A Patient’s Guide to Prolonged Exposure Therapy
Trauma and anxiety can leave a lasting impact on mental health, with conditions like Post-Traumatic Stress Disorder (PTSD) alone affecting millions of individuals worldwide. Fortunately, evidence-based treatments like Prolonged Exposure Therapy (PE) offer a pathway to healing and recovery. PE is a structured, effective form of therapy specifically designed to help individuals confront and process traumatic memories. Today, PE is also used to treat a number of anxiety disorders and phobias as well.
In this blog, we’ll explore what Prolonged Exposure Therapy is, how it works, and what patients can expect during treatment. We’ll also highlight its success rate and the transformative benefits it provides for those living with trauma.
What Is Prolonged Exposure Therapy?
Prolonged Exposure Therapy (PE) is a form of Cognitive Behavioral Therapy (CBT) that focuses on helping individuals process trauma by gradually confronting distressing memories, emotions, and situations they have been avoiding. Developed by Dr. Edna Foa, PE is widely recognized as one of the most effective treatments for trauma-related disorders, particularly Post-Traumatic Stress Disorder (PTSD).
What Is Prolonged Exposure Therapy Used to Treat?
PTSD: Prolonged exposure is most commonly used to treat PTSD, particularly in individuals who have experienced combat, sexual assault, natural disasters, or other traumatic events, such as car accidents.
Anxiety Disorders: PE has also been used to address severe phobias and generalized anxiety, which often times stem from traumatic experiences.
Avoidance Behaviors: Many trauma survivors develop avoidance behaviors as a coping mechanism. PE works to reduce these behaviors, enabling individuals to regain control over their lives.
The Benefits of Prolonged Exposure Therapy
Reduces Trauma-Related Symptoms: PE helps individuals manage and reduce symptoms like flashbacks, nightmares, and emotional numbing.
Improves Emotional Resilience: By confronting fears in a safe environment, patients build resilience and learn healthier coping strategies.
Restores Daily Functioning: PE empowers individuals to re-engage with life, reducing the impact of trauma on relationships, work, and daily activities.
Provides Long-Term Relief: Research shows that PE has long-lasting effects, with many individuals experiencing sustained improvement years after treatment.
How Prolonged Exposure Therapy Works
Prolonged Exposure Therapy follows a structured, step-by-step process to help individuals confront and process traumatic memories. It uses a technique known as ‘Graduated Exposure’, a hallmark of PE, in-which the therapist ensures that exposure tasks are introduced incrementally, so patients are never overwhelmed beyond their capacity to cope with their body’s stress responses. These gradual exposure exercises, overtime, will retrain the patients brain to no longer trigger the threat responses it once associated with the corresponding memories. Below is an outline of the key components of PE treatment:
1. Psychoeducation
In the initial sessions, therapists provide an overview of trauma and how their avoidance behaviors maintain or even exacerbate their PTSD symptoms. Patients are then educated on PE, what their treatment would look like, and how it can help them confront and process their emotions.
2. Breathing Techniques
Patients are taught breathing exercises to manage anxiety and stay grounded during emotionally intense moments. These techniques become a critical tool for self-regulation throughout their PE therapy, as they are gradually exposed over-time to their triggers.
3. Imaginal Exposure
Imaginal exposure involves the patient repeatedly recalling and describing their traumatic event or phobia in detail during therapy sessions. This process helps individuals process the memory, reducing its emotional intensity over time. During this phase, which will occur over a number of sessions, the patient’s therapist will ensure they are not overwhelmed beyond their ability to cope. It is important to understand, however, that in order for PE to be effective, it must trigger the patient’s threat response to a reasonable degree of distress, while staying within the limits of control.
Example: For someone with PTSD from a car accident, imaginal exposure might involve vividly recounting the moments leading up to, during, and after the crash, focusing on the emotions and thoughts experienced throughout the event.
4. In Vivo Exposure
When a patient’s level of distress minimizes towards imaginal exposure, they are then introduced to vivo exposure, which involves gradually confronting real-life situations or objects that the individual has been avoiding due to their trauma-related fears. This stage is pivotal, as it directly treats their day-to-day behaviors and phobias.
Example: A veteran with combat-related PTSD might start by watching war documentaries and gradually progress to visiting locations that previously triggered fear, such as a crowded park.
5. Homework Assignments
Patients are assigned homework to practice both imaginal and in vivo exposures outside therapy sessions. These assignments reinforce progress and build confidence in managing distress. These assignments are important, as patients must learn to manage their triggers while on their own in their daily lives. Otherwise, long-term benefits of PE will be less attainable.
What to Expect During PE Treatment
Early Sessions: Establishing a Foundation
During the first few sessions, your therapist will focus on building trust and understanding your trauma history. They will explain the treatment process, ensuring you feel prepared and supported. You will also learn stress management and breathing techniques, which will be used during your exposure sessions.
*If you’re interested in learning about general anxiety management techniques, checkout our article on Tips For Managing Anxiety: Strategies for Removing Stress and Improving Well-being.
Mid-Treatment: Confronting Trauma
Once you are ready, your therapist will begin to gradually expose you to your trauma or phobia. As you engage in imaginal and in vivo exposures, you may initially feel an increase in emotional discomfort. This is a natural part of processing trauma and is essential in order to reprogram your brain’s response to the stimuli. With time, over the course of many sessions, the distress will decrease, and you’ll begin to feel more in control of your emotions.
Later Sessions: Gaining Confidence
Toward the end of treatment, you’ll notice significant reductions in avoidance behaviors and emotional distress. By this stage, most patients feel more resilient and capable of facing situations that once seemed overwhelming.
Success Rates of Prolonged Exposure Therapy
PE is backed by extensive research demonstrating its efficacy in treating trauma-related disorders. Here are some key statistics:
Reduction in PTSD Symptoms: Studies have shown that 80% to 90% of individuals who complete PE experience a significant reduction in PTSD symptoms.
Sustained Improvements: Research indicates that PE provides long-term relief, with many patients maintaining progress years after treatment.
Comparison with Other Therapies: PE is as effective as, if not more effective than, other trauma-focused therapies like Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Processing Therapy (CPT).
Conclusion: A Path to Healing with Prolonged Exposure Therapy
Prolonged Exposure Therapy is a proven, evidence-based treatment that offers hope and healing to individuals struggling with trauma, anxiety disorders, and phobias. By gradually confronting distressing memories and situations, PE helps patients regain control over their lives, reduce symptoms, and experience long-term relief.
At Psychology House, our licensed therapists specialize in trauma-focused treatments like PE. Whether you’re seeking to address PTSD or other trauma or anxiety-related challenges, our compassionate team is here to guide you every step of the way. Offering both in-person and online therapy, Psychology House has cultivated a psychology practice built on comfort, safety, and connection; to create a space that feels like home.
If you’re ready to take the next step toward healing, contact Psychology House today to schedule a consultation.
About Psychology House - Tampa, FL
We know therapy can be challenging. The most important things always are. But we also know it can be transformative. We see it in our clients, their family lives, relationships, and in their careers. Located in South Tampa, Psychology House is home to highly trained psychologists who specialize in today’s most prominent mental health issues and evidence-based treatments. Prioritizing comfort, safety, and connection, we’ve cultivated a psychology practice built on the idea of home.
Psychology House provides both in-person therapy (Tampa, FL residents) and virtual sessions (Florida Residents). Our growing team of psychologists specialize in depression, trauma/PTSD, anxiety, relationship issues, addiction, and more.
