Exposure and Response Prevention (ERP)
in person for Lubbock, TX and virtually for all of Texas
ERP is the most effective treatment available for OCD — and one of the most powerful for anxiety more broadly. It works by teaching your brain that the things you fear can be tolerated without the rituals and avoidance that have been keeping you stuck.
Accepting new clients --- Most Insurances Accepted
IS THIS RIGHT FOR YOU?
Who is ERP for?
ERP is primarily used for OCD, but it's also effective for other anxiety disorders. It may be right for you if:
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You have intrusive, unwanted thoughts that cause significant distress
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You engage in compulsions — mental or behavioral — to reduce anxiety, but the relief is only temporary
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You avoid situations, objects, or people to prevent triggering anxiety or obsessions
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You've been told you have OCD, and you want the treatment that actually works
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Anxiety has been making your world smaller — keeping you from activities, relationships, or places
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You've tried to "just stop" the compulsions and found it impossible without a structured approach
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You're ready to do hard work and want a therapist to guide you through it step by step
ERP is challenging — but it's also one of the most transformative treatments in all of psychotherapy. Most people see real, lasting results.
THE APPROACH
How ERP Works
OCD and anxiety disorders share a common engine: the belief that uncomfortable thoughts or feelings are dangerous, and that they must be neutralized through compulsions or avoidance. Compulsions and avoidance provide short-term relief — but they teach the brain that the threat is real, strengthening the OCD cycle. ERP interrupts this cycle at its core.
Exposure involves deliberately and gradually confronting the situations, thoughts, or feelings that trigger anxiety or obsessions — in a controlled, therapist-guided way. Response Prevention means resisting the compulsion or avoidance behavior that normally follows. When you stay in contact with the feared situation without performing the compulsion, your brain learns something new: that the anxiety passes on its own, that the feared outcome doesn't occur, and — most importantly — that you can tolerate discomfort without neutralizing it. This learning process is called inhibitory learning, and it's what makes ERP so effective. Sessions are always collaborative. Your therapist works with you to build an exposure hierarchy — a personalized, graduated ladder of situations from least to most anxiety-provoking — and moves at a pace that challenges you without overwhelming you. You never do an exposure you haven't agreed to.
ERP has been extensively adapted for different presentations of OCD: contamination OCD, harm OCD, religious/scrupulosity OCD, relationship OCD, sexual orientation OCD, "pure O," and more. It's also adapted for postpartum OCD, pediatric OCD, and OCD in teens. Beyond OCD, ERP principles are applied to specific phobias, panic disorder, health anxiety, social anxiety, and ARFID. At Flatland Counseling, ERP is delivered individually and tailored to your specific obsessions, compulsions, and life.
Evidence-Based Care
ERP is designated by the International OCD Foundation, the American Psychological Association, and the National Institute for Health and Care Excellence (NICE) as the first-line treatment for OCD.
60–80% of people with OCD experience significant symptom reduction with ERP — making it the most effective treatment for OCD available
THE PROCESS
What to Expect
Step 1: Reach Out
We'll match you with a therapist trained in ERP for OCD and anxiety. Let us know ERP is specifically what you're looking for — we'll prioritize that match.
Step 2: Your First Session
Your therapist will conduct a thorough OCD assessment and work with you to build your personalized exposure hierarchy — a graduated ladder of exposures starting with what's most manageable.
Step 3: Start Making Progress
ERP is hard work, but the results are real. Most people notice significant reductions in OCD symptoms within 12–20 sessions. The skills you build generalize far beyond therapy.
COMMON QUESTIONS
Frequently Asked Questions
Does EMDR require me to talk about my trauma in detail? -- No — and this is one of the most important things to know about EMDR. You don't have to narrate or describe your trauma in detail for EMDR to work. You hold the memory in mind while the bilateral stimulation occurs, but you don't have to verbalize what you're seeing or feeling in the moment. Many clients find this a significant relief — especially those who have tried to talk about their trauma before and found that re-telling the story just re-traumatized them without producing change.
How is EMDR different from traditional talk therapy? -- Traditional talk therapy works primarily through verbal processing — exploring, understanding, and reframing experiences through conversation. EMDR works differently: it directly targets the way the memory is stored in the nervous system, using bilateral stimulation to help the brain reprocess it. Many clients who have done years of talk therapy find that EMDR produces shifts that conversation alone didn't reach — particularly around the emotional and physical charge of traumatic memories.
How many EMDR sessions will I need? -- This varies widely depending on the nature of the trauma. Single-incident traumas (a car accident, an assault, a medical trauma) often respond in 3–12 sessions. Complex or developmental trauma — abuse, neglect, or years of adverse experiences — typically requires a longer course of treatment, with more time spent in the preparation and stabilization phases. Your therapist will give you a clearer picture after assessing your history.
Is EMDR available via telehealth? -- Yes. EMDR can be delivered effectively via telehealth using audio tones or tapping (guided by your therapist) as the bilateral stimulation instead of eye movements. Research supports its effectiveness in an online format. We offer telehealth EMDR to clients anywhere in Texas.
Can EMDR be used with children? -- Yes. EMDR has been adapted for children and adolescents, often incorporating play, storytelling, or art rather than standard eye movements. At Flatland Counseling, we use developmentally appropriate adaptations for younger clients. EMDR is particularly effective for children who have experienced trauma, as it doesn't require them to verbalize their experience in ways that may feel overwhelming or impossible.
What does an EMDR session actually feel like? -- People describe EMDR sessions as different from other therapy experiences. You might notice memories, images, emotions, or physical sensations shifting — sometimes quickly, sometimes gradually. Some people cry; others feel calm or detached. Some sessions are intense; others feel surprisingly gentle. After a session, it's common to feel tired or to notice that processing continues in the following days (through dreams, memories, or realizations). Your therapist will prepare you for what to expect and ensure you always end sessions in a stable, grounded state.
Is EMDR only for PTSD? -- No. While EMDR was developed for PTSD and is best known for trauma treatment, research has expanded its application to depression, anxiety, panic disorder, phobias, OCD, grief, chronic pain, eating disorders, and more. The common thread is that EMDR works anywhere that distressing memories or early experiences are contributing to current symptoms.
Will I have to relive my trauma to process it? -- Not in the way you might fear. EMDR doesn't ask you to dwell in traumatic material or repeatedly tell your story. The bilateral stimulation facilitates processing that can happen relatively quickly, and your therapist will monitor your distress level throughout. The experience is often described as "watching a train go by rather than being hit by it" — you're aware of the memory without being consumed by it.
How do I get started? -- You can reach out through our contact page or click the Get Started button to request an appointment. Taking that first step is often the hardest part — I'm glad you're here.
CONDITIONS WE TREAT
Issues We Treat with ERP
ERP is most commonly used for OCD, but its principles apply across many anxiety-related conditions we treat at Flatland Counseling.