Prolonged Exposure Therapy (PE)
A structured trauma-focused therapy that uses repeated, guided recounting of the traumatic memory along with real-world exposure to safe but avoided situations.
What Is Prolonged Exposure Therapy (PE)?
Prolonged exposure therapy (PE) is a structured, manualized form of exposure therapy developed specifically for PTSD, involving repeated, guided recounting of the traumatic memory (imaginal exposure) along with gradual exposure to safe situations that have been avoided since the trauma (in vivo exposure).
How It Works
PE is based on the understanding that avoidance of trauma reminders maintains PTSD symptoms over time. By repeatedly and safely engaging with the traumatic memory and avoided situations, the therapy is thought to help the brain process the trauma and reduce excessive fear responses. This is a general description using original language.
What Happens During Therapy?
Sessions typically include psychoeducation about trauma reactions, breathing retraining, imaginal exposure (recounting the trauma memory aloud, often recorded for home practice), and gradually increasing in vivo exposure to avoided situations, with homework between sessions.
Evidence and Effectiveness
Research strongly supports PE for PTSD, with extensive evidence from randomized controlled trials, including in combat veterans and survivors of sexual assault, and endorsement in major clinical practice guidelines.
Who May Benefit?
PE may be considered as part of an individualized treatment plan specifically for people with PTSD, particularly those willing to engage in detailed recounting of the traumatic memory as part of treatment.
Limitations and Considerations
PE directly involves recounting and approaching trauma-related material, which can be emotionally demanding, particularly in early sessions. It requires a therapist with specific PE training.
Finding a Qualified Therapist
PE is delivered by psychologists, licensed clinical social workers, and other mental health professionals with specific PE training, often available through specialized trauma programs.
How Long Does Therapy Take?
PE is typically delivered over approximately 8 to 15 sessions, though treatment length varies according to the person and clinical presentation.
Therapy vs. Medication
For PTSD, PE and medication are not necessarily competing options and may be used alone or in combination, in consultation with a qualified healthcare professional.
What Conditions Is It Used For?
Related Therapy Types
Medical Information Disclaimer
Ratel Health provides general educational information and does not provide medical diagnosis, treatment, or individualized medical advice. Information on this page is not a substitute for evaluation or care from a qualified healthcare professional. Do not use this information to diagnose yourself or another person, or to start, stop, or change treatment or medication without consulting an appropriately qualified healthcare professional.
References
- U.S. Department of Veterans Affairs, National Center for PTSD.
- American Psychological Association. Clinical Practice Guideline for PTSD.
- Substance Abuse and Mental Health Services Administration.