How do you adapt ERP for a pandemic?

Many people wonder about where to draw the line with exposures. This conundrum has become particularly muddy in our current situation, as we are faced with new and uncertain risks. Some of my former colleagues at McLean Hospital’s OCD Institute recently wrote an article, detailing many of the considerations affecting how we deliver ERP during a pandemic. The article is featured in the Association for Behavioral and Cognitive Therapies’ newsletter, the Behavior Therapist and is called “Adapting Exposure and Response Prevention in the Age of COVID-19”.

In short, the article suggests that we can adjust by: doubling down on response prevention (given the limits on actual exposure), focusing on function over form (am I washing my hands to follow the recommended guidelines or to reduce distress?), and by leaning into inhibitory learning rather than habituation-focused exposures (changing our relationship to anxiety and uncertainty rather than trying to eliminate it).

Figure it out yourself!

“From Camping to Dining Out: Here’s How Experts Rate the Risks of 14 Summer Activities”

I love this article from NPR. Like me, it completely dodges the question of what you should or should not do in the current pandemic. Instead, it encourages you to gather reliable information about risk, then make your own choice about which risks you would like to take. There are no easy answers, no formulas to apply - just a rough approximation of risk and a choice to act with uncertainty.