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Prolonged Exposure Therapy (PE)


The Prolonged Exposure (PE) therapy, developed by Edna Foa, denotes a cognitive-behavioral approach to treat post-traumatic stress disorder. Accordingly, the PE reveals that the treatment program deviates from the traditional exposure therapy for anxiety disorders. Clients’ assistance in confronting safe and anxiety-provoking situations to overcome fear and anxiety was within the purview of the exposure therapy. Further, PE is dependent on the emotional processing theory of PTSD, which calls for the essence of successfully handling the traumatic experience to minimize its effects. Therefore, PE provides substantial empirical evidence on the effectiveness of dealing with PTSD and has been recognized by experts as the first-line approach to treating the disorder. Hence, an in-depth analysis of PE as a tool to provide an evidence-based treatment should generate insight into facets of its operations. Consequently, the effectiveness of the approach in teaching people to confront their emotions, memories, and situations is within the service delivery paradigm.

Research Surrounding Efficiency

Deng et al. (2019) accept that PE works effectively with PTSD and Anxiety patients by empowering them to confront their memories, cases, and feelings after a traumatic experience. Arguably, the approach entails promoting a setting whereby the individual can decrease avoidance (Craske et al., 2022). The need for its inclusion entails encouraging the patients to talk through their painful memories in a secure location. Further, engagement in activities geared at dealing with the related trauma is apparent in its execution (Craske et al., 2022). Therefore, the efficacy of the therapy emanates from its criticism for avoidance. Engaging the patients to deviate from pushing away their experiences or escaping traumatic situations is a beneficial approach (Craske et al., 2022). Central to its implementation is enhancing courage among the patients to confront their trauma, anxiety, and stressful situations.

Hence, the treatment used denotes education, breathing retraining, in-vivo, and imaginal exposure. The empowerment approach entails information provision to people on PTSD and anxiety on its symptoms, effects, and implications on well-being (Deng et al., 2019). Central to education is the provision of insight into the treatment goals. Breathing retraining entails a relaxing methodology for self-improvement (Craske et al., 2022). The provision of time to practice and engage in expressive conduct to enhance welfare is apparent. In-vivo exposure denotes the patient taking part in real-life situations. The therapist striving to develop a list of the situations that impact well-being is evident as the basis for decision-making (Deng et al., 2019). Imaginal exposure comprises talking about the traumatic or anxiety-induced experience. The approach assists the patient in confronting and changing negative feelings and thoughts.

Contraindications for the Use of Treatment

Criticism of PE is based on its focus on exposure as the basis for the treatment process. Especially for the veterans with PTS and anxiety disorder, the PE’s overemphasis on exposing the victim to traumatic experiences generates heightened debates. Morris (2015) acknowledges that the treatment approach has been grappling with a high dropout rate among patients in recent years. The confrontational feature of exposure therapy translates into heightened fear and unwillingness to engage or participate. As widely evaluated by Morris (2015), PE has had detrimental outcomes for patients among veterans due to the unwillingness to communicate and accept counseling or necessary therapeutic initiatives. For example, a veteran officers enlisted for PE survey showed that at least 50% dropped out of the therapy due to the confrontational feature (Morris, 2015). Arguably calling upon the veterans to re-live their experiences in the Iraq war translated into trauma-inducing sessions with adverse effects. Hence, the criticism by Deng et al. (2019) highlights the experiential approach of PE as significantly impactful on the mental and physical well-being of the patient. Hence, awareness about the limits to the PE’s focus on dealing with memories and personal experiences should be established.


Craske, M. G., Treanor, M., Zbozinek, T. D., & Vervliet, B. (2022). Optimizing exposure therapy with an inhibitory retrieval approach and the OptEx Nexus. Behavior Research and Therapy152, 104069.

Deng, W., Hu, D., Xu, S., Liu, X., Zhao, J., Chen, Q., … & Li, X. (2019). The efficacy of virtual reality exposure therapy for PTSD symptoms: A systematic review and meta-analysis. Journal of affective disorders257, 698-709.

Morris, D. J. (2015, July 21). Trauma Post Trauma. Medical Examiner.


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