Exposure and response prevention, commonly called ERP, and medication can both be discussed in OCD care. A guide cannot diagnose OCD, predict an individual response, decide a treatment order or recommend starting, changing or stopping medication. An assessment can consider the pattern of intrusive thoughts, compulsions, avoidance, health, risk, previous support and personal preferences. What ERP involves ERP is a CBT based approach that may involve collaboratively planned work with triggers and compulsive responses. It is not a self directed internet challenge, a promise that feared outcomes cannot occur or a test of willpower. Exposure based work should be planned with an appropriately trained clinician, with a pace, focus and safety plan that reflect the person’s assessment, health and goals. Medication questions Medication may be considered as part of a wider plan, but medication decisions belong with an appropriate prescriber. A prescriber can discuss potential benefits, possible side effects, interactions, monitoring, pregnancy considerations where relevant and alternatives. A therapy guide cannot advise on a dose, say that medication is necessary or tell someone to change a prescribed treatment. Comparing options without a hierarchy Research can inform discussion, but studies vary in participants, presentation, treatment formats, timing and outcome measures. Group findings should not be used to predict a result for an individual or to conclude that one option is universally superior. Some people may discuss ERP, medication or both; others may need medical review, specialist support or a different starting point. Medical and urgent safety boundaries New, severe or concerning physical symptoms, medication side effects, significant substance use, a sudden marked change in mental state or possible specialist needs should be discussed with an appropriate medical professional. If you cannot keep yourself safe, have thoughts of harming yourself, experience psychosis, severe agitation, confusion or a sudden deterioration, seek urgent help. In immediate danger, call 999 or attend A&E. Frequently asked questions Is ERP better than medication? Not for every person. The relevant option depends on an individual assessment. Can I practise ERP alone? Exposure based work should be planned collaboratively with an appropriately trained clinician, rather than self directed from online material. For related information, see https://lyceumclinic.co.uk/therapy/ocd/, https://lyceumclinic.co.uk/guides/ocd comprehensive guide/, https://lyceumclinic.co.uk/guides/ocd cbt tools today/ and https://lyceumclinic.co.uk/guides/ocd rates west london/. An enquiry can clarify whether CBT based support, medical review, prescribing advice or another source of help may be the relevant next step.