Stop letting fear and doubt make your decisions.

Maybe you check the stove "one more time" and still can't shake the feeling you missed something. Maybe you spend hours researching symptoms, replaying conversations, or asking the people close to you for reassurance. Maybe there's a long list of places and situations you quietly avoid. You might be wondering, "Why can't I just let this go?"

You're not alone, and this is very treatable. Exposure and Response Prevention (ERP) is the gold-standard psychological treatment for OCD, and exposure-based therapy is highly effective for many anxiety disorders and phobias. At SageMind Psychology, our team uses ERP to help adults step out of the cycle of fear and avoidance and get their time and energy back.

Available in person in Brooklyn Heights and online in New York, New Jersey, and 40+ additional states.

What is ERP?

ERP is a specialized form of Cognitive Behavioral Therapy (CBT). When anxiety shows up, it's natural to try to get rid of it by checking, avoiding, seeking reassurance, mentally reviewing, or performing a ritual. These behaviors bring quick relief, but they also teach the brain that the fear was real and the ritual was necessary. Over time, the anxiety and the rituals both grow.

ERP breaks this cycle. With your therapist, you gradually face the thoughts, situations, sensations, or uncertainty that trigger anxiety (the "exposure"), while practicing not responding with compulsions or avoidance (the "response prevention"). With practice, you learn that you can handle discomfort and uncertainty without needing to escape it.

The goal isn't to eliminate every anxious thought. It's to help anxiety stop making your decisions.

Signs ERP could help you

Clients tell us things like:

• "I check the locks and stove so many times that I'm late for everything."

• "I spend hours googling symptoms, and the reassurance never lasts."

• "I have intrusive thoughts that horrify me, and I'm afraid to tell anyone."

• "I can't stop asking my partner if everything is okay between us."

• "I had a panic attack on the subway, and now I avoid it whenever I can."

• "I'm so afraid of throwing up that I avoid restaurants and travel."

• "I've stopped flying, so I don't visit my family anymore."

• "I reread every email over and over before I hit send."

• "My world keeps getting smaller because there are so many things I avoid."

You don't need to know whether it's OCD, anxiety, or something else before reaching out. Helping you understand what's happening is part of our job.

What ERP can help adults with

ERP and exposure-based therapy may be used for concerns including:

• Obsessive-compulsive disorder (OCD): Contamination fears, checking, "just right" feelings, unwanted intrusive thoughts, relationship OCD, moral and religious worries, and mental rituals like reviewing or neutralizing. ERP is the most well-researched treatment for all of these.

• Perinatal and postpartum OCD: Frightening intrusive thoughts about harm coming to a baby, often with checking, avoidance, or reassurance seeking. These thoughts are common and treatable.

• Health anxiety: Frequent body checking, symptom researching, or seeking reassurance from doctors. ERP helps you reduce these habits while keeping appropriate medical care.

• Panic attacks and agoraphobia: Fear of the physical sensations of anxiety, or avoiding places where panic has happened. You practice with those sensations and situations until they feel less frightening.

• Social anxiety: Fear of being judged, embarrassed, or rejected that leads to avoiding meetings, dates, or social events. Exposure helps you take steps toward the situations that matter to you.

• Specific phobias: Fears of things like flying, vomiting, needles, blood, heights, driving, or elevators. You face the fear gradually, so it loses its hold.

• Body-focused worries: Preoccupation with perceived flaws in appearance, with mirror checking, comparing, or avoiding being seen. Exposure-based strategies can be part of treatment.

• Perfectionism and fear of mistakes: Rereading, redoing, or over-preparing until things feel "just right." You practice doing things "good enough" and learn you can tolerate the discomfort.

Many adults also experience depression, ADHD, or trauma alongside OCD or anxiety. ERP can be adapted for neurodivergent adults, with adjustments to pacing, communication, and sensory needs. Learn about our neurodivergent-informed therapy.

How ERP works

Step 1: Understand the cycle

Your therapist helps you map out your triggers, intrusive thoughts, compulsions, avoidance, and reassurance seeking, and how they keep anxiety going.

Step 2: Build a fear ladder

Together, you list challenges from easier to harder. This is your roadmap, and you decide where to start.

Step 3: Practice facing fears

Starting low on the ladder, you approach a trigger, like leaving the house after checking only once or sending an email without rereading it, and practice riding out the discomfort without the compulsion.

Step 4: Practice in real life

You practice at home, at work, and anywhere anxiety shows up, with your therapist's support along the way.

Step 5: Keep climbing

As each step gets easier, you move up the ladder and build confidence that you can live with uncertainty.

ERP is collaborative. You're never surprised or forced into exposures, and you build courage one step at a time.

What makes ERP at SageMind Psychology different

• Collaborative: You and your therapist set goals and plan every exposure together.

• Gradual: Treatment starts with manageable challenges and builds as your confidence grows.

• Compassionate: Facing fears takes courage. Our clinicians understand intrusive thoughts and won't be shocked by them.

• Real-world: Practice happens where anxiety actually shows up, at home, at work, and out in your life.

• Integrated when helpful: Clinicians may add CBT, DBT skills, or mindfulness when they fit your needs.

How partners and family can help

When someone we love is distressed, we want to help right away. Partners and family members often end up answering the same questions, joining in on checking, or changing routines to prevent distress. These responses come from love, but they can keep the anxiety cycle going.

With your consent, your therapist can help the people close to you learn supportive ways to respond that encourage your progress instead of feeding the cycle.

Programs for extra support

For some adults, a more specialized program can help:

• Adults who need more support than weekly therapy: our Intensive Outpatient Programs for adults

• OCD or anxiety alongside trauma: our Intensive Outpatient Program, DBT + EMDR Trauma Track

• Adults whose anxiety comes with intense emotions or overwhelm: our adult DBT program and DBT skills groups

• Adults who want a clearer picture of what's going on: our psychological assessments

A team behind every client. Our clinicians work together, receive ongoing supervision, and consult on cases, so you benefit from the experience of the whole team. We are LGBTQIA+ affirming and neurodiversity-informed. Meet our clinical team.

Getting started is simple

Reaching out is a brave first step. It starts with a 15-minute call.

1. Book a free 15-minute consultation. Tell us what you're experiencing, ask questions, and get a feel for how we work.

2. Get matched with the right clinician. We'll pair you with the team member best suited to your needs.

3. Start therapy. After an intake session, you begin building skills and working toward your goals.

We offer ERP in person at our Brooklyn Heights office and online (telehealth) in New York, New Jersey, and 40+ additional states. Online sessions can be especially helpful for ERP, since you can practice right at home, where many compulsions happen.

SageMind Psychology is an out-of-network practice. Many clients use out-of-network benefits, and we provide superbills to help you seek reimbursement. Learn about rates and insurance.

Book your free consultation or contact us with questions.