Show Notes
In this episode, we dive deep into the world of Exposure and Response Prevention (ERP)—the gold standard treatment for Obsessive-Compulsive Disorder (OCD)—through a clinical and ethical lens. We unpack the delicate balance between challenging clients and protecting their autonomy, exploring how therapeutic trust, client consent, and collaborative exposure tasks shape the success of ERP. This conversation asks the tough questions: How far is too far in exposure therapy? And what happens when fear is no longer the enemy, but the doorway to healing?
💬 Key themes: The role of informed consent in exposure therapy Building trust and safety in the therapeutic relationship Understanding OCD beyond the symptoms Why a collaborative approach is more effective than a prescriptive one Recognizing when a therapist's anxiety enters the room too
🔖 Chapters 00:00 Introduction to ERP and Client Concerns 02:46 Understanding OCD and Its Impact 05:53 The Role of Trust in Therapy 08:53 Navigating Exposure Tasks Collaboratively 11:51 Ethics of Exposure Therapy 14:54 Client Consent and Collaboration 17:38 Managing Anxiety During Exposure 20:45 The Importance of Client Agency 23:44 Conclusion and Key Takeaways
#ERP #OCDTreatment #ExposureTherapy #TherapyEthics #ClientConsent #MentalHealth #TherapyPodcast #TherapeuticTrust #CollaborativeCare #AnxietySupport #OCDRecovery #EthicalTherapy Hosted on Acast. See acast.com/privacy for more information.
More from Breaking the Rules: A Clinician's Guide to Treating OCD
This one's for the parents. In this episode of Breaking the Rules, Dr Celin Gelgec and Dr Tori Miller tackle one of the most common questions they hear from families - I think my child might have OCD. Where do I even start?
OCD or Anxiety? It's Not a Black and White Question
ERP is the gold standard for OCD. But what happens when it's not enough on its own? In this episode of Breaking the Rules, Dr Celin Gelgec and Dr Tori Miller explore one of the most important — and least talked about — questions in OCD treatment: when and how to bring in other therapeutic modalities, and how to do it without abandoning the principles that make ERP work. Tori shares what traditional manualized ERP actually looked like in the early days of her career — rate your SUDS, watch the clock, wait for the anxiety to come down — and how the field has shifted since the inhibitory learning model changed the way we think about exposure. Celin reflects on her experience of always working in an integrated way, and why the principles of ACT have always felt like ERP to her — because they are. They also get honest about the moments when ERP becomes a battle. When the exposure menu turns into a war. When a client has every reason in the world not to engage — and what to do instead. Whether you're a clinician looking to expand your toolkit or someone living with OCD who's wondered why their therapist keeps talking about values and mindfulness - this episode will change how you think about what treatment can look like.
Four years in, and we're going back to basics. In this episode of Breaking the Rules, Celin and Tori walk through the full OCD assessment process from the ground up - because with new listeners joining and so much focus on treatment in recent episodes, it felt like the right time to start at the beginning.
When Therapists Spiral Too: What OCD Taught Us About Ourselves