Prolonged exposure therapy for PTSD involves reintroducing triggers while in a safe space, with a therapist to coach you through the experience.

Every year, tens of millions of children, adolescents, and adults live with the symptoms of post-traumatic stress disorder (PTSD). PTSD is a mental health disorder that can develop after witnessing or experiencing stressful, shocking, or traumatic events.

PTSD can cause a wide range of symptoms that make it difficult to function from day to day, but treatment can help a person manage these symptoms. Prolonged exposure therapy is one treatment option that’s effective in helping reduce the symptoms of PTSD.

Ahead, we’ll explore more about what prolonged exposure therapy is, how this type of exposure therapy benefits people with PTSD, and resources for finding an exposure therapy specialist.

Exposure therapy is a cognitive behavioral therapy (CBT) technique in which someone exposes themselves to things or situations that make them anxious, but in a safe environment. Over time, this can lead to a decrease in fear and anxiety when faced with these triggers.

Prolonged exposure therapy is a form of exposure therapy in which someone gradually faces memories, situations, or feelings related to past trauma. Because prolonged exposure therapy targets the trauma-related triggers that people with PTSD tend to avoid, it’s an effective approach for treating the symptoms of PTSD.

One early study from 2018 explored the effectiveness of intensive prolonged exposure therapy in adults with chronic complex PTSD who hadn’t responded to other treatments.

In this study, treatment involved 18 total hours of intensive exposure in a single week, followed by weekly maintenance sessions. Results of the study found that intensive prolonged exposure therapy decreased PTSD symptom severity in 71% of study participants.

Another study published in 2019 found that prolonged exposure therapy more quickly reduced suicidal ideation in adolescents with sexual assault-related PTSD than client-centered therapy.

A more recent review from 2022, which explored prolonged exposure therapy for children and adolescents with PTSD, found that prolonged exposure was more effective at reducing PTSD symptoms than other treatments or nontreatment.

Prolonged exposure therapy uses a combination of psychoeducation and different exposure therapy techniques, including:

  • Imaginal exposure: This involves imagining and describing trauma-related memories or situations and processing your emotions in the present with a therapist.
  • In vivo exposure: This involves facing your trauma triggers in real life by engaging in activities like visiting specific places or seeing specific people related to your trauma.
  • Interoceptive exposure: This involves intentionally triggering and exposing yourself to trauma-related anxiety sensations, such as shortness of breath or a racing heart.
  • Virtual reality exposure: This involves using virtual reality in a safe space to face trauma-related triggers that might otherwise be difficult to face in real life.

For example, imaginal exposure for someone with complex PTSD due to childhood abuse might include recalling specific traumatic childhood experiences. In vivo exposure for a veteran who developed PTSD after military service may include visiting previous service locations.

While prolonged exposure therapy can be effective for PTSD by itself, research shows that it can also be beneficial when combined with other PTSD treatments, such as eye movement desensitization and reprocessing (EMDR) therapy.

With all of these approaches, one of the most important elements is that you aren’t going through the exposure alone. A therapist won’t only be there to monitor your safety but to coach you through it. They’ll be able to help you fully understand what you’re feeling and how it affects you — and then to find healthy coping mechanisms.

Eventually, you’ll be able to create new neuropathways that can lead to different responses to these triggers.

According to the American Psychological Association (APA), prolonged exposure therapy takes place once weekly for 8–15 weeks, or around 3 months total. Intensive prolonged exposure therapy is usually much shorter due to the more frequent weekly — or daily — sessions.

During treatment, a single prolonged exposure session can last anywhere from 60–120 minutes. Between sessions, therapists may also prescribe “homework,” which usually includes more exposure-related activities that can help increase the effectiveness of treatment.

Prolonged exposure therapy is typically well tolerated, with the biggest risk being an initial increase in PTSD symptoms at the start of treatment. But this heightened discomfort and anxiety is usually only temporary and gets better with treatment over time.

When starting this type of therapy, it’s important to talk with the therapist about your support system and emergency plans if you do experience a flare-up of severe PTSD symptoms or suicidal ideation.

Research also suggests that several barriers to care, such as mental health stigma, lack of access to specialists, and other personal or environmental barriers, can make it difficult for some people to get treatment.

Finding a prolonged exposure therapist for PTSD

If you’ve been considering giving prolonged exposure therapy a try to help you manage your PTSD symptoms, here are a few resources that can help you find treatment near you:

When you’re narrowing down possible therapist options, most of the tools listed above allow you to search by specialty. So, for example, you can search for therapists who specifically specialize in exposure therapy or treating PTSD.

Other resources for finding exposure therapists in your area include a doctor, hospital, or treatment referrals or even a Google search for “prolonged exposure therapists” that includes your city or zip code.

Was this helpful?

Prolonged exposure therapy is a type of CBT technique used to treat the symptoms of PTSD in adolescents and adults. Research shows that this type of exposure therapy may be more effective than other types of therapy for helping people manage their PTSD long term.

If you’re interested in trying prolonged exposure therapy for your PTSD, consider reaching out to a doctor or therapist to discuss the treatment options available to you.