Prolonged Exposure Therapy

In Prolonged Exposure Therapy, Dr. Sheila A.M. Rauch demonstrates this approach in an imaginal exposure session with a client with PTSD.

Prolonged exposure therapy, often called PE, is an evidence-based treatment for posttraumatic stress disorder that uses cognitive behavioral strategies to help trauma survivors reclaim their lives. Prolonged exposure provides an efficient and effective model for therapists to guide trauma survivors in approaching their trauma memory and trauma reminders, allowing them to experience less avoidance and distress related to their traumatic experience. In this third session of prolonged exposure therapy, Dr. Rauch provides guidance on how to approach the trauma memory in imaginal exposure and then follows the client as they recount their trauma memory. They then move to emotional processing of the trauma memory, checking in throughout with the client on their distress level.

This powerful demonstration is framed by an informative discussion hosted by fellow PE-expert, Dr. Peter W. Tuerk.

Prolonged Exposure therapy, often called PE, is an effective treatment for posttraumatic stress disorder that uses cognitive behavioral strategies to help trauma survivors reclaim their lives. Prolonged Exposure provides an efficient and effective model for therapists to guide trauma survivors to approach their trauma memory and reminders allowing them to experience less avoidance and distress related to their traumatic experience/s.

Prolonged Exposure therapy was first developed by Drs. Foa, Rothbaum, and Hembree; and Dr. Sheila A.M. Rauch joined their development team with the updated manual released in 2019.  Prolonged exposure therapy begins with assessment and foundational psychoeducation to ensure the provider and client are aligned in what they will be doing and why exposure works to reduce PTSD symptoms. Once this foundation is established, Prolonged Exposure therapy focuses on imaginal exposure to the trauma memory or memories, in vivo exposure (to previously avoided trauma-related people, places, and situations), and emotional processing of the meaning of the memory for the client at the time of the trauma and now. 

In this video program, Dr. Rauch demonstrates this approach in the first imaginal exposure session with a client with PTSD. In this session three of Prolonged Exposure therapy, she provides guidance on how to approach the trauma memory in imaginal exposure and then follows the client as they approach their trauma memory. They then move to emotional processing of the trauma memory they worked on this session.

Sheila A.M. Rauch, PhD, ABPP, co-led design and now serves as deputy director of the Emory Healthcare Veterans Program and director of Mental Health Research and Program Evaluation at the Atlanta VA Healthcare System. With the goal to improve access to effective mental health care, Dr. Rauch has been developing programs, conducting research, and providing PTSD and anxiety disorders treatment for over 20 years.

Her research focuses on examination of mechanisms involved in the development and treatment of PTSD and improving access to effective interventions. She has led several PTSD treatment outcome and mechanisms trials and has been providing care and training providers throughout the world on PTSD treatment since 2000.

She has published over 170 peer-reviewed scholarly articles as well as many chapters and books on anxiety disorders and (PTSD) focusing on neurobiology and factors involved in the development, maintenance, and treatment of anxiety disorders, psychosocial factors in medical settings, and the relation between physical health and anxiety. She is an author of the second edition of the Prolonged Exposure manual and patient workbook as well as the PE for Intensive outpatient programs manuals.

Dr. Rauch has been involved in the modification and adaptation of proven psychotherapeutic interventions for anxiety disorders for various populations and settings, including primary care and prevention of PTSD post-COVID-19. She is a fellow of the Association of Behavioral and Cognitive Therapy, was granted membership in the American College of Neuropsychopharmacology, and serves as a member of the Board of Directors and Scientific Council of the Anxiety and Depression Association of America.

APA Videos

Cognitive Processing Therapy
Patricia A. Resick

Trauma and Meaning
With Jeanne M. Slattery

Working With Developmental Trauma
With Julian D. Ford

Complex Posttraumatic Stress Disorder
With Steven N. Gold

Cognitive Behavioral Interventions for Posttraumatic Stress Disorder
With Candice M. Monson

Narrative Processes in Emotion-Focused Therapy for Trauma
With Lynne Angus and Sandra C. Paivio

APA Books

Retraining the Brain: Applied Neuroscience in Exposure Therapy for PTSD
Sheila A. M. Rauch and Carmen P. McLean

Treating PTSD in First Responders: A Guide for Serving Those Who Serve 
Richard A. Bryant

The Responsive Psychotherapist: Attuning to Clients in the Moment
Edited by Jeanne C. Watson and Hadas Wiseman

Addressing Moral Injury in Clinical Practice
Edited by Joseph M. Currier, Kent D. Drescher, and Jason Nieuwsma

A Practical Guide to PTSD Treatment: Pharmacological and Psychotherapeutic Approaches
Edited by Nancy C. Bernardy, and Matthew J. Friedman

Casebook to the APA Clinical Practice Guideline for the Treatment of PTSD
Edited by Lynn F. Bufka, Caroline V. Wright, and Raquel Halfond