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PTSD: National Center for PTSD


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Prolonged Exposure for PTSD



This section is for Veterans, General Public, Family, & Friends

This section is for Veterans, General Public, Family, and Friends

Prolonged Exposure for PTSD

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Practice guidelines have identified that trauma-focused psychotherapies have the most evidence for treating PTSD. Prolonged Exposure (PE) is one type of trauma-focused psychotherapy.

PE teaches you to gradually approach trauma-related memories, feelings, and situations that you have been avoiding since your trauma. By confronting these challenges, you can decrease your PTSD symptoms.

How Does It Work?

People with PTSD often try to avoid anything that reminds them of the trauma. This can help you feel better in the moment, but not in the long term. Avoiding these feelings and situations actually keeps you from recovering from PTSD. PE works by helping you face your fears. By talking about the details of the trauma and by confronting safe situations that you have been avoiding, you can decrease your symptoms of PTSD and regain more control of your life.

What Can I Expect?

Your provider will start by giving you an overview of treatment and getting to know more about your past experiences. You will also learn a breathing technique to help you manage anxiety. Around your second session, you will work with your provider to make a list of people, places, or activities that you have stayed away from since your trauma.

Over the course of therapy, you will work through your list step-by-step, practicing in vivo exposure. This means that you will gradually confront these situations. With time, you will feel more comfortable in these situations, and you will not need to avoid them anymore. After a few sessions, you will begin to talk through the details of your trauma with your provider. This is called imaginal exposure.

Talking about the trauma can help with emotions like fear, anger, and sadness. You will listen to recordings of your imaginal exposure between sessions. By confronting the details of the trauma in therapy, you will find that you have fewer unwanted memories at other times.

How Long Does Treatment Last?

PE usually involves 8-15 weekly sessions (so treatment lasts about 3 months), but this can vary. Sessions are 60 to 90 minutes each. You may start to feel better after a few sessions. And the benefits of PE often last long after your final session with your provider.

What Are the Risks?

It may be difficult to talk about the details of your trauma, especially at first. These feelings are usually brief and people tend to feel better as they keep doing PE.. Most people who complete PE find that the benefits outweigh any initial discomfort.

Group or Individual?

PE is an individual therapy. You will meet one-to-one with your provider for each session.

Will I Talk in Detail about My Trauma?

Yes, around your third session, you will start talking in detail about your trauma. Your provider will guide you through it, keep track of your anxiety level as you talk, and will make sure you take things at your own pace. You will listen to a recording of this part of your session at home between sessions.

Will I Have Homework?

Yes, you will practice doing some of the things you have avoided since your trauma. You will start with activities that you can manage, and you will work up to activities that challenge you more. You will also listen to a recording of your therapy sessions, including your imaginal exposure recording. Practicing these skills between sessions helps you get the most out of PE.

Does VA Have an App for That?

Yes, PE Coach is a mobile app that you can use while you are doing PE with a provider. PE Coach can help you to learn more about PE and PTSD symptoms, and the app helps you stay organized as you complete treatment. PE Coach is free and can be downloaded on most mobile devices.

Choosing the Best Treatment for You

Trying to figure out which PTSD treatment is best for you? For more videos about Prolonged Exposure and other treatments that work, get started with the PTSD Treatment Decision Aid.

Date this content was last updated is at the bottom of the page.

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Also see: VA Mental Health