrate Acceptance and Commitment Therapy (ACT) with ERP. ACT helps children and teens develop a different relationship with anxious thoughts and feelings, allowing them to focus on what matters most rather than becoming stuck in fear, avoidance, or compulsive behaviors.

Combining ERP and ACT can help young people build both practical skills and psychological flexibility, leading to long-term improvements in functioning and quality of life.

My Approach to ERP

As a child psychologist, teen therapist, and ERP therapist in Portland, Oregon, I strive to make therapy supportive, engaging, and evidence-based. ERP can feel challenging at times, but children and teens are often surprised by how much confidence they gain when they learn they can handle difficult thoughts and feelings without letting anxiety or OCD take over.

The goal of treatment is not to eliminate all anxiety. The goal is to help young people live fuller, more meaningful lives despite anxiety, OCD, or uncertainty.