
Straying from the Path or Forging a New One: Understanding Deviations in Exposure and Response Prevention for OCD
This presentation was originally reviewed on May 12, 2026, and live-streamed online on May 15, 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.
When learning about ERP for OCD in the “classroom setting,” the treatment can seem deceptively simple. However, the nuance and technical details of delivering high-quality ERP to a specific patient becomes far more complicated “in the therapy room,” leading many therapists to deviate from the prescribed protocol. For many ERP therapists, these alterations to standardized ERP practice can feel like mistakes or poor decisions, leading therapists to avoid discussing them in supervision or consultation. In many cases, therapists pivot away from ERP because of their own discomfort or intolerance of the discomfort of their patients. Yet, at the same time, therapists clinging too tightly to manuals, modules, and protocols may miss important treatment opportunities or patient-specific adjustments that could increase treatment response. These opportunities could reveal treatment needs that extend beyond OCD and/or they could help to access much-needed motivation for targeting core fears with ERP. This talk has two broad aims: 1. To bring the common practice of deviating from prescribed ERP protocol out of the shadows, addressing therapist’s reluctance to admit or discuss their own deviations and 2. To explore the common causes and outcomes of such deviations. Specifically, the workshop will address both therapist and patient factors that lead to deviations during a course of ERP, including examples of helpful and unhelpful deviations.
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:
- Describe at least two common deviations in the delivery of ERP.
- Identify one unhelpful reason for a therapist-driven deviation in ERP.
- Discuss one helpful reason for a therapist-driven deviation in ERP.
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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
Price: Free. All courses offered through Sheppard Pratt are free of charge. There is no need to cancel if you cannot attend or complete a course, as no refund is necessary. Not completing an activity acts as a cancellation.
There is no registration required for this course. The course expires and cannot be completed after July 17, 2028.
To request accessibility accommodations, please contact [email protected].
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Last reviewed on May 12, 2026.
Originally broadcast live May 15, 2026, from 1:00 PM- 2:00 PM ET.
Enduring Activity Credit Expiration Date: July 17, 2028.
Activity Time: One hour recorded webinar lecture with a 15-minute evaluation process. Total Time: 1:15.
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After downloading the handout, select NEXT to begin and watch the video.
You may need to select play for the video to begin.
After the video follow the prompts to complete the posttest, evaluation, and attestation of credit.
Once you have completed all the components of the Course Progress bar, the certificate will be immediately downloadable.
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About the speaker
Dr. Steven Tsao is a Co-Founder at the Center for Anxiety & Behavior Therapy, a specialty clinic in suburban Philadelphia focused on evidence-based care and treatment dissemination for primary anxiety disorders. Dr. Tsao completed his Ph.D. in clinical psychology at Fordham University and his postdoctoral fellowship at McLean Hospital/Harvard Medical School. He’s worked as a Staff Psychologist at the OCD Institute at McLean Hospital, the Clinic Director at the Center for the Treatment and Study of Anxiety at the Perelman School of Medicine at the University of Pennsylvania, and the Assistant Clinical Director at Rogers Behavioral Health-Philadelphia. He regularly presents on empirically-based treatments for OCD at numerous professional conferences and provides specialized training for therapists, hospitals, and other mental health organizations.
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.
Steven D. Tsao, PhD, reports being the owner of the Center for Anxiety & Behavior Therapy LLC within the past 24 months. He 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.
Physician Statement: Sheppard Pratt is accredited by The Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CME activity. Sheppard Pratt designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurse Statement: Sheppard Pratt is approved as a provider of nursing continuing professional development by the Maryland Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CME activity. This activity provides 1.0 contact hour for nurses.
Psychologist Statement: Sheppard Pratt is authorized by the State Board of Examiners of Psychologists as a sponsor of continuing education. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. Sheppard Pratt designates this educational activity for a maximum of 1.0 contact hour for Psychologists.
Social Worker Statement: Sheppard Pratt is authorized by the Board of Social Work Examiners of Maryland to offer continuing education for Social Workers. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. This activity is approved for 1.0 contact hour in Category II credits for Social Workers.
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Available Credit
- 1.00 ACEP NBCC clock hours
- 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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Hardware/Software Specifications
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