Obstacles in Implementing Exposure Therapy for PTSD

Case Discussions and Practical Solutions

Published in: Clinical Psychology and Psychotherapy, v. 3, no. 3, 1996, p. 176-184

Posted on RAND.org on December 31, 1995

by Lisa H. Jaycox, Edna B. Foa

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Despite the proven efficacy of exposure techniques for the treatment of Post-Traumatic Stress Disorder, some obstacles can arise that interfere with successful implementation of exposure-based therapy. In this paper, the theory behind exposure therapy for PTSD is reviewed and basic implementation procedures are detailed. The ways in which three obstacles to treatment (extreme anger, emotional numbing, and overwhelming anxiety) can impede progress in therapy are discussed in terms of theory and case examples. Specific suggestions for circumventing these obstacles are offered, including modifying the exposure techniques and augmenting exposure by using stress inoculation techniques or cognitive therapy.

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