Exposure Therapy

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Exposure therapy aims at the person learning to overcome their feared object or situations by teaching them their fears do not come true or are not as terrible as they imagine.


Exposure therapy is a technique used to treat phobias.  It requires the person to be exposed to their feared object or stimulus and remain in these feared situations for extended periods of time.  A fear hierarchy is often designed where the person is initially exposed to the situations eliciting only mild anxiety and builds up to the most anxiety-provoking situation.


The type of exposure therapy chosen depends on the person’s phobia, the person’s and therapist’s preference:


  • In Vivo Exposure: This requires the person actually being confronted with their fear in a gradual manner (hierarchy).  Someone afraid of spiders for instance, may start by looking at a picture of a spider, then moving onto touching one.  Although this is very effective, it is important to be mindful that both individuals’ acceptance and drop out rates can often be an issue.  It is not unusual for Therapists to model how to interact with the feared stimuli each step of the hierarchy.  This is called Guided mastery.


  • Virtual reality exposure: This requires a computer program to mimic the feared stimulus.  It could be a plane taking off or standing at the end of a balcony.  This exposure therapy is helpful for those phobias difficult to treat in vivo.


  • Systematic desensitization: This requires individuals being exposed to fear evoking images and thoughts (i.e. imaginal exposure) or to the actual feared stimuli, while pairing the exposure with relaxation to reduce the normal fear response. This type of exposure therapy seems to be effective at changing subjective anxiety, but not so much at reducing avoidance.


References: Exposure Therapies for Specific Phobias. Society of Clinical Psychology:  Division 12 of the American Psychological Association. 2006.

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