Exposure and Response Prevention (ERP) Training

CPD

Faculty

Caleb Lack, PhD Related seminars and products

---

Caleb W. Lack, PhD, is a Professor of Psychology and the Counseling MS program coordinator at the University of Central Oklahoma. A licensed clinical psychologist, Dr. Lack specializes in the treatment of children and adults with anxiety disorders, obsessive-compulsive and related disorders, and posttraumatic stress. He is regularly consulted for and interviewed by national, and international media outlets, including The New York Times, The Atlantic, and more.

 

Dr. Lack is also a best-selling author or editor of eight books on topics from psychopathology to critical thinking and pseudoscience to racism and sexism in early psychology. He has authored more than 75 scientific publications relating to the assessment and treatment of psychological problems such as Obsessive-Compulsive Disorder, Tourette’s Syndrome, pediatric mood disorders, and posttraumatic stress. An internationally sought-after clinical trainer and consultant, Dr. Lack has conducted workshops for clinicians across North and South America, Europe, and east Asia.

 

Speaker Disclosures:
Financial: Dr. Caleb Lack maintains a private practice and receives compensation as a consultant. He has employment relationships with the University of Central Oklahoma, the International OCD Foundation's Training Institute, and the Asociación Lationamericana de TOC’s Entrenamiento Intensivo para el Tratamiento del TOC. Dr. Lack was a previous consultant with BrainsWay USA. Dr. Lack receives royalties as a published author. He receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Caleb Lack serves on the board of directors with Oklahoma Psychological Association and is a member of Association for Behavioral and Cognitive Therapies, and the International Obsessive-Compulsive Disorder Foundation. He is an Ad hoc reviewer and editor for several peer review journals, for a complete list contact PESI, Inc.

Additional Info

Access never expires for this product.

Objectives

1. Analyze cognitive, behavioral, and neurobiological mechanisms that inform the development and clinical application of exposure therapy strategies.
2. Examine how anxiety and fear disorders are classified and diagnosed in the DSM-5-TR™.
3. Identify the foundational principles of exposure and response prevention.
4. Analyze the role of inhibitory learning in fear extinction and its implications for exposure therapy outcomes.
5. Appraise the evidence base supporting Exposure and Response Prevention for anxiety and obsessive-compulsive related disorders.
6. Utilize functional analysis to identify avoidance cycles, triggers, and maintaining factors associated with anxiety and fear-based disorders.
7. Restate the clinical rationale for identifying and reducing safety behaviors during exposure-based treatment for anxiety disorders.
8. Develop a hierarchy of feared situations for use in ERP.
9. Choose appropriate exposure strategies (imaginal, interoceptive, in vivo, or virtual reality) for clients presenting with OCD, anxiety disorders, panic disorders with or without agoraphobia and PTSD.
10. Analyze ethical issues, client safety considerations, informed consent, and professional responsibilities when implementing exposure-based interventions.
11. Compare advantages and limitations of telehealth versus face-to-face delivery of ERP for anxiety and obsessive-compulsive disorders.
12. Choose cognitive and behavioral strategies that complement ERP to support treatment engagement and response prevention.

Outline

Foundations of ERP & Clinical Context

• Overview of anxiety and avoidance cycles
• Habituation, inhibitory learning, and fear extinction
• DSM-5™ diagnostic criteria for anxiety and fear-based disorders
• Functional impairment and impact on daily life of clinical anxiety and fear
• Research, risks and limitations of ERP

Comprehensive Assessment & Case Conceptualization

• Standardized measures and structured interviews
• Functional analysis to identify triggers, safety behaviors, and avoidance patterns
• Identify maintaining factors
• Create a clear case formulation to guide ERP interventions

How to Build Effective Exposures

• Selecting exposure types: imaginal, interoceptive, in-vivo, and virtual reality
• Design graded exposure ladders with measurable steps
• Using and interpreting SUDS
• Write and review response prevention (RP) contracts
• Demonstration of exposure session planning and execution

Troubleshooting Common Challenges

• Address comorbid presentations
• Mental compulsions
• Detect safety behaviors and distraction
• Work with core fears rather than superficial triggers
• Risk management: safety planning and crisis protocols

Complementary Cognitive Strategies in ERP

• Role of cognitive therapy
• Common cognitive errors
• Non-attachment and “bossing back”
• Non-engagement responses
• Using humor in treatment

Special Topics, Ethics, and Relapse Prevention

• Informed consent
• Telehealth ERP delivery
• “Booster” sessions and maintenance strategies post-treatment
• Measure outcomes and track progress

ERP for Anxiety and Worry-Based Disorders

• Self-focused attention, negative self-imagery, anticipatory anxiety
• Covert safety behaviors
• Exposure targets: social performance, interpersonal risk-taking, spontaneity
• In vivo exposures with behavioral experiments

ERP for Panic Disorder & Agoraphobia

• Catastrophic misinterpretation of bodily sensations
• Agoraphobic avoidance, safety items
• Interoceptive targets + situational avoidance mapping
• In vivo exposures to avoided settings (crowds, driving, stores)
• Response prevention of checking, reassurance seeking

ERP for Obsessive-Compulsive Disorder

• Misinterpretation of thoughts, inflated responsibility, intolerance of uncertainty
• Identify covert mental rituals, reassurance loops, subtle avoidance
• Trigger – obsession – feared consequence – compulsion mapping
• Sort exposures into in vivo, imaginal, and behavioral experiments

ERP for Specific Phobias

• Classical conditioning, avoidance, catastrophic beliefs
• Safety behaviors
• Graded in vivo steps, use of variability and unpredictability
• Using in vivo exposures and “behavioral experiments”

ERP for PTSD

• Fear structures, trauma reminders, cognitive distortions about responsibility or danger
• Trauma type, triggers, dissociation, avoidance patterns
• Differentiate situational vs. memory-based avoidance
• Imaginal exposure (narrative retelling of trauma with processing)
• In vivo exposure to safe but avoided reminders

Target Audience

• Counsellors
• Social Workers
• Psychologists
• Marriage and Family Therapists
• Allied Health Provides
• Registered Psychotherapists
• Nurse Practitioners