Prolonged Exposure Therapy (PE)
Prolonged Exposure (PE) was developed with the overall aim of any trauma treatment in mind: to help an individual process their experiences and diminish PTSD symptoms that negatively impact their life.
Dr. Edna Foa, Director of the Center for the Treatment and Study of Anxiety, developed PE in the late 1980s and 1990s. It emerged from exposure therapy used to treat anxiety disorders by gradually approaching fear-evoking stimuli. The treatment programs of PE without any additional cognitive behavioural components has demonstrated efficacy in studies of various types of traumas, including victims of childhood abuse, female sexual assault survivors, victims of motor vehicle accidents and others.
Natural recovery of PTSD symptoms is possible, however, it occurs in a minority of trauma survivors (Foa, Hembree, & Rothbaum, 2007). Natural recovery can occur when emotional processing occurs through daily life. A key component of natural recovery is "repeated activation of the trauma memory, engagement with trauma-related thoughts and feelings and sharing them with others, and being confronted with situations that serve as reminders of the trauma," (Foa et al., 2007). Moreover, talking about the event with trusted and supportive others has benefits to integrate the memory in a helpful way.
PE for PTSD is a manualized treatment protocol that includes the following components:
- Psycho-education about common reactions to trauma.
- Breath retraining to develop grounding skills.
- Repeated in vivo exposure to situations or objects that are avoided because of trauma-related distress and anxiety.
- Repeated, prolonged imaginal exposure to the trauma memories (i.e., revisiting and recounting the trauma memory in imagery).
"No recovery from trauma is possible without attending to issues of safety, care for the self, reparative connections to other human beings, and a renewed faith in the universe. The therapist's job is not just to be a witness to this process but to teach the patient how." - Janina Fisher
References
- Eftekhari, A., Stines, L. R., & Zoellner, L. A. (2006). Do you need to talk about it? Prolonged exposure for the treatment of chronic PTSD. The behavior analyst today, 7(1), 70.
- Foa, E., Hembree, E., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences therapist guide. Oxford University Press.
Benefits:
- Effectiveness. Research shows that online therapy can be just as effective as in-person therapy for issues related to mental health.
- Accessible. Accommodates those living in rural or remote areas, people living with disabilities that prevent them from leaving the home, and eliminates transportation barriers.
- Convenience. No need to schedule time for a commute.
- Cost Effective. Eliminates cost of parking and transportation.
Considerations:
- Coverage. Some insurance companies may not cover it. We encourage you to check with yours.
- Confidentiality and Privacy. Although we use encrypted, HIPAA-compliant software and abide by telehealth guidelines, communicating over the Internet entails a greater risk for security breach compared to in-person. It also means possible Internet connectivity issues.
- Distractions. Possibilities for disruption depending on your living circumstances and others in the home.
Benefits:
- Trust and Body Language. Some people may prefer viewing the entire body language of their therapist for more effective communication.
- Severe mental health or psychiatric concerns. A more appropriate and accommodating option for people that may need crisis intervention that is better supported with in-person care.
- Participation. It is an opportunity to engage in an activity outside of your home.
Considerations:
- Time consuming. Ensuring commute time may be challenging for busy schedules.
- Expenses. Possible parking and transportation fees.
All virtual sessions are conducted using secure, HIPAA-compliant software. Research has shown that psychotherapy offered through telehealth is an effective solution for mental health treatment. The efficacy of either option depends on individual preference and comfort level.