
OCD Subtleties That Can Sabotage ERP Success
This presentation was originally reviewed on January 15, 2026, and live streamed online on January 16, 2026, from 1:00 pm – 2:00 pm ET.
The views and opinions expressed by this presenter in this lecture are their own, and do not represent the views of Sheppard Pratt.
Although Exposure and Response Prevention (ERP) is the gold-standard therapy for OCD, some clients struggle to achieve lasting gains because subtle compulsions quietly sabotage their progress. These hidden rituals—cognitive, emotional, and behavioral—can undermine ERP by reinforcing the very fears treatment is designed to address. Clinicians may misinterpret plateaus in progress as resistance or non-response, when the real barrier lies in unrecognized compulsive patterns. This presentation illuminates these nuanced obstacles and offers practical strategies for identifying and resolving them, empowering clinicians to deliver more effective ERP and help clients reclaim their lives.
Target Audience
This activity is intended for physicians, nurses, psychologists, social workers, counselors, and other mental health professionals.
Learning Objectives
At the conclusion of this activity, attendees will be able to:
- Identify subtle cognitive, emotional, and behavioral compulsions that can interfere with successful Exposure and Response Prevention (ERP) treatment for OCD.
- Explain how unrecognized OCD treatment obstacles, such as “emotions as a compulsion” or past trauma dynamically interacting with OCD, can maintain symptoms despite ERP participation.
- Apply strategies for helping clients identify and disengage from hidden compulsive patterns to enhance ERP effectiveness and long-term recovery.
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This is a recorded asynchronous distance learning format course where you will download the handout, watch a video recording, and complete the required pretest, posttest, evaluation, and attestation for credit. Once you have completed all the components of the Course Progress bar, the certificate will be immediately downloadable. The certificate will also be saved in your account transcript.
Outline of Activity:
Introduction- 5 minutes
Presentation- 45 minutes
Q&A- 10 minutes
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There is no registration required for this course. The course expires and cannot be completed after February 15, 2028.
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Originally reviewed on January 15, 2026.
Originally broadcast live January 16, 2026, from 1:00 - 2:00 pm ET.
Enduring Activity Credit Expiration Date: February 15, 2028.
Activity Time: One hour recorded webinar lecture with a 15-minute evaluation process. Total Time: 1:15.
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About the speaker
Shala Nicely, LPC, is the author of Is Fred in the Refrigerator? Taming OCD and Reclaiming My Life, and coauthor of Everyday Mindfulness for OCD: Tips, Tricks & Skills for Living Joyfully with Jon Hershfield, MFT. She is a counselor and cognitive behavioral therapist in metro Atlanta, GA, specializing in the treatment of OCD, anxiety disorders, and the dynamic co-morbidity between trauma/PTSD and OCD. Over the past decade, Shala has given numerous talks on OCD and its treatment at national conferences and was the keynote speaker for the 2013 IOCDF national conference. She sends the Shoulders Back! Tips & Resources for Taming OCD newsletter to thousands of subscribers each month and writes several blogs, including one for Psychology Today that offers an inside perspective on life with OCD.
Disclosure Statements
Sheppard Pratt holds the standard that its continuing medical education programs should be free of commercial bias and conflict of interest. In accord with Sheppard Pratt's Disclosure Policy, as well as standards of the Accreditation Council for Continuing Medical Education (ACCME) and the American Medical Association (AMA), all planners, reviewers, speakers and persons in control of content have been asked to disclose any relationship he /she has with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months. All planners, reviewers and speakers have also been asked to disclose any payments accepted for this lecture from any entity besides Sheppard Pratt, and if there will be discussion of any products, services, or off-label uses of product(s) during this presentation.
Shala Nicely, LPC, reports being the owner of Shala Nicely, LPC, and has received royalties within the past 24 months. She will not discuss any products, services, or off-label uses in this presentation. All relationships have been mitigated through review.
Event Planners/Reviewers Disclosures: The following event planners and/or reviewers are reported as having no financial interest, arrangement or affiliation with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months: Jon Hershfield, LCMFT, Todd Peters, MD, Michael C. Hann, MD, MBA, Ronald Means, MD, Rajeev Krishna, MD, PhD, MBA, Louis Marino, MD, Devi Bhuyan, PsyD, Manan Shah, MD, Vittoria DeLucia, MD, Chad J. Lennon, MD, Faith Dickerson, PhD, MPH, Carrie Etheridge, LCSW-C, Tom Flis, MS, BCBA, LBA, LCPC, Paula Bostwick, MSN, RN, CENP, Alfredo Sagisi, DNP, MS, RN, FACHE, Maggie O'Neill MSN, RN, PMH-BC, Lisa Illum, MLIS, MEd, and Jennifer Tornabene.
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Available Credit
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- 1.00 AMA PRA Category 1 Credit™
- 1.00 Category II credits for Social Workers
- 1.00 Psychologists
- 1.00 MNA Contact Hours for Nurses
- 1.00 Participation
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