Exposure and response prevention (ERP) therapy is a highly effective, evidence-based form of cognitive behavioral therapy (CBT) designed specifically to treat obsessive-compulsive disorder (OCD). ERP helps you face intrusive thoughts and fears that trigger your anxiety (obsessions) and teaches you how to resist performing rituals or behaviors (compulsions), ultimately helping you break free from the OCD cycle.
Over time, ERP should help you learn to manage your symptoms. You’ll get better at resisting compulsions, and you may even experience fewer, and less persistent intrusive thoughts. While everyone sees progress at a different pace, ERP is highly effective, so it’s common to get to a point where you no longer need to keep going to therapy as often—or even at all. This is a significant milestone, and something to be proud of, but you may be wondering what happens next.
Just because therapy is winding down doesn’t mean the work is done. Maintaining the progress you’ve made requires ongoing effort. Read on to learn how to maintain what you’ve learned from ERP therapy, what to do if OCD symptoms resurface, and how to keep strengthening your skills long after therapy ends.
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All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Do I still need to see a therapist once I’m feeling better?
After formal therapy ends, many people shift into what is known as the “maintenance phase.” This means continuing to apply the skills you’ve learned—like recognizing intrusive thoughts for what they are and resisting the urge to do compulsions. The frequency of your ERP sessions with your therapist can also likely decrease. Instead, your therapist might suggest occasional “booster” sessions or check-ins for support when symptoms resurface.
“Maintenance sessions means coming in every three months when your symptoms are better,” says Ibrahim. “Most of the time, people come in and everything’s fine. Some people come in with a flare-up of symptoms, and we’ll work on ERP exercises.”
These sessions will look different for everyone. You might need more frequent check-ins if your symptoms tend to fluctuate more often. Or, you may find that you only need occasional support as you continue to apply the skills they’ve learned in therapy.
Will I have to practice ERP skills forever?
ERP therapy isn’t something you do once and never revisit. It’s a skillset you can continue to use throughout your life, especially if OCD symptoms become more pronounced again. You might not be doing structured ERP exercises every day, but the mindset and techniques will remain part of your routine. The good news? You’ve already done the hardest part by learning ERP skills. Now it’s about maintaining and adapting them over time.
Some people find that once they’ve learned ERP, these skills become a natural part of your lifestyle that you don’t have to think about. You may reach a point where you can acknowledge and accept your thoughts and discomfort without feeling the need to act on them.
Facing exposures in the wild
“Life naturally gives you exposures, which can trigger you,” says licensed therapist Tracie Ibrahim, MA, LMFT, CST. “So the most important thing you can do is practice response prevention.”
For example, let’s say you have contamination OCD. ERP therapy taught you to resist washing your hands repeatedly after touching public surfaces. One day, you’re shopping and touch a few items that others have handled. You feel the familiar urge to wash your hands, but instead of reacting, you pause. You remind yourself that the anxiety is temporary and choose not to wash. By doing this, you’re using the ERP skills you’ve learned to manage the situation and prevent OCD from taking control.
If you find that your OCD symptoms have gotten better, response prevention in the maintenance phase looks like continuing to use the tools you’ve learned in therapy—especially when everyday life throws unexpected triggers your way.
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Dealing with flare-ups
OCD is a chronic condition, which means it can ebb and flow—even after you’ve made solid progress. You may not need to practice ERP every single day, but staying connected to the skills you’ve built is a lifelong tool. That way, when symptoms resurface or new triggers arise, you’re prepared to manage them with confidence.
ERP gives you tools to manage OCD on your own, so over time, you’ll get better at recognizing when it’s creeping back in, and you’ll know how to respond. Think of it like building mental muscles: the more you practice, the stronger you get at handling those intrusive thoughts without letting them take over.
“Things in life, like lack of sleep, and stressful situations like big changes, a new job, becoming a parent—these can make OCD flare up,” says Ibrahim. When you notice intrusive thoughts pop up, it’s an opportunity to practice response prevention, including non-engagement. This can look like sitting with discomfort instead of seeking reassurance, or resisting the urge to go back and check “just one more time.”
“Everybody compulses sometimes, but you’re going to always do your best to not engage in compulsions,” Ibrahim says. “That’s the long term goal.”
Lifestyle tips for maintaining ERP progress
- Maintain awareness: Even if your OCD symptoms have calmed down, it’s important to stay tuned in to your thoughts and behaviors. Notice when you’re feeling triggered and pay attention to any urges to fall back into compulsions.
- Reduce stress: Take a holistic approach to your mental health. You should be sleeping well, eating balanced meals, and moving your body regularly—whether that’s a full workout or just a walk outside. When your body and mind are taken care of, you’re better equipped to manage anxiety and recognize when OCD symptoms might be playing a bigger role.
- Practice self-compassion: Maintenance isn’t about being perfect. You might slip up, and that’s okay. What matters most is that you keep using the skills you’ve learned, and remind yourself that you have the tools.
Can I return to therapy?
There’s absolutely no shame in returning to therapy or recognizing when you need extra support. OCD can flare up during stressful life events, big transitions, or even for no obvious reason at all. Sometimes, you might notice that symptoms you had under control start creeping back in—or that new intrusive thoughts or compulsions are showing up in ways you haven’t experienced before.
Again, OCD is a chronic condition, and it makes sense that you may need to check back in with your therapist from time to time. Going back to therapy doesn’t mean you failed—it means you’re being proactive about your mental health.
Bottom line
Practicing ERP is an ongoing process—not a one-and-done fix. You may not need to seek out ERP exercises regularly, but staying aware of your triggers and knowing how to respond when OCD symptoms pop up is key. Some days will feel easier than others, and that’s okay. What matters most is showing up for yourself, using what you’ve learned, and giving yourself credit for the progress you’ve made. You’ve done the hard part—now it’s about keeping that momentum going.