Chronic posttraumatic stress disorder (PTSD) is an often complex and challenging disorder for clinicians to treat. With a lifetime prevalence of 8% in the population, and in the aftermath of recent terrorist events in the US, it is likely that clinicians will continue to see a sizable number of clients with PTSD and other trauma-related pathology.
Prolonged Exposure Therapy (PE) is…
- A theoretically-based and highly efficacious treatment for chronic PTSD and related depression, anxiety, and anger
- Empirically validated with more than 20 years of research supporting its use
- Based on basic cognitive-behavioral principals
- A flexible therapy that can be modified to fit the needs of individual clients
- Specifically designed to help clients process traumatic events and reduce trauma-induced psychological disturbances.
- A treatment that produces clinically significant improvement in about 80% of patients with chronic PTSD
I am a doctoral-level licensed psychologist in North Carolina; I have expertise in various evidence-based treatments for adults and am committed to providing scientifically validated interventions. I work with a diverse population, including trauma, insomnia, mood disorders, anxiety, and relationship problems. I take my work and clinical specializations seriously and continue to devote a considerable amount of time and effort to advance my training and professional development. For your convenience, my services are provided via telehealth.
Dr. Sara Michelson
Licensed Psychologist Chapel Hill N.C.
PE was developed by Edna Foa, PhD, Director of the Center for the Treatment and Study of Anxiety. Numerous well-controlled studies have shown that PE significantly reduces the symptoms of PTSD, depression, anger, and anxiety in trauma survivors. Practitioners throughout the United States and many foreign countries currently use PE to successfully treat survivors of varied traumas including rape, assault, child abuse, combat, motor vehicle accidents and disasters. PE has been beneficial for those suffering from co-occurring PTSD and substance abuse when combined with substance abuse treatment.
Over years of testing and development, PE has evolved into an adaptable program of intervention to address the needs of varied trauma survivors. In addition to reducing symptoms of PTSD, PE instills confidence and a sense of mastery, improves various aspects of daily functioning, increases client’s ability to cope with courage rather than fearfulness when facing stress, and improves their ability to discriminate safe and unsafe situations.
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.
Prolonged Exposure (PE) teaches you to gradually approach trauma-related memories, feelings, and situations that you have been avoiding since your trauma. By confronting these challenges, you can decrease your PTSD symptoms.
What Type of Treatment Is Prolonged Exposure Therapy?
Prolonged Exposure (PE) is a psychotherapy for PTSD. It is one specific type of Cognitive Behavioral Therapy. PE teaches you to gradually approach trauma-related memories, feelings, and situations that you have been avoiding since your trauma. By confronting these challenges, you can actually decrease your PTSD symptoms.
What Can I Expect?
Your provider will start by giving you an overview of treatment and getting to know more about your past experiences. You will also learn a breathing technique to help you manage anxiety. Around your second session, you will work with your provider to make a list of people, places, or activities that you have stayed away from since your trauma. Over the course of therapy, you will work through your list step-by-step, practicing in vivo exposure. This means that you will gradually confront these situations. With time, you will find that you can feel comfortable in these situations–and you will not need to avoid them anymore. After a few sessions, you will begin to talk through the details of your trauma with your provider. This is called imaginal exposure. Talking about the trauma can help with emotions like fear, anger, and sadness. You will listen to recordings of your imaginal exposure between sessions. By confronting the details of the trauma in therapy, you will find that you have fewer unwanted memories at other times.
Is It Effective?
Yes, trauma-focused psychotherapy (including Prolonged Exposure) is one of the most effective types of treatment for PTSD.
How Long Does Treatment Last?
PE usually takes 8-15 weekly sessions, so treatment lasts about 3 months. Sessions are 1.5 hours each. You may start to feel better after a few sessions. And the benefits of PE often last long after your final session with your provider.
What Are the Risks?
The risks of doing PE are mild to moderate discomfort when engaging in new activities and when talking about trauma related memories. These feelings are usually brief and people tend to feel better as they keep doing PE. There is also a slight risk that someone could listen to a therapy session without your permission if the recording was not secure. You and your provider can discuss ways to secure your personal information related to this program. Most people who complete PE find that the benefits outweigh any initial discomfort.
Group or Individual?
PE is an individual therapy. You will meet one-to-one with your provider for each session.
Will I Talk in Detail about My Trauma?
Yes, around your 3rd session, you will start talking in detail about your trauma. Your provider will guide you through it, keep track of your anxiety level as you talk, and make sure you take things at your own pace. You will listen to a recording of this part of your session at home between sessions.
Will I Have Homework?
Yes, you will practice doing some of the things you have avoided since your trauma. You will start with activities that are manageable for you, and you will work up to activities that are more challenging. You will also listen to a recording of your therapy sessions, including your imaginal exposure recording. Practicing these skills between sessions helps you get the most out of PE.
Choosing the Best Treatment for You
Trying to figure out which PTSD treatment is best for you? For more videos about Prolonged Exposure and other treatments that work, get started with the PTSD Treatment Decision Aid