Exposure and Response Prevention and Habit Reversal Training: Commonalities, Differential Use, and Combined Applications

Obsessive-compulsive spectrum disorders (OCSDs) have compulsive (i.e., anxiety reductive) and impulsive (i.e., driven by emotional or involuntary impulses) features. The best established psychological treatments for these disorders are behavioral/cognitive-behavioral in nature. More specifically, exposure and response prevention (ERP) (with or without cognitive therapy) and habit reversal training (HRT) are commonly indicated in the treatment of OCSDs. This paper reviews the use of various components of these therapeutic approaches to treat compulsive and impulsive symptomology in individuals with variants of these disorders. Specifically, ERP monotherapy for compulsive (e.g., obsessive-compulsive, body dysmorphic) and impulsive symptoms (e.g., tics, trichotillomania) is discussed as well as a combined treatment approach that integrates elements of ERP and HRT for individuals displaying mixed symptomology. A case example is also provided that illustrates the successful application of various components of ERP and HRT to treat OCSD symptoms. Lastly, other potential OCSD treatments are discussed.