Threshold Exposure with Response Prevention: Technical Specification, Clinical Decision Rules, and a Research Agenda for Change Under Consequential Load

This paper introduces Threshold Exposure with Response Prevention (TERP), a proposed clinical procedure within the broader PACT framework. TERP extends exposure and response-prevention principles into consequential developmental, relational, and identity-bearing situations. Rather than focusing exclusively on feared stimuli or symptom reduction, it identifies realities that an established psychological organization has difficulty accommodating. The procedure requires four elements to be specified in advance: the consequential reality, the functionally defined response class through which that reality is ordinarily escaped or neutralized, the capacities to be developed## Ketamine-Assisted Threshold Exposure with Response Prevention (TERP)