Podcast Summary
Your Anxiety Toolkit
Episode 474: ERP at Home: How to Build an Exposure Plan Without a Therapist
Host: Kimberley Quinlan, LMFT
Date: February 25, 2026

Overview:
In this episode, Kimberley Quinlan demystifies how individuals can design their own Exposure and Response Prevention (ERP) plans at home, especially for those lacking access to a trained ERP therapist. Kimberley, drawing on her extensive experience, offers a science-backed, practical roadmap for tackling OCD and related anxiety conditions using ERP principles. She provides listeners with step-by-step directions—rooted in self-compassion and realism—for building an actionable, personalized hierarchy of exposures, managing compulsions, and overcoming obstacles on the path to recovery.

Key Discussion Points & Insights

ERP Basics: What Is an Exposure Plan?

• Definition Correction: Exposure therapy is just part of the full process; the correct term is Exposure and Response Prevention (ERP), which involves both facing fears (exposure) and preventing the usual anxiety-reducing behaviours (response prevention).
  • “When we say the word exposure plan or exposure therapy, that's technically not the right terminology. … We're actually talking about something called exposure and response prevention.” (02:05)
• Vital Third Component: While not always included in ERP discussions, managing self-criticism is key for long-term recovery.
  • “Those who manage self-criticism … tend to do better mental health wise and tend to have reduction in relapse.” (03:07)

The Six Steps to Effective OCD Treatment

Kimberley’s treatment structure (from her online course and clinical work):

1. Assessment & Education
2. Treatment Planning (today’s focus)
3. Mindfulness Training
4. Self-compassion
5. Exposure and Response Prevention
6. Relapse Prevention & Maintenance

Creating Your ERP Plan (Treatment Planning)

Step-by-step Self-Assessment (07:12):
Kimberley urges listeners to honestly reflect, “get a piece of paper,” and respond to a series of questions to map out their unique anxiety triggers and safety behaviours.

Guiding Questions:

1. What do I avoid due to fear, uncertainty, discomfort?

2. What scares me? (Thoughts, feelings, situations, sensations, people, places)

3. What physical behaviours do I use to relieve discomfort? (e.g., hand washing, checking, reassurance seeking)

4. What mental behaviours do I use? (Rumination, mental checking, neutralizing thoughts, self-reassurance)

5. How do others (family/friends) accommodate my anxiety? (e.g., changing routines, avoiding triggers for you)

   • “If you are really in a trusting relationship with your family members, you may go to them and ask them, what behaviors do you do to reduce or remove my anxiety? How is it impacting your life?” (13:16)

Kimberley also notes the importance of considering cultural and religious influences (05:54), clarifying that compulsions are motivated by anxiety—not genuine values or routines.

Building Your Exposure List & Hierarchy

• Compile All Avoided Situations & Compulsions:
  • Examples: Avoiding eye contact, thoughts about sickness, holding breath near hospitals, repetitive prayer for safety, excessive hand washing, avoiding “trigger” movies, seeking reassurance, Googling illnesses. (16:55)
• Rate Difficulty: For each item, rate the difficulty of resisting the compulsion or facing the feared situation (scale of 1–10, or easy/moderate/hard).
  • “How hard would it be for me to do the opposite of this behavior?” (20:08)
• Create a Graded Plan:
  • Start with the least difficult exposure and increase gradually. Break larger exposures into manageable steps (e.g., “watch 5 minutes of the movie,” then 10, etc.).
  • Example: “On my pretend example list, it would be not avoiding movies. So I would start there… Then you can break each exposure down into small baby steps.” (22:55)

Essential ERP Principles

• Response Prevention:
  • Don’t “undo” exposures with safety behaviour afterwards–e.g., no extra-long hand washing after resisting the urge in public.
    • “If you did an extra long hand wash, that means you did the exposure, but the response prevention was the area you needed to work on.” (25:35)
• Pacing & Gentleness:
  • “Please go gentle. This is not easy.” (27:10)

Managing Setbacks: The Self-Criticism Factor

Kimberley’s strategies for resisting self-punishment during ERP (28:02):

• No self-judgment or harsh self-talk

• Avoid punishing yourself for thoughts or behaviours

• Don’t withhold pleasure as punishment for compulsions

• Stop “gathering” evidence against yourself

• Don’t isolate—seek support!

  • “[Self-] punishment might be saying like, you’re bad. So I’m going to induce pain on you now… We also don’t want to be doing any pleasure withholding…” (29:01)

Addressing Common Challenges & Fears (31:43)

• “What if my thoughts mean something?”
  • “Thoughts aren’t facts… you want to actually practice not giving meaning to whatever thoughts and feelings you’re having.” (31:50)
• “Can I handle this anxiety?”
  • “I’m going to tell you here 100% you can handle anxiety. You will not explode.” (32:20)
• “What’s the point?” / Hopelessness
  • “The point is with this work, you actually get your life back. You can start to reverse the cycle…” (32:41)
• “I don’t want to feel uncomfortable.”
  • “Practice your mindfulness skills as much as you can.” (33:12)
• “It’s not fair.”
  • “It is not fair… But I promise you that with practice and with compassion, it will get a little easier each time.” (33:36)
• “I need more help.”
  • If possible, seek a professional ERP therapist. If not, use available resources like Kimberley’s courses. (34:07)

Notable Quotes & Memorable Moments

• “It is a beautiful day to do the freaking hard things…” (35:34)
• “Please be kind with yourself, be gentle, it does take time and let it be messy.” (35:14)
• “Thoughts aren’t facts.” (31:50)

Timestamps for Important Segments

• [00:02] Why ERP? The Problem of Delayed Diagnosis
• [02:05] What is ERP? The importance of ‘response prevention’
• [03:07] The role of self-criticism in recovery
• [06:45 – 09:10] The 6-step approach overview
• [07:12] Self-assessment questions for building your plan
• [13:16] Involving family in understanding accommodations
• [16:55] Example compulsions and exposure list items
• [20:08] Rating exposures & hierarchy creation
• [25:35] Response prevention and why it matters
• [28:02] Managing self-criticism and self-punishment
• [31:43] Addressing common fears and resistance
• [35:34] Encouragement and closing remarks

Tone and Takeaway

Kimberley's approach is warm, encouraging, and practical, blending compassion with actionable advice. She normalizes difficulty and setbacks, emphasizes self-kindness, and provides hope, all while equipping listeners with essential tools for managing anxiety.

“Recovery is possible. Please do not forget that.” (15:28)

If you’re seeking to start ERP on your own, this episode offers a roadmap that’s both evidence-based and deeply humane.