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The Group Guide
Connecting people to community
Client and Family Education
What to know about

Exposure and Response Prevention (ERP) Groups for OCD

Exposure and response prevention (ERP) is the gold-standard psychological treatment for OCD, recommended as first-line therapy by every major clinical guideline. In ERP, people with OCD deliberately face the situations, thoughts, or images that trigger their obsessions, then refrain from the compulsions or mental rituals they'd normally use to ease distress. The mechanism is inhibitory learning: the brain comes to understand that the feared outcome doesn't occur and that distress fades without the compulsion. Group ERP makes this specialized, often scarce treatment far more accessible, since trained clinicians can't meet demand through individual delivery alone.

Who it's for, and who it's not

A fit for anyone with OCD willing to engage in exposure work.
Not for those unwilling to do exposures; avoidance produces no benefit.
Very severe OCD may need individual, intensive, or residential ERP first.

What it's for

OCD of any presentation: contamination, harm, symmetry, and intrusive-thought types.
Effective across all OCD subtypes.
Also used for BDD, hoarding, hair pulling, and skin picking.
What to expect
1Groups of 6 to 8 meet weekly for 90 minutes over 12 to 16 sessions.
2You build your own fear hierarchy and work it in session and as homework.
3Distress is expected; the goal is to tolerate it without a compulsion.

ERP is the most strongly supported treatment for OCD.

A meta-analysis of 16 trials found CBT with ERP produced large reductions in OCD severity (g=1.31 vs. waitlist), superior to medication alone.1
Network meta-analytic evidence supports group delivery of structured CBT protocols as comparable to individual for anxiety-related conditions.2
Making the most of it
Witnessing is medicine. Watching others survive an exposure beats reassurance.
Homework is the work. Improvement comes from repeated practice between sessions.
You're not alone in it. Recognizing your patterns in others lifts shame.
Questions to ask before you join
1Is the facilitator specifically trained and supervised in ERP?
2Does it include in-session exposures, not just discussion?
3How much between-session homework should I expect?

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In crisis? Call or text 988 (US Suicide and Crisis Lifeline, 24/7).

The Group Guide is a directory, not a clinic. This handout is general education, not medical or mental health advice. Listings are written by group leaders and are not endorsements. Confirm details, cost, and fit with any group you contact. Sources on page 2.

The Group Guide
Connecting people to community
Client and Family Education

Sources

Exposure and Response Prevention (ERP) Groups for OCD · references keyed to the numbers on page 1.

1Reid, J. E., Laws, K. R., Drummond, L., et al. Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: a systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry (2021), 106, Article 152223.

2Furukawa, Y., Sakata, M., Yamamoto, R., et al. Components and delivery formats of cognitive behavioral therapy for chronic insomnia in adults: a systematic review and component network meta-analysis. JAMA Psychiatry (2024), 81(4), 357–365.

In crisis? Call or text 988 (US Suicide and Crisis Lifeline, 24/7).

The Group Guide is a directory, not a clinic. This handout is general education, not medical or mental health advice. Listings are written by group leaders and are not endorsements. Confirm details, cost, and fit with any group you contact.