Table of Contents
What is imaginal exposure in CBT?
Imaginal exposure: Vividly imagining the feared object, situation or activity. For example, someone with Posttraumatic Stress Disorder might be asked to recall and describe his or her traumatic experience in order to reduce feelings of fear. During imaginal exposure, patients retell the trauma memory. During in vivo exposure, patients do activities where they gradually approach trauma-related memories, feelings and situations that are avoided because of the trauma. Prolonged Exposure (PE) Therapy In PE, the process of addressing the trauma memory is called “imaginal” exposure. The therapist works with you to change thoughts and feelings surrounding your trauma. The process of engaging with real life situations is called “in vivo” (“in real life”) exposure. Use your imagination! This is called imaginal exposure. All you have to do is close your eyes and imagine that you are in that situation. Use all your senses – imagine what you see, feel, hear, smell, taste, and touch. There are 4 major theories that attempt to explain the psychological mechanisms of exposure therapy: habituation, extinction, emotional processing, and self-efficacy (Table 2). Habituation theory purports that after repeated presentations of a stimulus, the response to that stimulus will decrease.
What is graded exposure in CBT?
Graded Exposure is an evidence based treatment used to tackle avoidance of feared situations, activities or objects due to anxiety. It works through a process called habituation, a gradual reduction in the physical sensations of anxiety. Exposure therapy is an essential component of evidence-based cognitive-behavioral therapy (CBT) treatments for phobia, panic disorder, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and social anxiety disorder. Imaginal exposure therapy is when a person participates in a guided imagery session that prompts them to imagine themselves being exposed to triggers. In doing so, the person is able to start to identify what they would need to do to overcome their fears. Ethical concerns regarding exposure treatment for anxiety include fears of symptom exacerbation, high treatment dropout rates, client safety concerns, and the blurring of boundary lines between therapists and clients. Exposure in vivo, which is a common behavioural component of CBT for different anxiety disorders, might be promising for reducing work-related adverse outcomes.
What is the difference between CBT and exposure therapy?
CBT is an umbrella term that refers to a large category of both cognitive and behavioral therapies. Exposure Therapy is behavioral therapy and therefore falls under the larger term of Behavioral Therapy. Exposure with Response Prevention is a specific type of Exposure Therapy that was designed to treat OCD. The gold standard treatment for OCD (obsessive-compulsive disorder) is a kind of CBT (cognitive behavioral therapy) called “exposure with response prevention,” or exposure therapy. When children experience anxiety they often try to avoid the things that trigger it. Exposure therapies and techniques help people gradually face their fears so they no longer need to avoid or worry about them. Such treatments help with phobias, anxiety disorders, post-traumatic stress disorder (PTSD) and more. Need resources right away? Imaginal exposure is effective when it evokes the same distress in a person as the actual obsession. A person with OCD typically fights the obsession because they believe that if they entertain the ideas, the feared outcome will be more likely to occur. However, fighting the obsession only strengthens it.
Is in vivo exposure therapy CBT?
In Vivo Exposure Therapy is a form of Cognitive Behavior Therapy that is used to reduce the fear associated with these triggers. There are two different kinds of Exposure Therapy, including: Flooding — this type of Exposure Therapy involves rapid exposure to feared situations. Imaginal and in vivo exposure are the primary tool in reducing client avoidance of memories, emotions, and situations and in correcting unhelpful thoughts and beliefs about the self, others, and the world that maintain PTSD. Imaginal exposure allows the patient to confront his or her most feared thoughts more fully, and may thereby contribute substantially to the overall treatment effect. Sometimes, imaginal exposure could also be used as a first step toward a strongly feared in vivo exercise. In distinction to the trauma narrative, which involves imaginal exposure to children’s trauma experiences, “in vivo” (“in real life”) mastery involves exposure to the actual innocuous situation (e.g., sleeping in one’s own bed; returning to school, etc.) that the child fears and avoids.
What is imaginal exposure in GAD?
Imaginal exposure involves the client imagining the feared object or situation to evoke fear and anxiety. Research has demonstrated that direct in vivo exposure to feared objects or situations is more effective than imaginal exposure to the same circumstance. With imaginal exposure, though, a licensed mental health clinician can guide a person through imagining and replaying their fears or phobias that stem from a traumatic event. Eventually, the person will learn to better manage their reactions to trauma memories, triggers, and flashbacks. In imaginal exposure, we ask the patient to go back in her mind’s eye to the time of the trauma and recount it out loud repeatedly, several times per session. And we’ll record it for homework practice. After the imaginal exposure, you’ll process the experience with the patient for about 15 to 20 minutes. Exposure exercises in behavior therapy for OCD operate on the same principles as those in the above example. Essentially, patients are exposed to feared objects, such as a contaminated door handle or difficult thoughts, like a loved one dying in a car crash, over and over again until their anxiety has decreased. In this example of an imaginal exposure narrative, the patient included information about the stimuli. “It looked dirty.” “It looked evil.” Her responses: “I could hear myself screaming.” And the meaning: “Now, I think this is really dangerous.” She speaks in the present tense to help engagement.