Prolonged Exposure (PE)

Prolonged Exposure Therapy is a type of Cognitive Behavioral Therapy, which means that it leverages the connection between thoughts, feelings, and behaviors. When individuals find themselves avoiding certain places, people, or situations after experiencing trauma, Prolonged Exposure Therapy can help them feel safe enough to move past their fears.

What is Prolonged Exposure Therapy?

Prolonged Exposure (PE) Therapy describes a type of Cognitive Behavioral Therapy that targets the avoidance of specific situations as a result of trauma experiences. Often, individuals who have experienced trauma develop fear or anxiety in the presence of reminders of the traumatic event. For example, a client who was attacked by a person wearing brown boots may find themselves feeling panicky when they spot that same type of shoe on the street, even when worn by a complete stranger. Prolonged Exposure Therapy aims to reduce the symptoms of PTSD by helping clients understand that they’re safe in the present moment and that their fears no longer serve them, all through gradual exposure to their triggers.

What happens in a Prolonged Exposure Therapy session?

Before engaging in Prolonged Exposure Therapy treatments, clients will discuss their backgrounds with their therapists. Therapists may ask about trauma histories, how their PTSD symptoms present on a daily basis, and what triggers these symptoms. Therapists may teach their clients various relaxation skills, including deep breathing or grounding techniques. Once clients feel comfortable using these skills in times of stress, the therapist will introduce Prolonged Exposure techniques.

There are two components to Prolonged Exposure Therapy. Throughout both, the therapist will encourage the client to lean on their relaxation skills and to take an objective look at their thoughts to notice any harmful patterns. The two components are:

• Imaginal exposure The therapist may ask the client to think back on their traumatic experience and to explore this memory, describing the various details they remember. Clients will often do this in the present tense, as if they were experiencing the situation for the first time.
• In vivo exposure This generally happens outside of the session, as the client navigates their daily life. The therapist will encourage clients to engage with objects or people that usually trigger their trauma symptoms, such as crowded coffee shops or empty parking lots.

Throughout both types of exposures, the therapist will guide the client through a conversation about their feelings to help them process through what comes up. They’ll encourage the client to replace harmful thoughts – like cognitive distortions or assumptions of present harm – with healthier versions. The goal of Prolonged Exposure Therapy is to help clients re-establish themselves in the present day by doing away with any trauma symptoms that occur because of their painful memories. By decreasing the fear or anxiety around triggers, clients can move forward in their lives.

What can Prolonged Exposure Therapy help with?

Prolonged Exposure Therapy was designed to treat PTSD. It is commonly used for clients who are veterans, survivors of abuse, or those who experienced violence.

Because of the nature of Prolonged Exposure Therapy, it’s essential that your therapist take a trauma-informed approach to working with you. Trauma symptoms can worsen if not handled in an appropriate, professional way. Therapists who are trained and credentialed in Prolonged Exposure Therapy offer the beneficial trauma-informed treatment for clients.