Prolonged exposure

Prolonged exposure: A trauma treatment that takes care of therapists 

Prolonged exposure (PE) is the gold-standard treatment for PTSD. It has been clinically proven to help clients confront and process traumatic memories, reduce anxiety and avoidance behaviours, and ultimately regain control over their lives. But prolonged exposure isn’t just a powerful tool for improving clients’ lives, it also offers many benefits to therapists trained in its use.

Trauma is rarely a simple condition to work with. Each case is unique and subject to a wide variety of highly-variable factors. PE provides therapists with a structured, yet flexible approach that allows them to feel confident and grounded even in the face of complex trauma presentations. The step-by-step approach allows therapists to meet clients at their own pace, without losing track of direction in individual sessions. In PE therapy, therapists and clients collaborate to create a map of exposure hierarchies. This structure allows therapists and clients to track progress over the course of treatments, and creates a sense of safety and movement for both parties.  

All therapists are faced with the risk of experiencing vicarious trauma or compassion fatigue; those who work with trauma are particularly exposed to these dangers. PE is a holistic approach that includes techniques for managing these difficulties, as well as education on therapist self-care strategies. It facilitates therapist self-awareness in recognising the signs of burnout and knowing how to take care of it should it arise. The structured approach mentioned above also helps maintain a clear sense of boundaries during treatment, reducing the risk that therapists become emotionally  entangled in the stories of their clients.

Countertransference will always be present to some degree in the therapy room. When emotional responses are intense, it becomes increasingly difficult to remain present and not react from unconscious triggers. PE training helps therapists get in touch with these triggers in the safety of a supervised workshop setting, facilitating self-awareness and allowing therapists to welcome their clients’ intensities from a place of grounded acceptance. 

At its core, the PE approach to trauma treatment is focused on client empowerment. Clients are encouraged to be active collaborators in their healing process, rather than passive patients. PE includes exposure exercises for clients to work with both in the therapy room and at home, allowing them to feel more ownership over the integration process. This central focus on collaboration can reduce client feelings of helplessness and dependence, which in turn helps therapists avoid taking too much responsibility in the therapy room. 

Every trauma therapist wants to create a safe space in which their clients can heal. PE approaches this goal by ensuring that the therapy room is also a safe space for the therapist. With the safety of a structured, evidence-based approach and a toolkit of self-care strategies, therapists have more freedom to focus on what is most important: being fully present with clients where they are, and acquiring the deeper understanding of trauma-related symptomatology that only experience can teach.