Not Just Right (NJR) is a prevalent and debilitating presentation of obsessive–compulsive disorder (OCD) in which compulsions are performed to relieve a sense of incompleteness. Exposure plus response prevention (ERP) is the first-line OCD treatment but shows diminished effectiveness for NJR unless specifically tailored. How clinicians modify ERP for NJR OCD in practice—and to what effect—remains unknown. In this study, 96 mental health clinicians completed an online survey assessing their experiences and perceptions applying ERP with NJR symptoms. Clinicians generally viewed ERP to be effective for NJR OCD. Of 22 tailoring strategies surveyed (derived from the empirical literature), the large majority were endorsed by at least 30 % of clinicians and rated as at least “fairly helpful” for both adult and youth clients. The most frequently used ERP modifications (endorsed by ≥70 %) were informal functional assessment, designing exposures that specifically elicit NJR sensations, emphasizing tolerating discomfort, additional acceptance and mindfulness techniques, more gradual ritual prevention, and adding cognitive therapy. Expertise in ERP and NJR OCD was not related to the total number of tailoring strategies endorsed, the endorsement of any given strategy, or ERP’s perceived effectiveness; expertise was moderately correlated with the perceived helpfulness of 9 tailoring strategies. In addition, 12 novel tailoring strategies were identified from open-ended response items. Results support the view that ERP can be tailored to treat NJR OCD, highlight the relevance of inhibitory learning and acceptance and commitment therapy, and inform the development and evaluation of the first treatment protocol for NJR OCD. 249/250 words.