Prolonged Exposure Therapy (PE)
Prolonged Exposure Therapy (PE) is an evidenced-based treatment for trauma with over 20 years of research. This model of therapy is considered to be a first line treatment for trauma by the Department of Veteran’s Affairs and the American Psychological Association and produces clinically significant improvement in 80% of participants with chronic PTSD. Benefits of this therapy occur after approximately 8-18 weekly sessions. PE is based on cognitive and behavioral theories. When trauma occurs, the brain associates other non-traumatic stimuli present with the trauma. When these stimuli are later encountered after the trauma ends the brain interprets these as dangerous, causing fear and anxiety. Avoiding these stimuli is a common response to trauma, however this avoidance reinforces fear and feelings of incompetence. The goal of PE is to gradually reengage in life after trauma. PE teaches people to gradually and systematically approach trauma related memories, feelings, and situations that are objectively safe. By approaching these, the person increases their ability to distinguish between safe and dangerous stimuli, and learns that trauma related memories and cues are not dangerous and do not need to be avoided.
This is accomplished through two types of exposures: imaginal exposure and in vivo exposure. Imaginal exposure occurs during sessions and involves describing the event in detail with guidance and support from the therapist. In vivo exposures involve gradually confronting avoided situations as homework outside of sessions. The therapist and client identify situations appropriate for exposure and devise a plan to gradually confront those that are objectively and reasonably safe and within a manageable threshold of distress. During this process, the client is empowered to make decisions about which exposures they want to participate in, and the level of exposure they are comfortable with. It is important to note that clients are never asked to engage in activities that are unsafe or traumatic. By engaging in these two forms of exposure, participants increase their confidence, sense of mastery, daily functioning, and ability to cope with courage. PE is a flexible therapy modified to meet the needs of the client. Many of our therapist are trained in PE and would be honored to support you in reentering your life!
