What Exposure Therapy Is
Exposure therapy is a behavioral therapy that contends avoiding, escaping out of, or neutralizing feared objects or situations maintains fear and distress. In many situations, the fear and distress are also significantly increased.
To reduce the crippling grip these feared stimuli can have, exposure therapy asks clients to face these fears directly. However, this is done gradually, in a systematic manner, with new coping skills, and with permission.
Facing the fears in this way can both reduce the distress and fear caused by these situations or objects, and produce a better sense of safety in their presence. Doing this can also reduce the control these feared stimuli have over your life and decision making.
Types of Exposure Therapy
There are different ways exposure therapy may be discussed. This list consists of some terms used within exposure therapy.
Exposure with Response Prevention (ERP)
This is exposure while preventing any purposeful or inadvertent behaviors done to try to avoid or neutralize the exposure. This is most often associated with OCD. However, it can also be used with any anxiety issue where there are unhelpful behaviors countering the therapy.
Interoceptive Exposure
This is exposure to uncomfortable senstations in the body. This is most often associated with fear of panic attacks. However, it can be used for a variety of fears or avoidances related to bodily sensations, including emetophobia.
In Vivo Exposure
In vivo is Latin for ‘within the living.’ In vivo exposure is any exposure conducted in real form.
Imaginal Exposure
This exposure, on the other hand, is any exposure conducted solely through imagining the experience. It is sometimes used as a stepping stone before graduating to in vivo exposure, or it can be used for any experience that is impossible or inappropriate to do in real form.
Length of Exposure Therapy
While some significant changes can be seen within one or a few sessions, it can be difficult to guarantee this timeframe due to several human factors in our growingly chaotic lives. This center has successfully graduated clients within a few weeks and up to a few months.
The length of time your therapy will take depends on several different factors, including
- the number of goals you have, and how complex and/or deeply rooted the issues are,
- how motivated you are to change,
- how well you follow through with practice between sessions, and
- the frequency and duration of your sessions.
How Therapy Progresses
Exposure therapy can be a stand alone therapy, or used in conjunction with other types of therapy. When exposure therapy is used at this center, it is also combined with CBT and ACT. The general breakdown of how therapy progresses at this center is as follows.
Phase 1: Assessment and Psychoeducation
Your therapy will begin with a thorough assessment of the presenting issues, diagnosing (if necessary), and goal setting. In order to fully and correctly address the problem(s), your therapist will need to take time to understand how they show up for you, personally. During this time, your therapist will also provide ample psychoeducation about your presenting problems, exposure therapy, the human mind, and human behavior. The length of this phase is typically 1 to 3 sessions. However, it can take up to several weeks if the presenting issues are very complex or undefined, your goals are uncertain, and/or you prefer your sessions to be less structured.
Phase 2: Active Phase of Therapy
During this phase of therapy, you and your therapist will collaboratively create a treatment plan based on your presenting issues and desired goals. You will be invited to experiment with and try various types of new behaviors, ways of talking to yourself, and techniques for better understanding yourself and your circumstances. You will also be expected to practice these new skills on your own between sessions in order to better reinforce the learning. This phase takes up the bulk of your therapy, and can take several weeks or several months.
Phase 3: Relapse Prevention and Termination
This phase of therapy focuses on consolidating all the learning done throughout your journey. Your therapist will discuss with you how to prevent backsliding, and what to do if you begin to struggle with using your tools on your own. Termination, or ending therapy, can occur whenever you want. However, it is best done when you have reached your therapeutic goals and feel confident in your ability to manage difficult situations on your own.
When Therapy Ends
While you may end your therapeutic journey at any time you choose, your therapist will look for certain markers to help determine when you may be most ready to end therapy.
- The symptoms and distress that were present at the start of therapy have significantly decreased.
- You are feeling more confident in your ability to manage difficult situations and have demonstrated an ability to recover well after distress.
- Your therapeutic goals have been met.
- You are making decisions that are more in line with your values.