Prolonged Exposure Therapy for PTSD (PE)
Prolonged Exposure Therapy (PE) is an evidenced-based, manualized protocol effective for the treatment of posttraumatic stress disorder (PTSD). Numerous well-controlled studies over the past two decades have shown that PE significantly reduces the symptoms of PTSD as well as co-morbid symptoms of depression, anger and anxiety. Besides reducing symptoms, PE also instills confidence and a sense of mastery. Clients are better able to discriminate safe and unsafe situations, and experience improvement in many areas of daily functioning.
PE is based in Emotional Processing Theory, which posits that PTSD symptoms arise as a result of cognitive and behavioral avoidance of trauma-related thoughts, reminders, activities and situations. PE helps the client interrupt and reverse this process by blocking cognitive and behavioral avoidance, introducing corrective information, and facilitating organization and processing of the trauma memory and associated thoughts and beliefs. This is accomplished through in vivo and imaginal exposure.
In vivo exposure involves repeatedly engaging in activities, situations, or behaviors that are avoided because of the trauma, but which are not actually dangerous. Over time, In vivo exposure reduces excessive fear, and other distressing emotions, and encourages the recognition that the avoided situations are not excessively dangerous, and that the client can cope effectively even when distressed.
Imaginal exposure involves repeatedly revisiting the traumatic experience in memory describing the event aloud in detail. The narrative is recorded and the client listens to the recording between sessions to maximize therapeutic value. Revisiting the event in this way promotes processing of the trauma memory by activating the thoughts and emotions associated with the trauma in a safe context. Imaginal exposure also helps the client realize he or she can cope with the distress associated with the memory.
In 2001, Prolonged Exposure for PTSD received an Exemplary Substance Abuse Prevention Program Award from the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA). PE was selected by SAMHSA and the Center for Substance Abuse Prevention as a Model Program for national dissemination.