Exposure is arguably the most important component of anxiety-related treatment. Despite decades of study, however, researchers are still developing an understanding of how it works and refining the procedures to improve effectiveness. This is an exciting time for exposure! Newer research is questioning the role of habituation in successful exposure and increasingly emphasizing the importance of developing a willingness to experience fear and anxiety.

For the last few years, I’ve been working to immerse myself in exposure research. This has been a steep learning curve, as I didn’t receive much background in graduate school. At times I’ve felt overwhelmed by the more technical accounts. However, I’ve persevered, and although I still have a lot to learn, I feel my clinical work is better for it.

I’ve written these posts to develop my own understanding of exposure and in the hopes that other therapists would find them helpful, too. I’m extremely interested in the cutting edge work being done to create more flexible models and approaches for applying exposure-based interventions, particularly in the context of Acceptance and Commitment Therapy.

If you’d like to see me write about another topic related to exposure therapy or want to get some input about using exposure therapy in your practice, write me an email: bthompson@portlandpsychotherapyclinic.com

I’m collecting all my posts about exposure therapy on this page, so please check back as I update it.

Exposure therapy: What can we take away from newer research

This series of posts is meant to serve as an introduction to exposure therapy, examine some of the cutting edge research, and  look at shortcomings of some of the older models.

• What is exposure and why does it matter?
• An overview of the Emotional Processing Theory
• Edna Foa on prolonged exposure
• The problem with habituation as an explanation for exposure treatment
• Exposure for Acrophobia—habituation may not matter
• Videos of exposure therapy
• Why understanding theory is important in conducting exposure therapy
• An Interview with Michelle Craske, PhD, on “Maximizing Exposure Therapy for Anxiety Disorders”

Research studies on exposure-based interventions

This series of posts summarizes some novel studies and applications of exposure-based interventions. Theory is less emphasized, if mentioned at all.

• Treating panic disorder with co-morbidities: Why focusing on the panic may be the best option
• Rape survivors who rely on avoidant coping may respond better to exposure-based treatment
• Motivating clinicians to learn and use exposure therapy
• Does war zone impact treatment response for veterans with PTSD?
• Activation, habituation, and drop-out in exposure therapy
• More avoidant therapists are less likely to use exposure in OCD treatment
• Shorter imaginal exposure sessions as effective as longer exposure for PTSD
• Shorter Imaginal Exposure Sessions as Effective as Longer Exposure for PTSD
• Interoceptive Exposure in OCD Treatment
• SUDS vs. Willingness: Values-Based ACT Exposure for OCD
• Study Suggests Clients Don’t Dropout of ERP for OCD More than for Any Other Treatment
• Is Exposure Practice More Effective in the Morning?

Understanding and using exposure in an Acceptance and Commitment Therapy context

This series of posts focuses on how exposure may be applied within ACT. This is still new territory, and some of these posts are my attempts to clarify and summarize my own ideas.

• Contextual behavioral exposure: An Acceptance and Commitment Therapy approach to exposure [VIDEO]
• How do you use exposure in Acceptance and Commitment Therapy?
• Experiential avoidance and its relevance to PTSD
• Why mindfulness may enhance exposure therapy for anxiety disorders
• Preparing clients for exposure using Acceptance and Commitment Therapy: Creative hopelessness through finger traps
• Preparing clients for exposure using Acceptance and Commitment Therapy: Creative hopelessness through tug-of-war
• Preparing clients for exposure using Acceptance and Commitment Therapy: Training clients in present moment awareness and affect
• An ACT-based worksheet for brainstorming exposure exercises
• Using ACT to Guide Exposure-Based Interventions for PTSD
• An alternative to exposure and response prevention for OCD