Helping OCD Clinicians Integrate IFS Without Abandoning What Works
Melissa Mose, LMFT | BTTI Graduate | IFS Level 3 Certified | President, OCD Southern California | Author, Internal Family Systems Therapy for OCD (PESI, 2024)
You know ERP works. But you also know it doesn't work for everyone and the clients who struggle most often carry the heaviest burdens: trauma histories, attachment injuries, or parts that can't yet tolerate effective treatment.
What if you could help them get there?
Self-Led ERP integrates Internal Family Systems therapy with evidence-based exposure work. Not to replace what you already do, but to address what's blocking it.
The Gap Between Best Practice and Clinical Reality
ERP is the gold standard for OCD treatment. The evidence is clear, and when clients can engage fully, outcomes are excellent.
But research also shows that 25-40% of clients don't respond adequately to first-line treatments. Some refuse exposure altogether. Others can't access the learning that makes exposure work—their nervous systems are too dysregulated, their attachment systems too activated, their internal protectors too vigilant.
These aren't treatment failures. They're clients who need something more before ERP can do its job.
Self-Led ERP: Integration, Not Replacement
Self-Led ERP brings together two powerful frameworks: the parts-based healing of IFS and the behavioral principles that make exposure effective.
The premise is simple: when clients can access Self-energy—the calm, curious, compassionate presence at their core—they can engage with difficult obsessional content differently. Not because they're forcing tolerance, but because their internal system has shifted.
This isn't about making exposure "softer" or avoiding what works. It's about creating the internal conditions under which exposure can actually do its job—including for clients who've previously struggled with or refused treatment.
Key Differentiators
Grounded in ERP Principles
Developed by a BTTI-trained clinician with 15 years of OCD specialization.
Informed by IFS Theory
Uses parts work to address why some clients can't yet tolerate effective treatment.
Trauma-Aware
Recognizes that OCD often coexists with attachment injuries and developmental trauma.
Clinician Tested
Refined through years of clinical practice and consultation with other practitioners.
Upcoming Groups
A Note on Evidence-Based Practice
Self-Led ERP is designed to enhance, not replace, evidence-based treatment. For many clients with OCD, well-delivered ERP remains the most efficient path to recovery.
This integrative approach is particularly valuable for clients who struggle to engage with traditional exposure, often due to trauma histories, attachment injuries, or internal systems that cannot yet tolerate the demands of effective treatment. The goal is always to help clients access what works, not to offer a gentler alternative that avoids what's necessary.
Clinicians using this framework should maintain competency in both IFS and evidence-based OCD treatment, and should be able to recognize when one approach should take precedence.
About Melissa
Melissa Mose is a Licensed Marriage and Family Therapist with 30 years of clinical experience and 15 years specializing in OCD and related disorders. She holds IFS Level 3 certification, is a BTTI graduate, and serves as President of OCD Southern California.
Her book, Internal Family Systems Therapy for OCD: A Clinician's Guide, was published by PESI in 2024 and represents the first comprehensive guide to integrating these two powerful treatment approaches.
Melissa developed Self-Led ERP not as an alternative to evidence-based treatment, but from years of clinical observation that some clients need additional support before they can access what works. Her approach bridges the IFS and OCD communities—grounded in the behavioral science that makes exposure effective, and informed by the parts-based perspective that makes it accessible.
• BTTI Graduate (Behavior Therapy Training Institute)
• IFS Level 3 Certified
• President, OCD Southern California
• 30 Years Clinical Experience
• Author, Routledge Publications
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