Medically reviewed by Kathleen Daly, MD
Exposure therapy is an evidence-based treatment option for many mental health disorders. It involves exposing someone to an object or situation that causes anxiety, stress, or fear through actual exposure, virtual exposure, or exposure through images or thoughts.
This article will discuss the techniques used in exposure therapy and the reasons some mental health providers use exposure therapy. It will also compare other treatments and options for seeking a provider.
Techniques Used in Exposure Therapy
There are different methods and pacing options for exposure therapy. A mental health provider can help determine the right approach for each person and situation.
Types of Exposure Therapy
There are several different types of exposure therapy, including:
Virtual reality: A person is exposed to traumatic situations or events using virtual reality at a pace and intensity level determined by the individual being treated and their provider.
Narrative: A person is guided through creating a timeline or map of their traumatic experiences, noting any particularly difficult or triggering times and any happy or positive times with different markers. This timeline is then turned into a written narrative and read aloud by the mental health provider.
In vivo: A person is exposed to anxiety-causing situations in real life through actual exposure to the stressor.
Imaginal: A person is slowly encouraged to recall memories of the traumatic incident with support from a mental health provider.
Interoceptive: A person is asked to try to recreate the feelings that come up when they experience anxiety or panic symptoms, such as by doing jumping jacks to raise their pulse and heart rate.
Though there is evidence to support each of these types of exposure therapy, in vivo and imaginal treatments are most commonly used.
Pacing Options in Exposure Therapy
There are also various paces at which exposure therapy is provided. These include:
Graded: A person works through a list of fears or "tasks," starting with the easiest or most tolerable and working toward the most feared or difficult.
Flooding: A person begins treatment by facing the most difficult or fearful images in their exposure.
Systematic desensitization: A person is gradually exposed to progressively more stressful situations while practicing relaxation techniques that slow or stop anxiety symptoms.
Exposure Therapy Is Not for Everyone
Though exposure therapy is safe and can be helpful for many people, the intervention is not for everyone. If your symptoms are overwhelming or unmanageable or if they turn into panic, work with a mental health provider to determine whether exposure therapy is the proper treatment. For some people, a slower pace or different treatment methods will be more effective.
Reasons People Start Exposure Therapy
Exposure therapy is an effective treatment modality for people experiencing certain mental illnesses, including those with:
People may be drawn to exposure therapy for its high effectiveness and ease of implementation, as well as the ability to work through certain aspects of the treatment, with or without a mental health provider.
Compared to Other Therapies, Does Exposure Therapy Work?
Exposure therapy is shown to be a safe and effective form of treatment for many mental health conditions. It is highly customizable and can be beneficial to people with stress, anxiety, or trauma symptoms.
One of the drawbacks of exposure therapy, however, is that people often stop treatment before its completion due to discomfort with the experience. This may be especially true for those with continuous exposure to trauma or who have experienced severe trauma, such as military veterans.
To increase tolerance and the effectiveness of exposure therapy, other modalities are commonly used in tandem with this treatment. Although exposure therapy is a type of cognitive behavioral therapy (CBT), it usually does not include all elements of standard CBT interventions, such as cognitive elements. For this reason, other forms of CBT are often used in combination with exposure therapy to increase its effectiveness.
Effectiveness for Different Types of Trauma
Exposure therapy may be more effective for certain types of traumatic experiences, like those related to natural disasters. Though the intervention can be helpful following any traumatic incident, research shows less effectiveness in traumatic situations related to medical procedures and sexual assault, which may warrant a different treatment approach.
Working With a Certified Provider
Mental health providers who offer exposure therapy have completed additional coursework, a consultation with a supervisor, and have earned a certification to treat patients. Confirm this is true for your provider before engaging in provider-guided exposure therapy.
When choosing a mental health provider, find someone you feel connected to. Exposure therapy is hard work, and finding a therapist who helps you feel calm and supported is vital to treatment success.
Does Insurance Cover Exposure Therapy?
Exposure therapy is a standard evidence-based treatment for trauma and anxiety and is, therefore, usually covered by insurance plans that include mental health therapy. The amount of coverage will depend on your insurance carrier and the type of insurance you have.
Before beginning exposure therapy, you may want to contact your insurance provider to understand what will be covered, as well as your mental health provider to ensure they take your insurance.
Many mental health providers offer services on a sliding scale to people who do not have insurance coverage and are required to pay out of pocket.
Self-Guided Exposure Therapy
Self-guided exposure therapy means the individual is in complete control of the stressors and the pace at which they are exposed. For example, in virtual reality therapy, the client is still in the room with a mental health provider but controls the pace at which they are exposed to the feared object or situation.
Though small amounts of exposure to mild stressors can potentially be done on your own, it is usually not advised to try exposure therapy without professional support and guidance. Self-guided exposure therapy does not mean exposing yourself to traumatic or highly stressful situations on your own without the help of a mental health professional.
Self-Guided Exposure Therapy Allows for More Control
There is a connection between feeling like you have control and the success of exposure therapy. Self-guided exposure therapy may encourage more people to complete the sessions since pacing and intensity are determined solely by the individual in therapy.
Exposure therapy is an effective treatment option for many people who are suffering from PTSD, phobias, and other forms of anxiety. During treatment, the person is exposed to the fear or stressor to reduce symptoms over time. There are different approaches to exposure therapy, which can vary in intensity.
Exposure therapy is a common therapeutic intervention and is often covered by insurance as part of general mental health treatment, though the amount of coverage varies by plan. When looking for a mental health provider, find someone who has completed their certification in exposure therapy treatment.
Read the original article on Verywell Health.