Common Methods of Exposure Therapy
With exposure therapy, the goal is to expose people (have them confront) the situation, object or activity they fear until these feelings decrease.
Exposure therapy is typically used to help people experiencing panic attacks, phobias, anxiety, obsessive thinking, trauma and social anxiety to effectively manage and overcome their fears.
At our clinic, we generally use 3 variations of exposure and response prevention.
This approach involves imagining the feared object, situation or activity until the feelings of anxiety decrease. For example, a person who has been involved in a traumatic incident would be asked to recall the distressing event and discuss it aloud with their clinician until their feelings of anxiety decrease.
This form of exposure therapy involves purposefully bringing on physical sensations that are experienced when a person feels anxious. The symptoms that individuals experience when anxious are harmless, but feel uncomfortable and are generally feared. For example, a person might be asked to run on the spot to elevate their heart rate, which is a symptom that can be feared when someone experiences an anxiety attack. By bringing on this symptom purposefully in the office, it can help the individual realize that the symptom is harmless and will gradually disappear.
With in-vivo exposure, the client directly faces a feared object, situation or activity in real life. For example, a person who was involved in a traumatic car accident would be asked to return to the scene of the accident. Please note: imaginal exposure is typically used before in-vivo exposure, as it is less anxiety-provoking. Once imaginal exposure is completed, clients are better prepared to participate in in-vivo exposure.
The Pace of Exposure Therapy
At our clinic we pace our exposure activities in 2 ways:
Graded Exposure
With this approach, a hierarchy is created which involves listing all of the feared objects, situations or activities that need to be addressed. The individual starts by challenging the least anxiety-provoking tasks on the hierarchy. As these fears are overcome, the person gradually progresses to the most anxiety-provoking activities on the hierarchy.
Systematic Desensitization
This approach is very similar to graded exposure except it involves utilizing relaxation exercises while engaging in exposure therapy. The addition of relaxation activities such as deep breathing and progressive muscle relaxation can help to make feelings of anxiety more manageable, while also allowing the person to associate the feared object, activity or situation with relaxation.