Prolonged Exposure Therapy for PTSD

What Is Prolonged Exposure Therapy?

Prolonged Exposure is a structured, evidence-based treatment for PTSD developed by Dr. Edna Foa. It is one of the most researched trauma therapies available and is recommended by major treatment guidelines, including those of the American Psychological Association and the VA.

PE is built on a simple idea: when we avoid trauma reminders, the brain never gets the chance to learn that the danger has passed. By approaching memories and situations step by step, in a supported and controlled way, your nervous system learns that you can remember without being overwhelmed. Over time, the memory becomes something that happened to you, not something that is still happening.

What to Expect in PE Therapy

PE usually takes place over about 8 to 15 weekly sessions. Each phase is planned together, and you're always in charge of the pace.

1. Education and planning We talk about common reactions to trauma, how avoidance keeps symptoms going, and what you want your life to look like.

2. Breathing retraining You'll learn a simple calming breath to help manage anxiety in daily life.

3. In vivo (real-life) exposure Together we build a list of safe situations you've been avoiding, ranked from easier to harder. You practice approaching them gradually between sessions.

4. Imaginal exposure In session, you revisit the trauma memory in detail with your therapist's support. Sessions are recorded so you can listen back between appointments, which helps the memory become less distressing.

5. Processing After each imaginal exposure, we talk through what came up: thoughts, emotions, guilt, shame and new understanding.

6. Wrapping up We review your progress, celebrate what's changed and plan how to maintain your gains.

Can Prolonged Exposure Be Done Online?

Yes. Research supports telehealth PE as effective as in-person treatment. Many clients find it easier to do this work from the comfort of a private, familiar space. Online sessions also make real-life exposure practice more natural, since you're already in your everyday environment.

Benefits of Prolonged Exposure

As an evidence-based trauma therapy, PE helps clients notice:

• Fewer nightmares, flashbacks and intrusive memories

• Less avoidance and more freedom in daily life

• Reduced anxiety, guilt and shame

• Better sleep and concentration

• A renewed sense of confidence and control

Prolonged Exposure or EMDR?

Both PE and EMDR are highly effective treatments for PTSD. PE focuses on directly approaching memories and avoided situations, while EMDR uses bilateral stimulation to help the brain reprocess stuck memories. Some people prefer the clear, step-by-step structure of PE, and others connect more with EMDR. During our consultation, we'll talk through both options and choose the approach that fits you best.

Is Prolonged Exposure Right for You?

PE may be a good fit if you:

• Have experienced a traumatic event such as an assault, accident, combat, abuse or a sudden loss

• Avoid places, people or conversations that remind you of what happened

• Experience intrusive memories, nightmares or feeling constantly on guard

• Want a structured, time-limited approach to trauma recovery

• Feel ready to stop letting the past decide where you can go and what you can do

Getting Started with PE Therapy

We offer Prolonged Exposure therapy via tele-health for adults living in California, Oregon, Washington and New Mexico. As trauma therapists trained in PE and EMDR, we begin with a consultation to understand your history and goals, followed by a personalized treatment plan.

Facing what you've been avoiding takes courage, and you don't have to do it alone. As Robert Frost wrote, the best way out is always through.