What is Prolonged Exposure Therapy?

 

What is prolonged exposure therapy?

Prolonged exposure therapy or PE, is a cognitive behavior therapy supported by 20 years of research. PE has more scientific support for its effectiveness than any other treatment for PTSD. PE involves two core components. Within session, trauma survivors learn to deal with unpleasant memories they may be avoiding or fixated on. In addition, we come up with safe and secure ways for trauma survivors to work towards engaging in important activities they may be avoiding since the trauma(s).  Treatment is delivered across 9-12 sessions on average.

Because this treatment can be intense, I will not begin PE without the client’s explicit consent and until the client understands the rationale for it. It is also crucial that we establish a relationship of trust and safety.

How does prolonged exposure therapy work?

The main points for the rationale of PE are as follows:

1. When we avoid things, we are unable to learn that they may not be as scary as we think.

2. In most anxiety-provoking but safe situations, our anxiety will drop down in about 45 minutes if we just stick it out.

3. When we tackle distressing memories or situations successfully, we begin to feel more competent and confident in our abilities.

A common metaphor for PE is that of a wound that has scabbed over but not properly healed. Through PE, we open and clean that wound, so that it may heal properly and no longer be so sensitive to the touch.

Can talking about trauma make me worse?

It is true in trauma treatment that some people may start to feel worse before they feel better. Sometimes people have been avoiding talking about painful experiences for years, even decades, so beginning to talk about these things can bring up some initial distress. For these reasons, it is not uncommon for people to drop out of treatment or avoid coming to session. However, these increases are temporary and people in PE usually begin to see a reduction in symptoms around the sixth session. For this reason, I track my client’s progress with self-report measures so that we can follow changes in symptoms.

How do I know if I’m right for prolonged exposure therapy?

That’s something we’ll assess in our first session. I’ll give you a written questionnaire to complete, and we’ll talk about what’s been going on for you. If you’re experiencing trauma symptoms but PE is not a good fit for you, we’ll discuss how we might design therapy to best fit your needs.