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PTSD: Prolonged Exposure Therapy

Evidence-based imaginal and in vivo exposure for trauma processing

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Psikiyatri department. Book Appointment →

What is PTSD: Prolonged Exposure Therapy?

Prolonged exposure therapy is a structured, time-limited (8-15 sessions) evidence-based treatment for PTSD developed by Foa and colleagues.

It combines psychoeducation, breathing retraining, in vivo exposure to safe trauma reminders and imaginal exposure to traumatic memories.

Therapy is grounded in emotional processing theory, helping the patient activate the fear network and integrate corrective information.

Sessions are typically 60-90 minutes weekly with audio recordings of imaginal exposures used between sessions.

Indications include single or multiple-event PTSD related to combat, assault, accidents, disasters and complex traumatic experiences.

Symptoms

Intrusive symptoms include flashbacks, nightmares, distressing memories and physiological reactivity to reminders.
Avoidance involves staying away from places, people, conversations or activities that trigger trauma memories.
Negative changes in cognition and mood include guilt, shame, detachment, distorted blame and persistent negative beliefs.
Hyperarousal symptoms involve hypervigilance, exaggerated startle, irritability, sleep disturbance and concentration problems.
Functional impairment in work, family, social relationships and self-care often accompanies clinical PTSD.

Risk Factors

Severity and chronicity of trauma exposure, multiple traumas and ongoing safety concerns.
Pre-existing anxiety, depression or substance use disorders complicate engagement and outcome.
Lack of social support, ongoing legal proceedings or compensation issues may delay engagement.
Severe dissociation or active suicidality may require stabilization before initiating exposure.
Cultural factors, language barriers and treatment beliefs influence acceptability and adherence.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent re-experiencing, avoidance or hyperarousal more than one month after trauma.
  • Self-medication with alcohol or drugs to cope with intrusive memories.
  • Suicidal ideation, self-harm or aggressive behavior require urgent psychiatric assessment.
  • Inability to fulfill work, parenting or social roles due to anxiety and avoidance.
  • Insufficient response to general counseling or supportive therapy after 3-6 months.

Treatment Methods

01
Sessions 1-3: psychoeducation about PTSD, treatment rationale, breathing retraining and avoidance hierarchy.
02
Sessions 4-12: imaginal exposure to traumatic memory followed by structured processing and graded in vivo assignments.
03
Hot spots are identified and revisited until distress decreases substantially across sessions.
04
Audio recordings of sessions are listened to between meetings to consolidate emotional processing.
05
Outcome is monitored using validated scales (PCL-5, IES-R) and treatment is supplemented with sleep hygiene, lifestyle changes and pharmacotherapy when indicated.

Which Department to Visit?

You can visit our Psikiyatri department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.