Exposure Therapy Is An Effective Treatment For Fear-Based Mental Health Conditions

Updated November 24, 2022 by BetterHelp Editorial Team

Exposure therapy provides a valuable therapeutic intervention for many people who experience a variety of mental health conditions. Perhaps you're wondering what this approach involves. What are the different types of exposure therapy, and how can it  improve your life? This article will answer these questions and more. It will also show you how to get the help you need if you feel like you would benefit from this type of therapy or from online counseling in general.

What Is Exposure Therapy?

Overcome Debilitating Fears And Phobias

Exposure therapy is designed to help people overcome mental health conditions arising from fear. According to the American Psychological Association, qualified therapists “create a safe environment where they can ‘expose’ people to the things they fear and avoid.”

Exposure therapy aims to break negative cycles of avoidance, which may cause a person to feel chronic or intense pain and suffering. There are specific ways to conduct exposure therapyso that participants become more acclimated to threatening stimuli. 

As people experience the same sounds and sights that they have previously associated with danger, they become less sensitive to them, and ideally experience a reduction in fear. Exposure therapy is often considered the first line of treatment for a number of disorders, and it can significantly change the life of a person experiencing a mental health condition.

What Techniques Does Exposure Therapy Use To Treat Mental Health Conditions?

Exposure therapy treats a wide variety of fear-based mental conditions. It has been scientifically proven to be helpful for emotional processing with each of the following conditions:

  • Generalized Anxiety Disorder

  • Panic Disorder

  • Phobias

  • Social Anxiety Disorder

  • Obsessive-compulsive disorder (OCD)

  • Posttraumatic Stress Disorder (PTSD)

In exposure therapy, participants are presented with the stimuli that they typically associate with danger in tiny, incremental steps. References to these eventually help them decrease their sensitivity to the triggers, enabling them to break the negative associations. Each feared stimulus is ranked according to the intensity of anxiety the participant feels when they experience it-- this is called the fear hierarchy. Stimuli on the fear hierarchy are presented in one of three ways: graded exposure, systematic desensitization, or flooding.

Flooding  is a way of presenting a feared stimulus, beginning with those that cause the most anxiety at the top of the fear hierarchy. As participants continue this intervention, the most anxiety-provoking stimuli cause less intense reactions and the stimulus transitions from negative to neutral (or positive).

 In graded exposure, the fear-inducing stimuli are presented in order of least to most fear-inducing. For example, if a participant feels extreme anxiety when they have to fly on a plane, the therapist might begin by taking them to sit in an empty plane on the ground. Next, they might prompt the participant to sit in a plane full of people. Eventually, they'll increase the exposure until the participant is able to take a flight without arresting, debilitating fear.

Systematic desensitization combines either flooding or graded exposure therapy techniques with relaxation techniques and exercises. Because participants are more relaxed before and during the exposure, the sights and sounds that they once associated with fear become more associated with a state of relaxation.

What Are The Types Of Exposure Therapy?

There are several variations of exposure therapy, each of which uses its own unique methods to help people overcome mental health challenges.In Vivo Exposure Therapy

Vivo exposure takes place in the actual location where the participant typically feels distressed. The scenario discussing the fear of flying earlier is an example of in vivo exposure therapy because it happens inside an airplane that was provoking fear in the patient.

Imagined Exposure Therapy

With this method, the participant is not actually exposed to stimuli that they perceive as dangerous. Instead, they imagine being exposed to it in great detail. This helps them confront the fear and hopefully overcome it. Imagined exposure therapy is especially helpful for unusual fears or fears based on specific incidents.

Interoceptive Exposure Therapy

  • Interoceptive exposure helps participants have the physical experience of the feared stimuli without actually being exposed to it. In the case of panic disorder, for example, patients are asked to exercise vigorously to induce the physical sensations of a racing heart and difficulty breathing. The more they are exposed to this set of sensations, the less anxious they become when they feel similar sensations during a panic attack.

  • Virtual Reality Exposure Therapy (VRET)

Virtual reality exposure presents the stimuli a participant associates with life-threatening situations through computer-generated sights and sounds. The exposure may occur via a desktop computer display, virtual reality technology, or what is called a "CAVE environment" – a cube-like compartment where projectors and audio equipment provide the stimuli.

  • Prolonged Exposure Therapy:

Prolonged exposure therapy has successfully helped people who go through PTSD due to combat experiences and other life-threatening situations. Because the traumatic event caused great fear, avoidance of situations that are reminders of that event may cause distress. This extended and consistent exposure works to decrease avoidance.

What Are The Benefits Of Exposure Therapy?

Exposure therapy is a powerful tool to help with anxiety and fear-based mental conditions by working to decrease avoidance of the fear. For individuals living with these issues, it has many important benefits.Decreasing Sensitivity: The sights and sounds in your environment can influence someone to feel deep distress if they convince the person that danger is near. However, when exposed to these stimuli in exposure therapy, participants become used to their presence in the environment.

Weakening Fear-Induced Associations: Another way exposure therapy helps relieve fear is in breaking previous associations between stimuli and negative outcomes. Through exposure therapy, the mind and body begin to react to those sounds for what they usually are: neutral, everyday noises.

Increasing The Capacity to Coexist With Fear: Even if exposure therapy is successful, there will always be situations where it's natural to feel anxious. Sessions may include helping participants learn to accept fear when it's natural and understand how to live with fear without becoming paralyzed or panic-stricken (especially when living with a panic disorder).

Building Personal Agency: During exposure therapy, participants can feel emboldened by their newly discovered agency. They can recognize that they have control over their thinking and thoughts, which can impact their feelings. Additionally, there are techniques they can use to adjust  their physical reactions to the environment.

Reducing Anxiety

After successfully completing exposure therapy, participants often feel less anxious. This happens as a result of repeated exposure to the stimuli that theybecome gradually less sensitive to throughout the course of treatment.

Improving Daily Functioning

If someone is prone to obsessive-compulsive behavior, they may not be able to get to work on time because they’re overwhelmed by the fear they associate with not going through a set of ritualistic behaviors. After exposure therapy, these self-care and survival tasks can become easier and make it more manageable to live with obsessive-compulsive disorder.

Boosting Social Skills

Many people have anxiety in social situations because they feel they are not good at relaxing around other people or contributing to conversations in interesting ways. By learning to manage this anxiety during sessions and with relaxation exercises, participants can become more relaxed.

Decreasing Symptoms Of Mental Disorders

Exposure therapy can help people decrease the symptoms of mental disorders like panic disorder, generalized anxiety disorders, obsessive-compulsive disorder, and PTSD. As symptoms decrease, people can begin to feel more in tune with others around them and with the reality of their situation.

BetterHelp Can Support You Through Online Therapy

Overcome Debilitating Fears And Phobias

Some people experience success in reducing their sensitivity to fear-provoking stimuli by seeking help from a counselor. Therapists can work with participants to find an approach that works best for them and provide them with relevant information. Research has proven treatment to be successful and it may be worthwhile for some people to try. 

People interested in learning if exposure therapy is right for them can get the answers they need by talking with a counselor on BetterHelp. Online therapy is a convenient, hassle-free way to get help on one’s own terms, wherever they are or wherever they feel comfortable. Beyond that, evidence shows that online therapy is "effective, acceptable and practical" to improve mental health needs Below are some reviews of BetterHelp counselors from people experiencing similar issues.

Counselor Reviews

"Dr. Broz is a brilliant, kind-hearted woman. She listens to everything I have to say and responds promptly. We're in contact constantly with each other. Her worksheets are very helpful and I'm starting to work my way towards being able to better handle my anxiety and panic attacks. She is very relatable and often chimes in with stories of her own that relate to what I am experiencing as well. I would definitely recommend Dr. Broz to anyone in need of help or someone to talk to."

"Kara has provided a safe environment for me to express my fears and anxiety. She has provided me tools to help manage my anxiety and continues to support me."

Exposure therapy is a process that can help lessen the symptoms of many different types of mental health conditions. When used properly, it can lessen the intensity and decrease the frequency of fearful and stressful reactions to situations that may have troubled someone in the past. If you're living with extreme fears that affect your daily life, contact BetterHelp. With the right tools, it's possible to have a fulfilling life that's free from fear. Take the first step today.

Frequently Asked Questions

What Is Exposure Therapy And How Is It Conducted?

Exposure therapy techniques include in vivoexposure, imagined exposure, interoceptive exposure, virtual reality exposure (VRET), and prolonged exposure for PTSD. All of these are widely considered effective therapies for a specific phobia or long-held beliefs like a spider phobia or fear

Is Exposure Therapy A Form Of Cognitive Behavioral Therapy (CBT)?

Yes, exposure therapy is part of the greater cognitive behavior therapy family. Sometimes it is beneficial to talk to a primary physician or read peer reviewed studies before starting this therapy. Additionally, while there are huge treatment gains, participants want to achieve a significant reduction in trauma, not add further trauma resulting from treatment that might exacerbate symptoms of social anxiety.

How Long Does It Take For Exposure Therapy To Work?

Compared to other methods, exposure treatment works on a quick timeline, with results appearing within a few weeks or few months. Full treatment usually takes between five and 20 sessions, depending on a variety of factors, like the issue the client is looking to make progress on, the person's openness to change, and the person's overall self-efficacy.  

Does Exposure Therapy Help Anxiety?

Yes, exposure therapy can be helpful to treat anxiety disorders and social anxiety disorders. After undergoing this type of cognitive restructuring and emotional processing therapy, about 60-90 percent of people had either no symptoms or mild symptoms of their original anxiety disorders following completion of the therapy plan, according to EBBP.org. This type of exposure and response prevention could be a breakthrough when it comes to people who are overwhelmed or uneasy — or experiencing nervous thoughts, like many others who seek cognitive therapy. 

What Can I Expect During Exposure therapy?

An exposure therapist will help the client or patient learn to create new understandings about their fears — whether those are objects, activities, or situations — so they can become more comfortable confronting those fears in their day-to-day real life. This is why repeated exposure therapies for specific fears can be so effective, as it can target their fear head on. 

Clinical psychology has also found that exposure therapy can also be effective in targeting depression. Participants should know that, without a doctor present in the process, they  will not be prescribed medication specific to this approach. This is a great technique when working through social anxiety disorder, or when figuring out how social anxiety disorder impacts one’s life.

It's worth noting that sleep directly after a session of exposure therapy has been shown to be effective, according to this study. Studies like this one and research in clinical psychology show that this approach will play out a little differently in everyone in real life.

Can Exposure Therapy Worsen Anxiety?

The effectiveness of exposure therapy for anxiety will depend on each person's situation and existing levels of worry. It's best to consult with a therapist to understand how exposure therapy will affect one personally, and empirical evidence shows being in a safe environment leads to the most effective treatment and progressive muscle relaxation .

Is Eye Movement Desensitization And Reprocessing (EMDR) The Same As Exposure Therapy?

EMDR and exposure therapy are not the same, but they do have similar elements at their core. With EMDR therapy, the patient is not re-exposed to the original trauma or fear.

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