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Prolonged Exposure (PE)

Prolonged Exposure (PE) is a short-term and highly effective treatment for PTSD that focuses on getting clients to gradually approach the memories, feelings, and situations they have been avoiding since their trauma occurred. Confronting these challenges can help decrease PTSD symptoms and improve quality of life.

Frequently Asked Questions
about PE

What is Prolonged Exposure?

 

Prolonged Exposure (“PE”) is a highly effective, short-term treatment for people with PTSD. 

 

People with PTSD often try to avoid anything that reminds them of their trauma. This might include avoiding certain places, situations, and people, as well as avoiding trauma-related memories and feelings. While this avoidance relieves fear and intense emotions in the short run, over the long term, this avoidance serves to increase symptoms of PTSD and distressing feelings. 

 

PE teaches you to gradually approach the memories, feelings, and situations you have been avoiding since your trauma. By confronting these challenges instead of avoiding them, you can decrease your PTSD symptoms and improve your quality of life. 

 

Research shows that PE is effective in treating PTSD across a variety of populations and types of traumas. It has worked well for people who have experienced combat, rape, sexual assault, childhood trauma, violence, natural disasters, and other types of traumas. PE is effective whether you have experienced a single traumatic event, many traumatic events, or prolonged abuse. 

 

What can I expect during PE treatment? 

 

PE treatment typically takes place over 8 - 16 sessions. In most cases, you will meet weekly with your therapist for about 90 minutes. During treatment: 

 

  • You will learn more about PTSD and the common ways people respond to trauma.

  • You will learn more about how PE therapy works. 

  • Your therapist will teach you a breathing technique to help manage anxiety. 

  • You and your therapist will develop a list of the people, places, and activities you have been avoiding since your trauma.

  • You will practice in vivo exposure, which means you will gradually confront the situations you have been avoiding. Over time, you will learn that you can feel comfortable in these situations and no longer need to avoid them. 

  • You will practice imaginal exposure, which involves discussing the details of your traumatic experience(s) with your provider. This helps decrease the feelings you associate with the trauma, like fear, anger, and sadness. It also helps to decrease unwanted and intrusive memories of your trauma.  

 

During PE treatment, you will gradually confront things you’re afraid of. These will be things that are actually safe but that cause you to be anxious, on guard, or scared. 

 

What if I have multiple traumas or “complex” PTSD? 

 

PE is very effective for people who have experienced multiple traumas. People who have experienced multiple traumas or chronic trauma can benefit from PE just as much as someone who experienced a single-incident trauma. Therapy will start by focusing on the traumatic experience that bothers you the most, and then the focus can shift to other traumas as needed. The length of treatment doesn’t vary based on the number of traumatic experiences you have had.  

 

What if my trauma occurred a really long time ago? 

 

PE has been shown to be effective whether your trauma occurred recently or decades ago. 

 

How long does PE treatment last?

 

PE treatment typically lasts between 8 and 16 sessions. You will meet weekly with your therapist for about 90 minutes. In some cases, 90-minute sessions are not possible, and we may be able to adapt PE to 60-minute sessions.

 

Will I have to talk about my traumatic experiences in detail? 

 

Yes. Starting around your third session, you will start discussing your trauma in detail. (This is the imaginal exposure mentioned previously.) Your therapist will guide you through it, track your anxiety level throughout the discussion, and make sure that things go at your pace. While this can be uncomfortable at first, these feelings are usually brief, and people tend to report feeling better as they keep doing PE. 

 

What if I don’t want to talk about the details of my traumatic experiences? 

 

This is understandable and one of the reasons we offer several different treatment options for PTSD. If PE does not sound like the right therapy for you, we can discuss whether CPT, EMDR, or CBCT might be a better fit. Those treatments do not require you to discuss the details of your traumatic experience(s). 

 

Will my therapy sessions be recorded? 

 

Recording therapy sessions is an essential component of PE therapy. Part of your homework each week will be to listen to the session recording. Your therapist will delete all session recordings after providing them to you and won’t share the recordings with anyone else. 

 

What if I don’t want my therapy sessions recorded? 

 

That is understandable and one of the reasons we offer several different treatment options for PTSD. If PE does not sound like the right therapy for you, we can discuss whether CPT, EMDR, or CBCT might be a better fit. Those treatments do not require sessions to be recorded. 

 

Will I have to do homework? 

 

Yes. In between sessions, you will practice doing some of the things you have avoided since the trauma. You will start with activities that are manageable and gradually work up to more challenging ones. You will also listen to a recording of your therapy session, including a recording of your imaginal exposure. Homework is an essential part of PE therapy because the homework helps you get better

 

Will I be able to handle PE? 

 

Engaging in new activities and talking about trauma-related memories can cause mild to moderate discomfort. These feelings are usually brief, and people tend to feel better as they continue to engage in PE therapy. With time, PE will help to decrease the feelings of distress and anxiety associated with the situations and memories you have been avoiding. 

 

Is PE my only treatment option? 

 

Absolutely not! We offer multiple, effective treatments for PTSD and can work together to determine which one is right for you. If PE doesn't sound like a good fit, I also offer EMDRCognitive Processing Therapy (CPT), and CBCT Couples Therapy for PTSD

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