Prolonged exposure therapy (PE)

Prolonged exposure therapy (PE) is a kind of psychotherapy that’s primarily used to help treat the symptoms of post-traumatic stress disorder (PTSD). Because prolonged exposure therapy is a form of cognitive behavioral therapy (CBT), its focus is on helping patients address their trauma-related thoughts, feelings, and behaviors by using skills and techniques they acquire during therapy. According to the Department of Veterans Affairs (VA), “PE teaches you to gradually approach trauma-related memories, feelings, and situations that you have been avoiding since your trauma. By confronting these challenges, you can actually decrease your PTSD symptoms.”

When is prolonged exposure therapy used?

Prolonged exposure therapy is used to help people suffering from the symptoms of PTSD. This disorder can develop from witnessing or experiencing a traumatic event or situation. PE can be helpful for combat veterans and people who’ve experienced sexual trauma, natural disasters, intimate partner violence, and other traumas. PE is used in PTSD treatment because it is an evidence-based treatment for the symptoms of PTSD, which can vary widely, but generally fall into four categories:

• Intrusion, like flashbacks of the traumatic event
• Avoidance, such as avoiding anything that could trigger memories of the event
• Negative distortions of mood and emotions
• Irritability, vigilance, and difficulty sleeping.

How does prolonged exposure therapy work?

Prolonged exposure therapy “uses repeated, detailed imagining of the trauma or progressive exposures to symptom ‘triggers’ in a safe, controlled way to help a person face and gain control of fear and distress and learn to cope.” The therapy works in four main ways:

• Habituation – The fear and upset that you experience when triggered will reduce over time with the controlled, gradual exposures in therapy
• Extinction – Some of the reactions you have to triggers will decrease or even disappear after repeated exposures
• Emotional processing – With the help of a therapist, you’re better able to think through your fear and become less reactive to it
• Self-efficacy – With improvements to your reactions, you’ll be able to gain more confidence that you can manage your fear

What is prolonged exposure therapy like?

In prolonged exposure therapy, your therapist will get to know you and the past experiences that are negatively affecting you. Your therapist will also learn about what triggers your PTSD and what you’ve been avoiding. Depending on your needs and your therapist’s treatment plan, you may experience one or more of the following exposures:

• Imaginal exposure – This is when a therapist guides a client to recall their traumatic experience
• In vivo exposure – This is the “real life” kind of exposure when a client faces fears outside of a therapy session, as guided and supported by the therapist
• Virtual reality (VR) exposure – This is when virtual reality tools are used to simulate a triggering environment
• Interoceptive exposure – This is when a therapist helps a client to induce similar bodily sensations that they experience during a triggering event

Is prolonged exposure therapy effective?

According to the VA, “trauma-focused psychotherapy (including prolonged exposure) is one of the most effective types of treatment for PTSD.”

How to find a therapist who practices prolonged exposure therapy

If you think prolonged exposure therapy might be right for you, it’s important to speak with a licensed and experienced clinician trained in this model. Since PE can bring up intense emotions, you’ll want a therapist who is not only compassionate and patient but also experienced in creating a supportive environment. Don’t hesitate to ask about their background to make sure their clinical practice is the right fit for your specific needs.

There are many types of mental health care providers who practice PE, including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs) and more.

On top of finding someone specializing in PE, you want to make sure they meet your other needs. For example, if you experienced trauma as a combat veteran, you’ll want to find a therapist who can practice PE and also has experience working with veterans. In addition, finding a therapist who accepts your insurance can make therapy much more affordable.

You can find a therapist who accepts your insurance and specializes in prolonged exposure therapy by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Prolonged Exposure Therapy” from the “Treatment methods” drop-down.