An effective trauma treatment that empowers clients to face fears, heal from PTSD, and restore a sense of safety and control.
Prolonged Exposure (PE) Therapy is a behavioral treatment for post-traumatic stress disorder (PTSD). It helps clients gradually confront trauma-related memories and situations in a safe, structured way.
Through imaginal exposure (retelling the trauma story) and in vivo exposure (approaching avoided but safe situations), clients reduce avoidance, build tolerance for difficult emotions, and lessen the distress tied to trauma. PE is typically delivered in 8–15 sessions and has been shown to significantly decrease PTSD symptoms and improve daily functioning.
The primary goal of Prolonged Exposure Therapy is to reduce PTSD symptoms by decreasing avoidance behaviors and diminishing the intense emotional distress tied to trauma memories. Through repeated, safe exposure, clients gradually learn that trauma reminders are tolerable and not inherently dangerous.
Over time, PE helps people reclaim parts of their life they’ve been avoiding, restore daily functioning, and improve their sense of safety and control.
Prolonged Exposure primarily treats PTSD and other trauma-related disorders, including:
It is also sometimes used for:
While there are no fully separate “subtypes” of Prolonged Exposure (PE), there are important adaptations of the standard PE model designed for particular settings or age groups. These include:
Some emerging formats push even further in flexibility, including massed/intensive PE (compressed delivery over days or weeks) and telehealth formats to increase accessibility.
Prolonged Exposure Therapy was developed by Dr. Edna Foa and her colleagues at the University of Pennsylvania in the 1980s and 1990s. Dr. Foa built on earlier work in exposure therapy and systematic desensitization, specifically adapting these techniques for trauma treatment and creating the structured prolonged exposure protocol that became widely used.
Prolonged Exposure Therapy is highly evidence-based and considered one of the most researched and effective treatments for PTSD. It has been validated through numerous studies over several decades, consistently showing significant reductions in PTSD symptoms.
Prolonged exposure is recommended as a first-line treatment by major organizations including the American Psychological Association, the Department of Veterans Affairs, and the World Health Organization, and is included in most clinical practice guidelines for PTSD treatment.
Prolonged Exposure Therapy works by breaking the cycle of avoidance that maintains PTSD symptoms. The process involves several key elements:
Early sessions involve psychoeducation about PTSD and treatment planning, while later sessions typically include:
Sessions are often recorded so you can listen to them as homework to reinforce the exposure work.
It’s important to note that Prolonged Exposure Therapy sessions can be emotionally difficult, especially during imaginal exposure where you’ll recount your trauma in detail. You may experience:
The in vivo assignments can also feel intimidating at first. However, your therapist will prepare you thoroughly by teaching coping skills and explaining what to expect. You’ll start gradually, at a manageable pace, and most people find their distress levels drop substantially as treatment progresses.
The structured, predictable nature of Prolonged Exposure Therapy helps many clients feel more in control of their recovery. Throughout treatment, your therapist will monitor your progress closely and adjust the approach if needed.
Prolonged Exposure Therapy typically involves 8–15 weekly sessions, each lasting about 90 minutes. The therapy follows a highly structured protocol:
Each session follows a clear format that includes:
Alma’s directory has many therapists who specialize in Prolonged Exposure PE, including:
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This article was written and medically validated by Drs. Jill Krahwinkel-Bower and Jamie Bower.
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