During the course of ERP, a sufferer is asked to manage his anxieties, specifically by doing something that he has been avoiding or by not doing something that he has been don’t repeatedly. For example, if the person has been avoiding touching the washroom door handle for fear of contamination, he is encouraged to not only touch the handle with bare hands, but also sit and tolerate the anxiety that comes with not being allowed to either use a paper napkin to open, or wash hands immediately after touching the handle.
While theoretically this sounds easy to people who do not have this particular obsession, for the sufferer it may become impossible to conceive that it can be done. So it is up to the therapist to make sure that the sufferer is encouraged enough and provided sufficient inputs on not just what is to be done (which is easy – touch the door handle and don’t wash your hands), but also how it is to be done because for the sufferer it is close to impossible to be able to do that. So the therapist has to use various methods to get it done. One of the methods that the therapist can use is called modeling.
Simply put, modeling refers to demonstrating the required action for the sufferer. In the above example, since the sufferer is scared of touching the door handle, the therapist instead of verbally urging him to try and touch it, could resort to modeling and touch the door handle himself. The sufferer needs to watch the therapist touching the door handle and then continuing therapy comfortably, without displaying any need to wash his hands. This action of the therapist provides encouragement to the sufferer, and he sees that despite having touched the door handle, nothing is really happening to the therapist and also the therapist is not anxious at all. He could as a result feel a little more confident to copy the modeled behavior of his therapist, and face his fear by touching the door.
Modeling works well where the compulsions of the sufferer are visible. If the sufferer suffers from manifestations like contamination OCD or Just right OCD, or any other form that is not Pure-O, (and in some types of compulsions, even in Pure-O), modeling can be effectively used. Modeling cannot be used well in case of mental compulsions like rumination, or safety behaviors like praying, etc.
Care needs to be taken however that the modeling does not actually result in the fear coming true for the sufferer, while the therapist is performing the action in front of his eyes. Like if the therapist touches the door handle and finds something sticky on his hands, making it necessary for him to wash his hands, the entire exercise can prove to be greatly counter productive. It can reinforce the validity of the fear in the mind of the sufferer. The sufferer could reason that if the therapist had to wash his hands, it definitely means that it can happen again, and his safety behavior (compulsion of either touching the handle using a paper napkin, or not touching it at all), becomes justified for him. This could put him off the entire process altogether, undoing some of the progress made by the therapist, if not all.