Exposure and response prevention — structured clinical viva

You are the psychiatry registrar in an anxiety disorders clinic. A 34-year-old woman with longstanding OCD (harm thoughts with mental rituals and checking) remains moderately ill on fluoxetine 60 mg oral daily. The consultant asks you to: define ERP; contrast habituation vs inhibitory learning; design an imaginal and in-vivo plan with response prevention; cite Foa 2005, Simpson SRI-augmentation trials, and POTS briefly; list pitfalls and family accommodation issues; and outline risk management if exposure transiently increases distress.