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What Is Exposure Therapy?

Medically Reviewed by Dan Brennan, MD on April 12, 2021

Exposure therapy is a mental health treatment used to help people confront their fears. Through the use of various systematic techniques, a person is gradually exposed to the situation that causes them distress. 

The goal of exposure therapy is to create a safe environment in which a person can reduce anxiety, decrease avoidance of dreaded situations, and improve one's quality of life.

How Does Exposure Therapy Work?

When you are fearful of something, you may tend to avoid objects, activities, or situations related to that thing. Although avoiding these things might make you feel less afraid in the short term, it can make the fear worse in the long term.

A psychologist or mental health professional might recommend exposure therapy to help break the pattern of avoidance so you can overcome what's holding you back. During these therapy sessions, psychologists create a safe environment where you are exposed to the things you are afraid of and coached through the process.

What Conditions Can Exposure Therapy Help With?

Exposure therapy can help with a variety of conditions including:

  • Phobias: A type of anxiety disorder defined by a persistent and excessive fear of an object or situation. 
  • Panic Disorder: Recurring unexpected surges of intense fear or discomfort that peak within minutes.
  • Social Anxiety Disorder: Sometimes referred to as a social phobia, it is a type of anxiety disorder that causes extreme fear in social settings.
  • Obsessive-Compulsive Disorder: A condition that results in unreasonable thoughts and fears (obsessions) that lead to compulsive behaviors.
  • Post-Traumatic Stress Disorder: A disorder in which a person has difficulty recovering after experiencing or witnessing a terrifying event.
  • Generalized Anxiety Disorder: Severe, ongoing anxiety that interferes with daily activities.  

Types of Exposure Therapy

In vivo exposure. This type of exposure therapy involves confronting the feared object or situation. For instance, if you have a fear of spiders, a professional therapist might start by asking you to picture a spider in your mind. Once you're able to do that, the therapist may encourage you to imagine more intense scenes with spiders while providing support and coping skills.

Once you feel more comfortable, the therapist may progress to real-life exposure where they place a real spider in the room with you and eventually place it in your hand. The treatment can last a few hours or across multiple hour-long sessions. 

Applied muscle tension. This treatment is similar to in vivo exposure but incorporates muscle tension exercises. During the treatment, you tense your body's muscles thus increasing your blood pressure, which makes it less likely that you'll faint. This can be especially helpful for people with a fear of things like blood or needles.  

Virtual reality exposure. This type of exposure therapy uses a computer program to stimulate the phobic situation (i.e. being on a plane, leaning over a large balcony ledge, seeing a spider, etc.) and integrates body tracking devices that allow you to interact with the virtual environment. 

Systematic desensitization. When you engage in this type of therapy, you are exposed to fear-evoking images and encouraged to imagine the things you are afraid of while pairing the exposure with relaxation to help manage the fear response. This treatment takes longer than other methods like in vivo exposure but tends to be more effective at reducing anxiety and avoidance tendencies.

Is Exposure Therapy Effective?

Yes, exposure therapy can be a practical and cost-effective option for addressing irrational fears, phobias, anxieties, and more. The benefits of exposure therapy have been documented in many studies that are effective for several different mental health conditions:

  • The Journal of Rehabilitation Research and Development showed that prolonged exposure therapy was the gold standard for posttraumatic stress, especially for trauma related to combat and military-related trauma.
  • The International OCD Foundation found that 7 out of 10 people with obsessive-compulsive challenges experience a 60-80% decrease in symptoms when participating in a combination of exposure therapy and cognitive restructuring.
  • According to an article published in the Psychiatric Times, participants who engaged in exposure therapy studies reported a 90% reduction in their anxiety symptoms and a 65% decrease in their phobia.

Limitations of Exposure Therapy

Although research shows that exposure therapy can be effective for many, there are some notable limitations of the treatment. Despite the success rate, many professional counselors and therapists don't implement it. Some professionals believe that exposure therapy may make symptoms worse, especially when dealing with PTSD.   

Additionally, exposure therapy is difficult work that causes people to feel and confront things that they have worked hard to avoid. Because of this, if the therapy is not implemented correctly, the positive effects of exposure therapy may wane over time. That's why patients must participate in the treatment to the fullest extent and follow a well-trained therapist's directions.   

The Bottom Line. With those limitations in mind, for many people, exposure therapy has proven to be effective in delivering long-term results. The research continues to support its effectiveness for treating anxiety, phobias, and other mental health conditions.   

WebMD Medical Reference

Sources

SOURCES:

AMERICAN PSYCHOLOGICAL ASSOCIATION: "What Is Exposure Therapy?"

GoodTherapy: "Exposure Therapy."

SOCIETY OF CLINICAL SOCIETY: "EXPOSURE THERAPIES FOR SPECIFIC PHOBIAS."

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