Prolonged Exposure Therapy (PE)

Prolonged Exposure Therapy (PE) is a form of cognitive-behavioral therapy specifically designed to help individuals who are struggling with post-traumatic stress disorder (PTSD) and other trauma-related disorders. Developed by Edna Foa in the 1980s, PE is based on the principle that repeated, controlled exposure to trauma-related cues and memories reduces the power those memories hold, helping individuals process the trauma and reduce their PTSD symptoms. PE is a well-researched and highly effective treatment for PTSD, with numerous studies supporting its efficacy.

Understanding Prolonged Exposure Therapy

PE teaches individuals to gradually approach trauma-related memories, feelings, and situations that they have been avoiding since their trauma occurred. By facing these fears in a safe and controlled environment, individuals can decrease their PTSD symptoms, including intense fear, helplessness, and horror.

Core Principles of Prolonged Exposure Therapy

  • In Vivo Exposure: Involves direct confrontation with situations or objects that are safe but have been avoided because they remind the individual of their trauma.
  • Imaginal Exposure: Encourages clients to repeatedly recount the traumatic event to a therapist, reducing the event’s power through detailed verbal processing.
  • Processing: Facilitates understanding and integration of the traumatic event by discussing thoughts and feelings during the exposure exercises.
  • Habituation: Over time, the emotional response to the trauma memory diminishes through repeated exposure.

Methodologies in Prolonged Exposure Therapy

PE involves several key components delivered over a series of therapy sessions, typically ranging from 8 to 15 sessions:


Clients learn about common trauma reactions and the PE treatment rationale, helping to normalize their experiences and set the stage for active therapy.

Breathing Retraining

Teaches controlled breathing techniques to help manage acute anxiety and physiological arousal.

Imaginal Exposure

Involves revisiting and recounting the traumatic event in the safety of the therapy session, helping to reduce fear and emotional avoidance.

In Vivo Exposure

Assignments designed to gradually expose the client to real-world situations related to the trauma, which are safe yet have been avoided.

Benefits and Application

PE has been effectively used to treat PTSD arising from a variety of traumatic experiences, including military combat, sexual assault, natural disasters, and accidents. Benefits include:

  • Reduced PTSD Symptoms: Significant reductions in PTSD symptoms, including re-experiencing, avoidance, and hyperarousal.
  • Improved Mood and Functioning: Enhancements in overall mood, reduced anxiety and depression symptoms, and improved social and occupational functioning.
  • Increased Emotional Processing: Facilitates the processing of traumatic memories, reducing feelings of fear, helplessness, and horror.

Who Can Benefit from Prolonged Exposure Therapy?

PE is suitable for individuals with PTSD or those experiencing significant distress related to traumatic memories. It is particularly beneficial for those who have not benefited from other treatment approaches or who continue to struggle with avoidance and fear related to their trauma.

Training and Practice

Practitioners of Prolonged Exposure Therapy are typically mental health professionals who have undergone specialized training in PE techniques and protocols. Certification often involves completing a comprehensive training course, including supervised clinical practice.


Prolonged Exposure Therapy offers a highly effective and evidence-based approach for individuals seeking to overcome the debilitating effects of PTSD and reclaim their lives from the grip of trauma. Through structured exposure to traumatic memories and stimuli, PE enables individuals to process their trauma, reduce symptoms, and improve overall functioning.