Exposure therapy is a CBT technique used for helping people who suffer various anxiety disorders and phobias. Research of this technique has shown that when provided by a skilled practitioner it is both effective and safe.

Exposure therapy is used mainly to treat: Post-Traumatic Stress Disorder (PTSD) Panic attacks Obsessive-compulsive Disorder (OCD) Social Anxiety Disorder (SAD) Generalized Anxiety Disorder (GAD)

This type of therapy has variations of methods. They are tailored by the therapist to suit the individual’s needs.

In-Vivo Exposure

A treatment path which directly exposes the suffer to the stimuli. This would be carried out under the supervision of a trained therapist and is about confronting the fear. An example could be a client who has an inhibiting fear of flying. One aspect of the treatment could involve them visiting an airport and actually boarding a plane. They will not do this alone as they will be accompanied by a trained therapist. Throughout the event the client is encouraged to practice calming techniques, such as controlled breathing.

Interoceptive Exposure

A technique whereby the therapist induces physical sensations. This is encouraging the client to think about and describe their fear. Such physical feelings may include shortness of breath, muscle tension, and a racing heartbeat. The purpose is to show that these sensations, while uncomfortable, are not actually dangerous.

Imaginal Exposure

Often used in a complementary fashion to In Vivo Exposure. The difference being that it uses Imaginal Exposure. The client is not exposed directly to the situation that causes their anxiety. Instead, they are encouraged to visualize the traumatic fear. Similar to Interoceptive Exposure, the intent is to provoke the feelings of anxiety.

Virtual Reality Exposure

This is a new technique. It involves immersing the patient in a virtual reality environment, usually with a headset. It is ideal for exposing a client to certain situations that they perceive as dangerous in the real world. Particularly useful for those suffering PTSD and has been successful with combat veterans.

An important element to using exposure therapy is determining the level of exposure to the anxiety-inducing stimuli. Too much too soon may be damaging to the client. There are three basic methods of determining exposure levels in CBT.

Systematic Desensitization

Exposure to the anxiety-inducing stimuli, while engaging in stress-reducing activities. This would include exercises such as controlled breathing, or other relaxation techniques.

Graded Exposure

With the help of the therapist, the client is asked to construct a hierarchal list of anxiety-inducing situations. This treatment will involve exposing the client to the less threatening fears first. Then, a build-up to the more difficult situations at a gradual pace.

Flooding Exposure

This is a more aggressive and somewhat controversial method of exposure therapy. That is because this method overwhelms the client with anxiety-inducing stimuli. Whilst it can only be used on a limited number of clients, it is perhaps the most cost-effective and quickest method. It has proven to help cure phobias and other anxiety issues.

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