Exposure treatment Health Article

Definition

Exposure treatment is a technique that is widely used in cognitive-behavioral therapy (CBT). Exposure treatment is used for a variety of anxiety disorders, and it has also recently been extended to the treatment of substance-related disorders. Generally speaking, exposure treatment involves presenting a patient with anxiety-producing material for a long enough time to decrease the intensity of their emotional reaction. As a result, the feared situation or thing no longer makes the patient anxious. Exposure treatment can be carried out in real situations, which is called in vivo exposure; or it can be done through imagination, which is called imaginal exposure. The category of imaginal exposure includes systematic desensitization, which asks the patient to imagine certain aspects of the feared object or situation combined with relaxation. Graded or graduated exposure refers to exposing the patient to the feared situation in a gradual manner. Flooding refers to exposing the patient to the anxiety-provoking or feared situation all at once and kept in it until the anxiety and fear subside. There are several variations in the delivery of exposure treatment: patient-directed exposure instructions or self-exposure; therapist-assisted exposure; group exposure; and exposure with response prevention.

Purpose

The basic purpose of exposure treatment is to decrease a person's anxious and fearful reactions (emotions, thoughts, or physical sensations) through repeated exposures to anxiety-producing material. This reduction of the patient's anxiety response is known as habituation. A related purpose of exposure treatment is to eliminate the anxious or fearful response altogether so that the patient can face the feared situation repeatedly without experiencing anxiety or fear. This elimination of the anxiety response is known as extinction.

Precautions

Exposure treatment is generally a safe treatment method; however, some patients may find that the level of anxiety that occurs during treatment sessions is higher than they can handle. Some studies of exposure treatment have reported a high dropout rate, perhaps because the method itself produces anxiety. In addition, exposure treatment is not effective for all patients; after treatment, some continue to experience anxiety symptoms.