Reducing contamination by exposure plus safety behaviour

► Exposure and Response Prevention (ERP) for OCD is a difficult treatment associated with high rates of dropout and refusal. ► We found that incorporating safety behaviour into treatments for contamination-related fear did not interfere with the outcome, even when the safety behaviour was washing. ► Our new treatment, Exposure plus Safety Behaviour (ESB) was associated with a moderate return of contamination between sessions (as is common in all exposure-based therapies), but was at least as effective as ERP.