The Inhibitory Learning Approach to Exposure and Response Prevention for Obsessive-Compulsive Disorder

Exposure and response prevention (ERP) is the most effective treatment for obsessive-compulsive disorder (OCD), with robust symptom gains consistently observed. Yet, both research and clinical practice indicate ERP is not equally efficacious for all individuals with OCD, and a considerable portion fail to achieve full symptom remission or experience relapse despite substantial short-term gains. To this end, inhibitory learning theory (ILT) has emerged as an empirically driven conceptual framework for implementing ERP with the goal of optimizing the efficiency and durability of treatment gains. This chapter reviews the conceptual framework for ERP, illustrates ERP through a case example in which common pitfalls were encountered, defines ILT, and illustrates the use of ILT to address these pitfalls.