Exposure Response Prevention (ERP) Therapists in Indianapolis, IN

Photo of Alexa Hart, LMHC, ATR-BC, Counselor
Alexa Hart
Counselor, LMHC, ATR-BC
Verified Verified
Indianapolis, IN 46220
ERP for OCD trained by BTTI & PDA level 1 trained by PDA North America.
Feeling stuck and having trouble engaging in what really matters to you? Your brain has done an excellent job keeping you safe, but some strategies developed as a reaction to stressors may no longer meet your needs. Issues like family of origin discord, medical illnesses, neurodivergence, and stressful work environments can all add up to impact our relationship with ourselves and others. I especially love working with high achievers who have issues with perfectionism, burnout, dissociation, procrastination and later in life neurodivergent diagnoses.
ERP for OCD trained by BTTI & PDA level 1 trained by PDA North America.
Feeling stuck and having trouble engaging in what really matters to you? Your brain has done an excellent job keeping you safe, but some strategies developed as a reaction to stressors may no longer meet your needs. Issues like family of origin discord, medical illnesses, neurodivergence, and stressful work environments can all add up to impact our relationship with ourselves and others. I especially love working with high achievers who have issues with perfectionism, burnout, dissociation, procrastination and later in life neurodivergent diagnoses.
(317) 597-8618 View (317) 597-8618
Photo of Christopher Toomer, MPA, MSW, LCSW, Clinical Social Work/Therapist
Christopher Toomer
Clinical Social Work/Therapist, MPA, MSW, LCSW
Verified Verified
Indianapolis, IN 46240
I have an MSW from The Ohio State University, MPA from Harvard University, BA in Psychology from Northwestern University, and advanced training in CBT, ERP, SPACE, Prolonged Exposure Therapy, and EMDR.
I specialize in OCD and anxiety disorders, parenting anxious children, and trauma and PTSD. Adults & Children 8+. We will define success, use evidence-based treatment modalities, and achieve results in the most efficient time period possible. Expect homework!
I have an MSW from The Ohio State University, MPA from Harvard University, BA in Psychology from Northwestern University, and advanced training in CBT, ERP, SPACE, Prolonged Exposure Therapy, and EMDR.
I specialize in OCD and anxiety disorders, parenting anxious children, and trauma and PTSD. Adults & Children 8+. We will define success, use evidence-based treatment modalities, and achieve results in the most efficient time period possible. Expect homework!
(317) 350-8762 View (317) 350-8762
Photo of Adam Goff, MA, LMHC, Counselor
Adam Goff
Counselor, MA, LMHC
Verified Verified
Indianapolis, IN 46202  (Online Only)
I specialize in the use of Exposure and Response Prevention ( ERP) therapy for the treatment of Obsessive Compulsive Disorder (OCD). ERP is considered the gold standard treatment for OCD. All of my sessions are virtual.
I specialize in the use of Exposure and Response Prevention ( ERP) therapy for the treatment of Obsessive Compulsive Disorder (OCD). ERP is considered the gold standard treatment for OCD. All of my sessions are virtual.
(317) 695-7995 View (317) 695-7995
Photo of Nicole Martin, LMHC, LPC, Counselor
Nicole Martin
Counselor, LMHC, LPC
Verified Verified
1 Endorsed
Indianapolis, IN 46240
I utilize many modalities (CBT, DBT, ERP, art/play therapy techniques) and each session is truly tailored toward what YOU need and hope to achieve.
Hi there! I'm Nicole. Congratulations on taking the first step in getting support you deserve. Some clients come to therapy with specific issues to address, others to have a safe space for an unbiased perspective. No matter what you're currently facing, I'd be happy to help. My areas of expertise include depression, anxiety, and relationship difficulties. I work best with clients who are motivated to create positive change in their lives!
I utilize many modalities (CBT, DBT, ERP, art/play therapy techniques) and each session is truly tailored toward what YOU need and hope to achieve.
Hi there! I'm Nicole. Congratulations on taking the first step in getting support you deserve. Some clients come to therapy with specific issues to address, others to have a safe space for an unbiased perspective. No matter what you're currently facing, I'd be happy to help. My areas of expertise include depression, anxiety, and relationship difficulties. I work best with clients who are motivated to create positive change in their lives!
(463) 275-2245 View (463) 275-2245
Photo of Christopher Toomer - Indy OCD, Clinical Social Work/Therapist
Indy OCD
Clinical Social Work/Therapist
Verified Verified
Indianapolis, IN 46240
This includes advanced training in CBT, ERP, EMDR, Prolonged Exposure Therapy, and SPACE, as well as academic degrees from Harvard University, Northwestern University, and The Ohio State University.
We help adults and children (8+) achieve lasting relief from OCD, PTSD, social anxiety, separation anxiety, generalized anxiety, health anxiety, panic, and phobias. We build strong therapeutic relationships with kindness and humor, and include and educate family members to support clients at home.
This includes advanced training in CBT, ERP, EMDR, Prolonged Exposure Therapy, and SPACE, as well as academic degrees from Harvard University, Northwestern University, and The Ohio State University.
We help adults and children (8+) achieve lasting relief from OCD, PTSD, social anxiety, separation anxiety, generalized anxiety, health anxiety, panic, and phobias. We build strong therapeutic relationships with kindness and humor, and include and educate family members to support clients at home.
(463) 243-6494 View (463) 243-6494
Photo of Aly Richardson, MSW, LCSW, LISW-CP, Clinical Social Work/Therapist
Aly Richardson
Clinical Social Work/Therapist, MSW, LCSW, LISW-CP
Verified Verified
1 Endorsed
Indianapolis, IN 46216  (Online Only)
For those wanting to conquer symptoms of OCD, I utilize ERP (Exposure and response prevention) blended with ACT.
Hi there, I’m Aly! I am passionate about helping my clients move from surviving to thriving. I work hard to create an atmosphere of balance and self-acceptance. I want you to be able to break free from the vicious cycle of trying to be perfect, “failing”, then trying it all over again. My primary focus areas include eating disorders/disordered eating, anxiety, life transitions, and obsessive-compulsive disorder. Not only do I have years of professional experience and training regarding these struggles, but I also have years of personal experience and recovery!
For those wanting to conquer symptoms of OCD, I utilize ERP (Exposure and response prevention) blended with ACT.
Hi there, I’m Aly! I am passionate about helping my clients move from surviving to thriving. I work hard to create an atmosphere of balance and self-acceptance. I want you to be able to break free from the vicious cycle of trying to be perfect, “failing”, then trying it all over again. My primary focus areas include eating disorders/disordered eating, anxiety, life transitions, and obsessive-compulsive disorder. Not only do I have years of professional experience and training regarding these struggles, but I also have years of personal experience and recovery!
(765) 295-6527 View (765) 295-6527
Photo of Natalie ( Samuels ) Seitz, MSW, LCSW, Clinical Social Work/Therapist
Natalie ( Samuels ) Seitz
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Indianapolis, IN 46204  (Online Only)
I am in the process of becoming certified in ERP, which is the gold standard treatment for OCD, and am also in the process of becoming an ADHD Clinical Services Provider.
Bring a cup of tea or coffee with you to our session together, and let's take the time to talk together and hear your story. I specialize in helping adults (18 yrs & older) discover their resiliency and find peace in their everyday lives. I work with those affected by anxiety, depression, trauma and OCD, as well as issues including life changes, perfectionism & self-esteem. I also work with women diagnosed with ADHD, especially those diagnosed later in adulthood, or who are curious if they could have ADHD. My focus is on providing individual therapy, and I like to use an eclectic approach that's tailored to each individual client.
I am in the process of becoming certified in ERP, which is the gold standard treatment for OCD, and am also in the process of becoming an ADHD Clinical Services Provider.
Bring a cup of tea or coffee with you to our session together, and let's take the time to talk together and hear your story. I specialize in helping adults (18 yrs & older) discover their resiliency and find peace in their everyday lives. I work with those affected by anxiety, depression, trauma and OCD, as well as issues including life changes, perfectionism & self-esteem. I also work with women diagnosed with ADHD, especially those diagnosed later in adulthood, or who are curious if they could have ADHD. My focus is on providing individual therapy, and I like to use an eclectic approach that's tailored to each individual client.
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Photo of Julie Timke - Indy Counseling Professionals, LCSW, Clinical Social Work/Therapist
Indy Counseling Professionals
Clinical Social Work/Therapist, LCSW
Verified Verified
4 Endorsed
Indianapolis, IN 46226
Thank you for considering Indy Counseling Professionals for your counseling needs! We specialize in EMDR, ERP and Neurofeedback. Experiencing symptoms from Anxiety, PTSD, OCD, ADHD or Depression? We have over 12 therapists that can help you.
Thank you for considering Indy Counseling Professionals for your counseling needs! We specialize in EMDR, ERP and Neurofeedback. Experiencing symptoms from Anxiety, PTSD, OCD, ADHD or Depression? We have over 12 therapists that can help you.
(317) 653-4188 View (317) 653-4188
Photo of Mallory Carr, MA, LMHC, Counselor
Mallory Carr
Counselor, MA, LMHC
Verified Verified
3 Endorsed
Indianapolis, IN 46260
I have recently completed training for ERP to treat OCD.
I specialize in working with adolescents, college students, and young adults. I have been working with clients for over 10 years to address stress, anxiety, family challenges, and more. My goal is to provide a trusting, authentic, and collaborative relationship, where my clients feel comfortable expressing their thoughts and feelings in a nonjudgmental environment. I enjoy using humor in sessions as a way of connecting with my clients and coping with the tough stuff. I currently have a short waitlist for new clients.
I have recently completed training for ERP to treat OCD.
I specialize in working with adolescents, college students, and young adults. I have been working with clients for over 10 years to address stress, anxiety, family challenges, and more. My goal is to provide a trusting, authentic, and collaborative relationship, where my clients feel comfortable expressing their thoughts and feelings in a nonjudgmental environment. I enjoy using humor in sessions as a way of connecting with my clients and coping with the tough stuff. I currently have a short waitlist for new clients.
(317) 286-4080 View (317) 286-4080
Photo of Dr. Colter Snethen, PsyD, HSPP, Psychologist
Dr. Colter Snethen
Psychologist, PsyD, HSPP
Verified Verified
2 Endorsed
Indianapolis, IN 46204
Waitlist for new clients
Life often hands us challenges we don't feel capable of managing. Our thoughts, feelings, and expectations can be so overwhelming that they become obstacles to making decisions and living our lives to the fullest. Therapy is a safe environment to understand our thoughts and feelings, face pain and fear, and align our lives to our values. The freedom that comes from understanding and facing our challenges is well worth the effort. In treatment, I help cultivate an environment of trust and compassion to face and overcome life's challenges through an integration of CBT, ACT, ERP, relational, and dynamic therapies.
Life often hands us challenges we don't feel capable of managing. Our thoughts, feelings, and expectations can be so overwhelming that they become obstacles to making decisions and living our lives to the fullest. Therapy is a safe environment to understand our thoughts and feelings, face pain and fear, and align our lives to our values. The freedom that comes from understanding and facing our challenges is well worth the effort. In treatment, I help cultivate an environment of trust and compassion to face and overcome life's challenges through an integration of CBT, ACT, ERP, relational, and dynamic therapies.
(317) 751-2382 View (317) 751-2382
Photo of Stephanie Montague, PhD, HSPP, Psychologist
Stephanie Montague
Psychologist, PhD, HSPP
Verified Verified
Indianapolis, IN 46240  (Online Only)
While I have extensive experience treating anxiety, depression, ADHD, and other disorders, for the past 15 years I have focused on the treatment of Obsessive Compulsive Disorder, and over the past 2 years I have immersed myself in a relatively new approach to OCD called I-CBT (Inference Based CBT). Using I-CBT techniques I have had the privilege of helping my clients, many of whom had limited success in prior OCD treatment, finally achieve freedom from this distressing disorder. When indicated I also use Exposure and Response Prevention ( ERP) and Cognitive Behavioral Therapy (CBT). My style is warm, inviting, and collaborative.
While I have extensive experience treating anxiety, depression, ADHD, and other disorders, for the past 15 years I have focused on the treatment of Obsessive Compulsive Disorder, and over the past 2 years I have immersed myself in a relatively new approach to OCD called I-CBT (Inference Based CBT). Using I-CBT techniques I have had the privilege of helping my clients, many of whom had limited success in prior OCD treatment, finally achieve freedom from this distressing disorder. When indicated I also use Exposure and Response Prevention ( ERP) and Cognitive Behavioral Therapy (CBT). My style is warm, inviting, and collaborative.
(341) 999-5237 View (341) 999-5237
Photo of Naomi Boucher, MA, LMHC, CSAYC, Counselor
Naomi Boucher
Counselor, MA, LMHC, CSAYC
Verified Verified
8 Endorsed
Indianapolis, IN 46250
Waitlist for new clients
I am trained in EMDR, ERP, and TF-CBT.
I have experience working with clients with trauma, OCD, depression, anxiety, and difficulty living under oppression. I am passionate about working with clients who need their identities embraced and empowered by the therapeutic process. I specialize in working with LGBTQIA+ individuals as well as their families to find ways to best support them. Clients from all walks of life seeking change and understanding find themselves in my office. Here they have a nonjudgmental space to explore their pasts to find resolution, work through daily stressors, and search for meaning.
I am trained in EMDR, ERP, and TF-CBT.
I have experience working with clients with trauma, OCD, depression, anxiety, and difficulty living under oppression. I am passionate about working with clients who need their identities embraced and empowered by the therapeutic process. I specialize in working with LGBTQIA+ individuals as well as their families to find ways to best support them. Clients from all walks of life seeking change and understanding find themselves in my office. Here they have a nonjudgmental space to explore their pasts to find resolution, work through daily stressors, and search for meaning.
(317) 676-3720 View (317) 676-3720
Photo of Leslie Rowan, LMHC, MA, Counselor
Leslie Rowan
Counselor, LMHC, MA
Verified Verified
1 Endorsed
Indianapolis, IN 46237
I utilize Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention ( ERP), and solution focused techniques.
For some, the thought of beginning therapy can be overwhelming and intimidating, and my goal as a therapist is to prioritize my clients’ welfare and adapt my counseling strategies to meet individuals where they are. As a person-centered therapist, I will offer support and guidance throughout the therapy process and help my clients develop hope and strategies to build a life worth living. My strengths-based approach of counseling allows me to build a safe, strong therapeutic alliance with my clients where we can work together to explore emotions, thoughts, and behaviors and make shifts that will enhance their lives.
I utilize Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention ( ERP), and solution focused techniques.
For some, the thought of beginning therapy can be overwhelming and intimidating, and my goal as a therapist is to prioritize my clients’ welfare and adapt my counseling strategies to meet individuals where they are. As a person-centered therapist, I will offer support and guidance throughout the therapy process and help my clients develop hope and strategies to build a life worth living. My strengths-based approach of counseling allows me to build a safe, strong therapeutic alliance with my clients where we can work together to explore emotions, thoughts, and behaviors and make shifts that will enhance their lives.
(317) 548-6581 View (317) 548-6581
Photo of Ruri (Nuri) Kim, LCPC, LSW, NCC
Ruri (Nuri) Kim
Licensed Clinical Professional Counselor, LCPC, LSW, NCC
Verified Verified
1 Endorsed
Indianapolis, IN 46227  (Online Only)
I have provided a range of evidence-based treatments including CBT, ACT, DBT, EMDR, Exposure and Response Prevention ( ERP), Trauma-Focused CBT, Parent Management Training, and Supportive Parenting for Anxious Childhood Emotions (SPACE) program.
My clinical approach is authentic and integrative, resulting in a collaborative treatment plan based on client’s culture and values, the best available clinical research, and clinical expertise for my clients to thrive in their lives. I enjoy working with children, adolescents and adults in individual, family and group settings. I specialize in the treatment of anxiety, ADHD, OCD, Executive Functioning (EF) skills, complex trauma/PTSD, bipolar disorder, depression, racial/cultural identities, academic performance, family conflicts, relationship issues, grief, life transitions, stress and other life concerns. I also speak Korean.
I have provided a range of evidence-based treatments including CBT, ACT, DBT, EMDR, Exposure and Response Prevention ( ERP), Trauma-Focused CBT, Parent Management Training, and Supportive Parenting for Anxious Childhood Emotions (SPACE) program.
My clinical approach is authentic and integrative, resulting in a collaborative treatment plan based on client’s culture and values, the best available clinical research, and clinical expertise for my clients to thrive in their lives. I enjoy working with children, adolescents and adults in individual, family and group settings. I specialize in the treatment of anxiety, ADHD, OCD, Executive Functioning (EF) skills, complex trauma/PTSD, bipolar disorder, depression, racial/cultural identities, academic performance, family conflicts, relationship issues, grief, life transitions, stress and other life concerns. I also speak Korean.
(312) 376-4293 View (312) 376-4293
Photo of Tommy Parry, MS, MEd, BCBA, LMHC, Counselor
Tommy Parry
Counselor, MS, MEd, BCBA, LMHC
Verified Verified
1 Endorsed
Indianapolis, IN 46236
Therapy is about more than reducing your unwanted thoughts and emotions - it's about building a life that feels authentic, meaningful, and vital. My ideal clients are folks who are seeking to expand their lives from a place of stuckness, trauma, depression, anxiety, or behavioral challenges. We can work on building a life with the qualities you desire, without spending unnecessary time attempting to remove thoughts, emotions, memories, or urges that have been around for a while. What if you could drop the struggle with those challenging experiences completely and invest your energy where it matters?
Therapy is about more than reducing your unwanted thoughts and emotions - it's about building a life that feels authentic, meaningful, and vital. My ideal clients are folks who are seeking to expand their lives from a place of stuckness, trauma, depression, anxiety, or behavioral challenges. We can work on building a life with the qualities you desire, without spending unnecessary time attempting to remove thoughts, emotions, memories, or urges that have been around for a while. What if you could drop the struggle with those challenging experiences completely and invest your energy where it matters?
(571) 536-7982 View (571) 536-7982
Photo of Nathan Timmons, MA, LMHCA, Counselor
Nathan Timmons
Counselor, MA, LMHCA
Verified Verified
Indianapolis, IN 46250
My primary goal in therapy is to make a space where you do not have to be “on.” Instead, you can feel at ease to share your pain, stress, and struggles with authenticity. I'm intentional about providing an experience that starts with a trusting, hopeful relationship and is tailored to your unique relationships and experiences. Having this type of safe and secure relationship is a launching pad to healing and flourishing in therapy and beyond. From there, we work together to create a plan to move toward the envisioned change that led you to take the vulnerable jump Into therapy.
My primary goal in therapy is to make a space where you do not have to be “on.” Instead, you can feel at ease to share your pain, stress, and struggles with authenticity. I'm intentional about providing an experience that starts with a trusting, hopeful relationship and is tailored to your unique relationships and experiences. Having this type of safe and secure relationship is a launching pad to healing and flourishing in therapy and beyond. From there, we work together to create a plan to move toward the envisioned change that led you to take the vulnerable jump Into therapy.
(317) 953-4884 View (317) 953-4884
Photo of Melissa Ulewicz, RBC, CCTP, LCSW, Clinical Social Work/Therapist
Melissa Ulewicz
Clinical Social Work/Therapist, RBC, CCTP, LCSW
Verified Verified
1 Endorsed
Indianapolis, IN 46256
I have direct experience working with families, groups, and individuals. I have a passion for Perinatal Mental Health. I enjoy working with individuals who are struggling with Anxiety, Depression, Grief and Loss, and Trauma Recovery. All of my therapy sessions are held on a secure online platform. This allows you to have therapy in the comfort of your own space and be able to access therapy from anywhere in Indiana.
I have direct experience working with families, groups, and individuals. I have a passion for Perinatal Mental Health. I enjoy working with individuals who are struggling with Anxiety, Depression, Grief and Loss, and Trauma Recovery. All of my therapy sessions are held on a secure online platform. This allows you to have therapy in the comfort of your own space and be able to access therapy from anywhere in Indiana.
(317) 342-0593 View (317) 342-0593
Photo of Dr. Samantha Wolfe-Taylor, LCSW, Clinical Social Work/Therapist
Dr. Samantha Wolfe-Taylor
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Indianapolis, IN 46220  (Online Only)
No matter where you are at in your readiness for change, I will meet you right where you are and help you work towards your mental health goals at the pace that works best for you. Each client comes with a unique perspective on life and mental health that should be heard, seen, and appreciated throughout the process. I love working with clients who recognize the collaborative experience that comes from therapy. Clients that desire to become the best version of themselves. I am passionate about serving clients with diverse perspectives, values, and lived experiences.
No matter where you are at in your readiness for change, I will meet you right where you are and help you work towards your mental health goals at the pace that works best for you. Each client comes with a unique perspective on life and mental health that should be heard, seen, and appreciated throughout the process. I love working with clients who recognize the collaborative experience that comes from therapy. Clients that desire to become the best version of themselves. I am passionate about serving clients with diverse perspectives, values, and lived experiences.
(463) 220-4293 View (463) 220-4293
Photo of Carl Quedenfeld, MA LMHC, LCSW, LCSAC, Counselor
Carl Quedenfeld
Counselor, MA LMHC, LCSW, LCSAC
Verified Verified
Indianapolis, IN 46237
I provide counseling to teens (age 15 on up) ,adults and couples for a variety of issues regarding both mental health and addiction concerns. With over 46 years of experience I have a wide array of training and certifications to meet needs you may have. I practice in Indiana, Wisconsin (virtually), Arizona (virtually) and California ( virtually). I work with both mental health and substance abuse patients/ My focus is on practical, usable skills to help you get results as soon as possible.
I provide counseling to teens (age 15 on up) ,adults and couples for a variety of issues regarding both mental health and addiction concerns. With over 46 years of experience I have a wide array of training and certifications to meet needs you may have. I practice in Indiana, Wisconsin (virtually), Arizona (virtually) and California ( virtually). I work with both mental health and substance abuse patients/ My focus is on practical, usable skills to help you get results as soon as possible.
(317) 830-3071 View (317) 830-3071
Photo of Priscilla Moore, MSW, LSW, Pre-Licensed Professional
Priscilla Moore
Pre-Licensed Professional, MSW, LSW
Verified Verified
3 Endorsed
Indianapolis, IN 46220
Are you ready to finally feel confident in your here-&-now body? As a therapist specializing in body image & self-acceptance, I work with college students & young adults who are tired of letting a number on the scale dictate their mood & day. If you find yourself waking up each morning feeling anxious about your body, food choices, or calorie counts, know that you're not alone, & it doesn’t have to be this way forever. Together, we’ll work towards food freedom & a healthier relationship with your body. You deserve to appreciate your body for what it does, not how it looks. Let’s embrace spontaneity in meals and reclaim your life!
Are you ready to finally feel confident in your here-&-now body? As a therapist specializing in body image & self-acceptance, I work with college students & young adults who are tired of letting a number on the scale dictate their mood & day. If you find yourself waking up each morning feeling anxious about your body, food choices, or calorie counts, know that you're not alone, & it doesn’t have to be this way forever. Together, we’ll work towards food freedom & a healthier relationship with your body. You deserve to appreciate your body for what it does, not how it looks. Let’s embrace spontaneity in meals and reclaim your life!
(463) 348-2522 View (463) 348-2522
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Exposure Response Prevention (ERP) Therapists

Do I need exposure and response prevention therapy?

Many clients decide to seek help for obsessive thoughts and compulsive behaviors when these symptoms are distressing enough to disrupt everyday life. Any thoughts or behaviors that cause friction in close relationships are also worth addressing. In addition, the client’s symptoms don’t have to be severe for them to benefit from ERP therapy.

Is exposure and response prevention therapy part of cognitive behavioral therapy?

Exposure and response prevention is one specific type of CBT that focuses on behavioral change in response to triggering stimuli. It is related to exposure therapy but adds an additional component of preventing compulsive and harmful responses.

How long does exposure and response prevention therapy take?

While every patient is different, exposure and response prevention therapy typically lasts around 12 sessions, although some treatments can take longer. A therapist will determine if the treatment is complete based on how the client faces their fears, particularly the strongest ones. When a client feels less anxiety about stimuli that once evoked terror or distress, that is generally an indication that they are nearing the end of ERP therapy.

What are the limitations of exposure and response prevention therapy?

The most common pitfalls of exposure and response prevention therapy include not addressing a client’s core fears, allowing the client to avoid their most distressing stimuli, and using imaginary exposure when the client requires real-life exposure (and vice versa). ERP therapy is most effective when the client commits to the full course of treatment; if the client stops early or doesn’t practice what they have learned outside of therapy sessions, they are less likely to have successful outcomes.