Exposure therapy psychoeducation

Exposure therapy can be a valuable intervention to help clients overcome their fears and process trauma. 

In this article, we explain exposure therapy’s psychology definition, provide an overview of the intervention and how it works, and summarize key information for providing exposure therapy psychoeducation to clients. 

We’ve also included a free downloadable “What is exposure therapy?” guide to save to your electronic health record (EHR) and share with clients. 

Exposure therapy explained

So, first up, what is exposure therapy? 

Exposure therapy is an intervention used by mental health therapists to help individuals overcome common fears, anxieties, and the impacts of trauma, including anxiety, panic, phobias, social anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD).

The theory behind exposure therapy psychology posits that avoiding things we fear (situations, objects, or activities) provides only temporary relief. Over time, however, these anxieties worsen, having a negative impact on physical and mental health. 

Exposure therapy helps people face those fears gradually in the safety of a therapeutic relationship. 

Working alongside a therapist in a secure environment, clients face their fears through gradual, controlled exposure. This process helps decrease anxiety responses over time. 

The treatment period usually spans weeks to months, depending on each person's specific objectives and therapeutic plan.

How effective is exposure therapy?

Exposure therapy is considered the gold standard of treatment for PTSD. It’s also considered a vital and effective psychotherapy for anxiety disorders, including obsessive-compulsive disorder and anxiety disorders in children.

When providing exposure therapy psychoeducation, some of the main benefits to describe include: 

• Decreased response to fears

• Reduced association between fears and adverse outcomes

• Improved self-efficacy, demonstrating resilience and capacity to face and overcome difficult situations and challenges

• Strengthened emotional regulation skills by reframing fears into more realistic thoughts and beliefs about feared objects, activities, or situations

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Approaches to exposure therapy 

As with any mental health treatment, there are various approaches to exposure therapy psychoeducation, depending on the type of anxiety disorder or trauma being treated and the individual's pacing needs.

According to the American Psychological Association, psychotherapists may use any of the following exposure strategies: 

In vivo exposure

Also called real exposure, this approach involves directly facing the object, situation, or activity in real life. 

For example, a person with a severe fear of spiders may gradually expose themselves to spiders, starting by looking at pictures of them, then watching videos of spiders, observing spiders in a closed container, and finally, allowing a spider to crawl on an item of their clothing or even their hand. 

Imagined exposure

This type of exposure involves imagining the situation, activity, or object and describing the experience in detail. 

For instance, someone with PTSD may imagine their traumatic event and recall the specific details to reduce their emotional response to their trauma. 

Virtual reality exposure

Also called simulation exposure, this type of virtual exposure involves using technology to simulate an experience. 

For instance, if a person is fearful of flying, a clinician might use a flight simulator in the safety of their office, but still expose the person to the sensory experience of flying with the sights and sounds of being in an airplane. 

Interoceptive exposure

This approach involves increased exposure to feared physical sensations that may trigger anxiety or panic. 

For example, if an individual fears shortness of breath and thinks it may lead to a panic attack, they may engage in an activity to simulate breathlessness, like running in place, holding their breath, or straw breathing. 

Through the exposure, their fears gradually decrease, and they can replace their thoughts with more realistic ones.

There is also prolonged exposure (PE), another exposure therapy method which is recommended for treating PTSD. In PE, therapists use imagined and in vivo exposure together with distress tolerance skills to process trauma.  

There are various ways to pace exposure therapy, including:

• Graded exposure: In this approach, therapists may use an exposure therapy worksheet with the client to create a fear exposure hierarchy, ranking fears in order of distress. They may approach mild fears first, progressing to processing more distressing situations.

• Flooding: This technique involves beginning with the most distressing fear. 

• Systematic desensitization: In this approach, the therapist may combine relaxation techniques with exposure to make the process feel more tolerable and to increase positive feelings associated with the client’s fears.

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How to use the exposure therapy psychoeducation handout

You can download and use the exposure therapy psychoeducation handout in several ways.

For example, print or screen share the PDF and use it during sessions to answer client questions like “What is exposure therapy?”.

Therapists can also give the worksheet to clients to remind them of what was discussed during therapy. 

Or, you can use the exposure therapy psychoeducation handout to accompany other related worksheets, like an exposure therapy worksheet. Then, ask the client to list their specific fears between sessions or collaboratively create a fear hierarchy in the next session.  

Sources

• American Psychological Association. (2017). What is Exposure Therapy? 

• Catanese, L. (2024). Exposure therapy: What is it and how can it help?

• Odgers, K., Kershaw, K. A., Li, S. H., & Graham, B. M. (2022). The relative efficacy and efficiency of single- and multi-session exposure therapies for specific phobia: A meta-analysis.

• Rauch, S. A., Eftekhari, A., & Ruzek, J. I. (2012). Review of exposure therapy: a gold standard for PTSD treatment.

• Schopf, K., Mohr, C., Lippert, M. W., Sommer, K., Meyer, A. H., et al. (2020). The role of exposure in the treatment of anxiety in children and adolescents: protocol of a systematic review and meta-analysis. 

• University of Michigan. (n.d.). Exposure and Desensitization. 

• Watkins LE, et al. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. 

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