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Clinician guide

Using Delay with ERP homework

A short, practical guide. It assumes you're already doing ERP with the client and want something for the days in between. Read time is about four minutes.

Written by Max McKenna, maker of DelayNot clinical advice. Your judgment comes first.

Who it tends to fit

Not a fit: anyone in crisis or at risk of self-harm, situations where waiting would be unsafe (real medical or safety needs), or clients who are early enough that they can't yet tell an urge from a real concern. Delay doesn't assess risk.

Setting it up in session (about five minutes)

  1. Pick one target. One compulsion or one kind of reassurance seeking. "Texting my partner to ask if they're still attracted to me" works better than "my ROCD."
  2. Pick a starting delay. Choose something they can actually finish. The app ramps automatically from two minutes, or they can set a fixed length from 1 to 60 minutes under Me, Timer Duration.
  3. Write both on the handout. There's a space for the target, the delay length, and anything you want them to skip.
  4. Do one together. Have them start a two-minute delay in the room. The first one is the hardest to start alone.

What they do during the week

  1. When the urge shows up, open Delay before responding. The home screen has buttons for the common ones: Google it, reread the message, ask for reassurance.
  2. Let the timer run. They don't need to feel better, they just need to not do the thing yet.
  3. When it ends, they can stop or add time if the urge is still loud.
  4. Log what happened: sat with it, delayed it, responded partway, acted on the urge, or not sure.
Delay home screen
Urge still present screen
What happened? outcome screen

Reviewing it in session

Fading it out

The end goal is not needing the app. A rough path that has made sense for people:

  1. Longer delays, then delays that end with no compulsion at all
  2. Fewer delays, used only for the hardest moments
  3. Maintenance mode: two minutes a day with no streak pressure
  4. Not opening it, or deleting it

Signs it's turning into a ritual

If you see any of these, it's a good time to change the target, shorten the role of the app, or set it aside.

Safety

Delay isn't monitored and can't respond to a crisis. Every timer screen links to crisis resources, and the app lists 988 for the US. Please make sure clients know the app is practice, not a way to reach you or anyone else.

Tell me what's wrong with it

If anything in Delay works against how you run ERP, I want to know. Email max@delayocd.com and you'll hear back within 48 hours with what I'm changing, or why I can't.

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