What Our Therapists Actually Think About ERP (And Why We Keep Coming Back to It)

When people ask me why I believe so strongly in ERP, my answer is pretty simple. It's structured. It's clear. And it works.

That's not a common combination in therapy. A lot of approaches have two out of three. ERP has all three — and our whole clinical team has felt that firsthand.

Earlier today, we wrapped up an ERP consultation led by our Senior Clinical Team Lead. Several of us sat together and talked through cases, technique, and what keeps drawing us to this work. What came out of that conversation stayed with me. So I wanted to share it.

Here's what our team actually thinks about ERP — in their own words.

Why Is ERP Different from Other Types of Therapy?

ERP isn't just another version of talk therapy. It's fundamentally different in structure, approach, and goal. Instead of helping clients think differently about their fears, it helps them behave differently in the face of them — and that behavioral change is what actually rewires the brain.

Mikayla Wichern, LCSW put it well:

"I love working with OCD and doing ERP because it's so different than any other type of therapy we do and it's incredibly effective. It addresses the root issues and builds so much confidence to tackle so many other things."

That last part is worth sitting with. ERP doesn't just help with OCD. The confidence clients build from facing their fears — and surviving — often spills into the rest of their lives. They stop avoiding hard things. They stop outsourcing their sense of safety to rituals. That's a real shift.

Is ERP Hard? What Should Clients Expect?

Yes — ERP is an OCD treatment asks clients actively face their fears to experience real relief. It's not passive. But the discomfort is intentional, structured, and temporary. The work is hard because change is hard. Not because the process is careless or unkind.

Katherine Ottofy, LPC said it this way:

"ERP is a fantastic treatment to assist in battling against OCD, and helping clients regain peace of mind and time back in their day. It is hard work, but well worth the effort!"

"Time back in their day" — I love that framing. OCD is relentless. It steals hours. People spend so much time managing their obsessions and compulsions that they lose whole chunks of their lives to it. ERP gives that back.

Jill Hasso, LPC offered a perspective that resonates with me too:

"I'm drawn to ERP for how direct and unfiltered it is — it doesn't soften the work, but instead intentionally pushes clients beyond their comfort zones where real change happens. I also value that it's a gold standard, evidence-based treatment, with a clear structure designed to produce measurable, lasting results."

That directness is something we take seriously at Aspire Counseling. It was a big part of our consultation group today. We talked about how we have to prepare clients for we’re not acting as the reassures, the validators, etc. that they are used to therapists being. When we’re doing ERP, we’re doing what WORKS. We are focused on caring for the client…but that’s because we’re focused on giving them true relief. Which means not reassure. Which means when they express a fear, we ask, “What if that happens? What if that’s true?” It feels different for clients. Honestly, at first it feels different for therapists.

But why do we do this?

Because it works. And we believe OCD symptoms are misterable to live with by the time a client comes to us. Those clients deserve our directness. They deserve for us to stop reassuring them and start doing what works.

We're not interested in keeping clients in therapy longer than they need to be. ERP has a real arc. You can see progress. That matters.

What Makes OCD Respond to ERP Specifically?

OCD involves a very specific brain loop: intrusive thought → anxiety spike → compulsion → temporary relief → repeat. ERP works because it interrupts the compulsion — and when the relief never comes, the brain slowly stops sounding the alarm.

One of our newer clinicians, Dustin Frieda, offered a perspective I hadn't heard framed quite this way before:

"I find the way that the brain works in OCD fascinating — sometimes it almost feels like the brain is doing too much of a good thing."

That's such a sharp observation. The OCD brain isn't broken. It's an overactive protection system. It's genuinely trying to keep you safe — it's just misfiring constantly. ERP doesn't fight the brain. It teaches it that the threat isn't real.

Can ERP Help Kids and Teens Too?

Yes. In fact, getting effective OCD treatment early can change the entire trajectory of a child's development. ERP is appropriate for children, teens, and adults — and the earlier it starts, the less OCD has had time to take hold.

Madison Bryant, LMSW spoke to this directly:

"I'm interested in expanding my knowledge of ERP so I can better support clients, especially children, in accessing effective treatment as early as possible."

This is something we think about a lot at Aspire Counseling. OCD often starts in childhood or adolescence. When kids don't get the right treatment early, they spend years building their lives around compulsions — avoiding things, relying on rituals, falling behind socially and academically. Starting ERP early matters.

And luckily, Aspire Counseling is one of the few places that offers ERP for children. Kristi Sveum has a large number of children with OCD on her caseload and a great deal of experience treating children with OCD. It’s incredible the difference it can make!

It is important to know that one of the biggest differences with treating OCD in children is that parents are very actively involved. Parents are often involved in helping set up exposures and very involved in response prevention. Honestly, ERP isn’t easy on the parents. It feels like you’re just causing your child all of this distress. So, an ERP therapist works closely with parents so they know the rational, what to expect and have the support they too need through the process.

Why Does the Aspire Team Invest So Heavily in ERP Training?

Because we only want to offer treatments that actually work. ERP is the gold standard for OCD — not because it's trendy, but because decades of research back it up. We'd rather be truly skilled in a few evidence-based approaches than broadly familiar with many.

At Aspire Counseling, multiple members of our team hold specialized ERP training. We consult together regularly. We talk through cases. We push each other to stay sharp.

That's not something you find at every practice. But it's something we're proud of — and something our clients feel.

What Does Recovery from OCD Actually Feel Like?

ERP doesn't just reduce symptoms. At its best, it changes a person's entire relationship with anxiety and intrusive thoughts. Clients stop needing to avoid, control, or escape — and that freedom shows up in every area of their life.

Kristi Sveum, LPC, our Senior Clinical Team Lead and one of Missouri's most experienced ERP therapists, has seen this transformation up close more times than she can count:

"I love using ERP because it helps clients learn that they can tolerate anxiety without needing to avoid or control it. It also empowers them to experience intrusive thoughts without fear, reducing their impact over time. After completing ERP, I've had many clients say they feel like they have their life back."

"They feel like they have their life back."

That phrase says everything. OCD doesn't just cause distress — it shrinks people's worlds. It reroutes their days around rituals and avoidance. It makes ordinary moments feel like minefields. ERP reverses that. Not by making the thoughts disappear, but by making them matter less. Clients stop organizing their lives around fear — and start living them.

Ready to Work with an ERP Therapist in Missouri?

If OCD has been running your life — or your child's life — you don't have to keep white-knuckling through it. ERP works. Our team has seen it over and over again.

We have offices in Columbia, MO and Lee's Summit, MO, and we offer telehealth throughout Missouri. Call our Columbia office at (573) 328-2288 or our Lee's Summit office at (816) 287-1116to schedule a free consultation with our client care team.

No pressure, no judgment — just compassionate support when you're ready.

About the Author

Jessica Oliver, MSW, LCSW, is the founder and Clinical Director of Aspire Counseling. She has been providing trauma-informed, evidence-based therapy since 2017 and holds advanced training in EMDR, CPT, ACT, and DBT.

Her investment in ERP is personal. When someone she loves experienced life-changing symptom relief through ERP, it shifted something. She wanted to understand it — and offer it. Around 2019, Jessica and Senior Clinical Team Lead Kristi Sveum attended their first formal ERP training together, and Aspire Counseling has offered it ever since.

What started as curiosity became a deep commitment. The team maintains an active consultation group that has met monthly for several years, with ongoing case consultation happening throughout the month as well. Because doing ERP well isn't just about knowing the model — it's about staying sharp, staying humble, and continuing to learn.