ERP Technique — MRCPsych Paper B MCQ

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EasyPsychotherapyERP TechniqueMRCPsych Paper B

A 38-year-old woman with obsessive–compulsive disorder has intrusive thoughts about contamination and compulsive hand-washing. During CBT, her therapist asks her to touch a doorknob and then refrain from washing her hands despite the resulting anxiety. Which component of CBT for OCD is being used?

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Correct answer: A — Exposure and response prevention (ERP)

The correct answer is A, exposure and response prevention. Touching the doorknob is exposure to the feared contamination stimulus, while refraining from hand-washing is prevention of the compulsive response. Repeated practice allows the patient to learn that distress can be tolerated without ritualising and that the feared consequences do not occur. Cognitive restructuring examines and modifies maladaptive appraisals rather than primarily preventing rituals. Systematic desensitisation classically combines graded exposure with relaxation and does not specifically target compulsions. Behavioural activation is principally used to increase rewarding activity in depression, while mindfulness develops non-judgemental awareness rather than directly pairing exposure with ritual prevention.

Reference: National Institute for Health and Care Excellence. Obsessive-compulsive disorder and body dysmorphic disorder: treatment (CG31), recommendations 1.5.1 and 1.5.2. 2005. https://www.nice.org.uk/guidance/cg31/chapter/Recommendations