Exposure and Response Prevention Specialists In NYC
At ParityWell we specialize in treating OCD with evidence-based treatment including Exposure and Response Prevention (ERP) and Acceptive and Commitment Therapy (ACT). ERP is one of the most well-researched therapies to treat Obsessive-Compulsive Disorder (OCD) and is based on principles of Cognitive Behavioral Therapy (CBT). ERP works by carefully and systematically reversing patterns of intrusive thoughts and compulsive behaviors.
ERP therapy has decades of research supporting its effectiveness for OCD, anxiety disorders, and related conditions.
At ParityWell, our therapists are trained in ERP and use this approach as part of an integrated, individualized treatment plan in person in Manhattan. Our therapists offer in-person sessions at our office near Columbus Circle, across from Central Park and major subway lines. It’s a quick stop from the Upper West Side, Upper East Side, Midtown, Chelsea, or even parts of Brooklyn and Queens during your commute.
We also provide online ERP therapy for clients across New York City, New York State, New Jersey, and Pennsylvania.
Comprehensive Assessments From Day One
At ParityWell, every client receives a thorough clinical assessment from the start regardless of what brings them in. We screen all clients for OCD, anxiety, depression, and other mental health disorders because we believe it’s the therapist’s responsibility to identify what’s present, not the client’s responsibility to know what to ask for.
If OCD or an anxiety disorder is identified, we explain what we’re seeing, why it matters, and what an effective treatment plan could look like tailored to your specific needs. This could include ERP, or we may recommend another type of therapy. But we always work with you and will make sure support is tailored to your goals and preferences. We believe you are the expert in your own life.
We will collaborate together so you'll leave your first appointment with clarity.
What Is Exposure and Response Prevention?
ERP has two core components:
Exposure: Deliberately and gradually approaching the thoughts, situations, sensations, anxieties, doubts or stimuli that trigger fear, doubt or anxiety.
Response Prevention: Resisting the urge to engage in behaviors that would normally follow in order to reduce that distress. The behavior can be mental (internal) or something you do behaviorally.
Exposure and response prevention are two components designed to interrupt the cycle that keeps anxiety and OCD locked in place.
The goal of ERP is to reduce the power of obsessive thoughts and fears, and to change how you respond to them. Over time, repeated exposure without the fear-based, kneejerk response teaches your brain that the fear is tolerable and anxiety is eliminated.
ERP is active and collaborative. Your ERP therapist works with you to build a structured exposure hierarchy, starting with what feels manageable and working toward what feels difficult at a pace that is effective but not overwhelming.
ERP Therapy for OCD, Anxiety and Trauma
ERP was originally developed for OCD and remains the gold-standard treatment for the disorder. ERP targets the obsession-compulsion cycle directly by breaking the link between intrusive thoughts and compulsions.
ERP’s application has expanded across anxiety-related conditions where avoidance is a central maintaining factor:
OCD
At ParityWell, our NYC-based therapists specialize in both OCD therapy and ERP therapy. ERP is the most evidence-based psychotherapy for OCD across all subtypes, such as:
Contamination OCD: Fear of touching public objects like the door to your apartment building in Chelsea. Frequently accompanied by washing compulsions and rituals.
Harm OCD: Intrusive thoughts that stab into your consciousness out of nowhere. An example would be pushing a bystander into traffic, even though you would never do that and have no actual desire to do so.
Checking OCD: Leaving your apartment three times to make sure the stove is off before making it to your morning meeting in the Financial District.
Pure O or Purely Obsessional OCD: OCD that is confined to mental rituals without obvious external expressions. Intrusive thoughts and the mental dispelling of them are common symptoms. Someone with Pure O can have intrusive thoughts in a crowded subway in the East Village but no one else would be able to tell.
Relationship OCD or ROCD: Obsessive doubts and compulsions targeted toward a romantic relationship, even if the threat is imaginary. A quiet time in Central Park could be marred by constant questioning and doubts about your partner being the right one even though you feel like you should be happy.
We also work with many other forms of OCD including morality based OCD, existential OCD, false memory OCD, perfectionism OCD, sexual orientation OCD, postpartum OCD and somatic OCD.
Anxiety Disorders and Phobias
Exposure-based approaches are central to effective anxiety treatment, because anxiety conditions create an avoidance response that worsens over time. ERP principles apply directly to panic disorder, social anxiety, generalized anxiety disorder and specific phobias.
PTSD and Trauma
Exposure-based work is a component of several evidence-based trauma treatments. At ParityWell, we integrate exposure principles with EMDR, IFS, and trauma-informed approaches carefully tailored to each client’s history and readiness. We never push clients into exposure work before safety and trust have been established.
Integrated and Adapted ERP Therapy at ParityWell
Standard ERP protocols are highly effective, but everyone is different. At ParityWell, we specialize in working with adults who have often felt that previous treatment almost worked but never quite reached the root.
ERP can be adapted or integrated alongside other therapies to maximize its healing potential:
Trauma-informed pacing: Clients with trauma histories may need a slower, more carefully scaffolded approach by building safety and stabilization before moving into deeper territory.
EMDR integration: When intrusive thoughts or compulsions are rooted in traumatic memories, Eye Movement Desensitization and Reprocessing (EMDR) can help process underlying issues.
IFS integration: For clients whose anxiety or OCD has deep relational or developmental roots, Internal Family Systems (IFS) helps build the internal safety that makes exposure work more sustainable.
ACT alongside ERP: ACT provides the acceptance and psychological flexibility framework that helps clients stay present and committed during the harder work of exposure, which is particularly useful for clients who struggle with the uncertainty that ERP deliberately evokes.
Psychodynamic integration: For some clients, long-standing patterns of fear or self-criticism stem from early relational experiences. Integrating psychodynamic therapy allows us to explore those underlying conflicts and emotional themes, creating insight and self-awareness that strengthen the effectiveness of ERP.
How ERP Therapy Works
ERP is structured and goal-directed, but not rigid. Here is how the process typically unfolds at ParityWell:
Comprehensive assessment: Before any exposure work begins, we conduct a thorough clinical assessment by mapping your specific fears, avoidances, compulsions, and any underlying factors like trauma, ADHD, depression or neurodevelopmental differences that need to be part of the treatment plan
Psychoeducation: Understanding how the avoidance cycle works and why ERP interrupts it. This phase alone is often immediately relieving for clients who have spent years not understanding what was happening to them
Building an exposure hierarchy: Collaboratively creating a structured list of situations to approach, ordered from least to most distressing
In-session exposures: Practicing exposures together with your therapist guiding the response prevention component
Between-session practice: Applying exposures independently between sessions — this is where much of the lasting change happens
Ongoing review and integration: Regularly assessing progress, adjusting the hierarchy, and integrating other treatment components as needed
ERP Integrated with ACT
At ParityWell, we frequently use Acceptance and Commitment Therapy (ACT) alongside ERP.
ACT is a form of therapy that helps you notice difficult thoughts and feelings without getting stuck in them. It focuses on accepting what you cannot control and taking action guided by your values.
ERP works by having clients deliberately confront feared situations or thoughts without performing the compulsive or avoidant response that follows. ACT addresses the psychological willingness to do that in the first place.
OCD and anxiety are fundamentally disorders of intolerance for uncertainty, and no amount of exposure therapy entirely eliminates uncertainty. ACT builds the psychological flexibility to move forward in the presence of uncertainty.
ACT alongside ERP may involve developing a different relationship with intrusive thoughts, such as learning to observe them but without treating them as truths that require a response.
Why New Yorkers Choose ParityWell for ERP Therapy
Trained ERP therapists: Our therapists have specific training in ERP therapy.
Integrated approach: Everyone is different. We use ERP alongside EMDR, IFS, ACT, and trauma-informed care where needed
Comprehensive assessment from day one: We identify everything relevant before treatment begins. It’s not your job to tell us what’s wrong; it’s our job to identify and treat it.
Specialization in complex presentations: Co-occurring disorders can complicate the healing process. We make sure to treat the root causes for a comprehensive treatment plan.
In-person in Manhattan and online: Serving NYC, New York State, New Jersey, and Pennsylvania
How to Get Started
Reach out: Click the button below and tell us about yourself.
Meet your therapist: We’ll connect you with a therapist trained in ERP. Not sure if ERP is the right approach for you? That’s our job to figure out: every client receives a clinical assessment from the start.
Start your first session: In person at our Manhattan office or online
Frequently Asked Questions
-
ERP and EMDR are both effective, but they treat different mechanisms. ERP is the gold-standard treatment for OCD because it directly targets the obsession–compulsion cycle that maintains the disorder. EMDR, on the other hand, is primarily designed for processing traumatic memories and reducing trauma-related triggers.
At ParityWell, we sometimes integrate both. The decision isn’t about one being “better,” it’s about which combination best addresses your unique history and goals. -
Description text goes hereERP helps by disrupting the fear/avoidance pattern at the heart of OCD. Each time you face a triggering thought or situation (exposure) and resist the urge to perform your usual compulsion (response prevention), your brain learns that the feared outcome doesn’t actually occur or isn’t as catastrophic as it feels. Over time, the compulsion is weakened.
The ERP process rewires how your mind interprets threat signals, reducing both the intensity and frequency of obsessions and compulsions.
-
Most people with OCD or anxiety who’ve had unsuccessful ERP experiences were either working with a therapist who wasn’t specifically trained in the protocol, or may have had underlying factors like trauma or neurodevelopmental differences that weren’t identified or accounted for in treatment.
At ParityWell, we conduct a comprehensive assessment before any exposure work begins specifically to ensure those factors are identified and integrated.
-
ERP can be done effectively in a remote setting, in your own home. In fact, for some presentations, online ERP is particularly well-suited. For example, those with checking OCD can get direct help while facing actual triggers in real time at home. Those with contamination OCD can find it easier to get remote help, with the increased comfort and safety of being at home.
-
Exposure therapy is a broad term covering any therapeutic approach that involves deliberately confronting feared stimuli. ERP is a specific, structured protocol within that category and was originally developed for OCD. ERP pairs exposure therapy with explicit prevention of the compulsive or avoidant response that normally follows. All ERP involves exposure, but not all exposure therapy is ERP. At ParityWell, our therapists are trained in the specific protocols relevant to each condition.
-
You can email us at hello@paritywell.com or contact us here. We are accepting new patients!