What Is Exposure Therapy?

An introduction to exposure therapy - an effective evidence-based treatment for fear.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Overview

Exposure is an effective evidence-based treatment for fear. This information handout describes the key principles of exposure therapy. Clients who are nervous about attempting exposure will find it helpful to understand the theory behind the approach.

Why Use This Resource?

This resource is designed to help clients:

  • Become more familiar with exposure therapy.
  • Understand the theoretical ideas that exposure therapy.
  • Appreciate the potential benefits of exposure therapy.

Key Benefits

Clear

Provides a clear and accessible introduction to Exposure Therapy.

Informative

Offers insights into the key ideas in Exposure Therapy.

Flexible

Suitable for clients experiencing a wide range of psychological issues.

Who is this for?

Phobias

Fears of specific objects or situations.

Post-Traumatic Stress Disorder (PTSD)

Fear associated with traumatic events.

Panic Attacks

Fear associated with particular bodily sensations.

Obsessive Compulsive Disorder (OCD)

Fears involving contamination harm.

Integrating it into your practice

01

Educate

Use the handout as a psychoeducation tool to explain Exposure Therapy to clients.

02

Reflect

Encourage clients to reflect on their difficulties and the relevance of Exposure Therapy to them.

03

Explore

Explore whether Exposure Therapy might be helpful.

Theoretical Background & Therapist Guidance

Exposure therapy is a behavioral intervention widely used in the treatment of anxiety-related disorders. It is grounded in the principle that avoidance of feared stimuli maintains anxiety over time, while approaching feared stimuli helps promote new learning and reduces distress. Early conceptualizations of exposure therapy were rooted in classical conditioning, with fear considered a learned association between a neutral stimulus and an aversive outcome. Repeated exposure without the feared consequence was thought to extinguish the conditioned fear response (Foa & Kozak, 1986; Marks, 1978). This view emphasized habituation — the natural reduction of fear that occurs over time when individuals remain in anxiety-provoking situations — as the primary mechanism of change.

More recent theoretical developments challenge the idea that fear is “unlearned” through extinction, instead proposing that exposure therapy works by creating new, inhibitory learning. According to the inhibitory learning model, fear associations are not erased but are overridden by new learning that signals safety or the absence of threat (Craske et al., 2014). Effective exposure tasks therefore rely less on fear reduction within a session and more on maximizing discrepancy between expected and actual outcomes. Brewin (2015) offers a complementary account with the retrieval competition model, which suggests that therapy strengthens adaptive memories so that they are more easily retrieved than fear-based ones. These memory-based models are supported by neurobiological and cognitive research showing that trauma and anxiety can distort memory encoding, retrieval, and integration, which exposure therapy helps to recalibrate (Brewin, Gregory, Lipton, & Burgess, 2010).

Clinical research continues to refine best practices for implementing exposure. Strategies such as varying the context of exposure, eliminating safety behaviors, and focusing on expectancy violation have all been found to improve outcomes (Kircanski et al., 2012; Culver, Stoyanova, & Craske, 2011). Moreover, evidence suggests that helping clients understand the rationale for exposure, preparing them to tolerate initial distress, and reinforcing new learning through reflection are critical elements of success (Abramowitz, Deacon, & Whiteside, 2011). Exposure therapy is effective across a range of disorders, including specific phobias, panic disorder, obsessive-compulsive disorder (OCD), social anxiety, and post-traumatic stress disorder (PTSD), and can be adapted to suit individual client needs. It is one of the most rigorously supported interventions in cognitive behavioral therapy, with decades of empirical evidence demonstrating its efficacy and safety.

What's inside

  • Introduction to exposure therapy.
  • Suggestions for using the resource with clients.
  • Key references for learning more about exposure therapy.
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FAQs

Exposure therapy involves facing fears directly, rather than avoiding them, to reduce fear and anxiety.
Clients experiencing phobias, PTSD, panic attacks, and OCD can significantly benefit from exposure-based interventions.
Graded exposure is a structured, step-by-step approach to facing fears in order of increasing intensity, starting with less anxiety-provoking situations.

How This Resource Improves Clinical Outcomes

By integrating this Exposure Therapy resource into their practice, therapists can help clients:

  • Better understand the key ideas in exposure therapy.
  • Judge whether exposure therapy might be the right therapeutic approach for them.
  • Prepare for exposure therapy.

References And Further Reading

  • Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. H. (2011). Exposure therapy for anxiety: Principles and practice. Guilford Press.
  • Brewin, C. R. (2015). Reconsolidation versus retrieval competition: Rival hypotheses to explain memory change in psychotherapy. Behavioral and Brain Sciences, 38, e4. https://doi.org/10.1017/S0140525X13000615
  • Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychological Review, 117(1), 210–232. https://doi.org/10.1037/a0018113
  • Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23. https://doi.org/10.1016/j.brat.2014.04.006
  • Culver, N. C., Stoyanova, M., & Craske, M. G. (2011). Clinical relevance of retrieval cues for attenuating context renewal of fear. Journal of Anxiety Disorders, 25(2), 284–292. https://doi.org/10.1016/j.janxdis.2010.09.004
  • Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35. https://doi.org/10.1037/0033-2909.99.1.20
  • Kircanski, K., Mortazavi, A., Castriotta, N., Baker, A. S., Mystkowski, J. L., Yi, R., & Craske, M. G. (2012). Challenges to the traditional exposure paradigm: Variability in exposure therapy for contamination fears. Journal of Behavior Therapy and Experimental Psychiatry, 43(2), 745–751. https://doi.org/10.1016/j.jbtep.2011.10.010
  • Marks, I. M. (1978). Living with fear: Understanding and coping with anxiety. McGraw-Hill.