In Vivo exposure is a type of exposure therapy that directly exposes an individual to the anxiety-provoking situation, object, or activity.

In Vivo Exposure



This component of ERP involves the patient imagining the trigger rather being directly exposed to it. This is used in place of exposure in vivo for triggers that may be harmful for the therapist to expose the patient to in real life. If for example the patient is afraid of being infected with a serious disease if they go to a park and don't immediately wash their hands, the therapist can't in vivo them getting infected by a grave disease to expose them to their fear so they must take an imaginal approach instead to decrease the fear of getting sick by going to a park.

Imaginal Exposure

Interoceptive exposure involves deliberately bringing on physical sensations that are harmless, yet feared. This allows for individuals to learn feared sensations are not dangerous. 


Interoceptive Exposure 


Virtual reality exposure therapy is a technique where a simulation is used to help individuals overcome their fears. This method is particularly useful when re-creating anxiety-provoking situations is impractical, costly, or embarrassing. By using a computer-generated environment, therapists can effectively treat numerous anxiety disorders, including the fear of public speaking, claustrophobia (fear of enclosed spaces), aviophobia (fear of flying), and post-traumatic stress disorder (PTSD).

Virtual Reality Exposure Therapy



- In Vivo Exposure
- Imaginal Exposure
- Virtual Reality Exposure
- Interoceptive Exposure

University of San Diego

Exposure therapy is a therapeutic technique where a client is presented with a feared object, situation, or activity in a safe environment, with the goal of reducing their fear and avoidance through habituation, or getting used to it. This method can be implemented through real-life exposure (in vivo), imagination, or virtual reality. First reported by Mary Cover Jones in 1924, this approach is used to treat various anxiety-related conditions like phobias, PTSD, and OCD. It works by facilitating processes such as habituation, extinction, building self-efficacy, and emotional processing.

Exposure Therapy

What Is Exposure Therapy? (n.d.). American Psychological Association. Retrieved July 20, 2022, from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy

What is Exposure Therapy ? 

Variations of Exposure Therapy



- Graded exposure
- Flooding
- Systematic Desensitization

 Paces for Exposure Therapy



Add reference nodes for Exposure Therapy here.

References for Exposure Therapy

Developed by Joseph Wolpe in 1958 as a refinement of earlier techniques, systematic desensitization is a form of exposure therapy that pairs graduated exposure to a feared stimulus with relaxation techniques. The process involves creating a hierarchy of anxiety-provoking situations and teaching the client relaxation methods. The client then confronts the stimuli, starting with the least frightening, while in a relaxed state. The therapy is based on the principle that an individual cannot be anxious and relaxed simultaneously, aiming to replace the fear response with a relaxation response.

Systematic Desensitization

You can learn more about how exposure therapy is used in treating PTSD here: 

Video: Exposure Therapy and PTSD

This example illustrates how exposure therapy, based on classical conditioning principles, can be used to treat a phobia. The process involves four stages:
1.  **Initial State**: A rabbit, the conditioned stimulus (CS), elicits a fear response in the individual.
2.  **Introduction of Pleasant Stimulus**: A naturally enjoyable item, like milk and cookies, serves as the unconditioned stimulus (US), which produces a positive unconditioned response (UR).
3.  **Pairing**: The rabbit (CS) is repeatedly presented to the individual at the same time as the milk and cookies (US). This pairing causes the individual to experience the positive unconditioned response (UR) in the presence of the rabbit.
4.  **New Association**: After multiple sessions, the rabbit (CS) alone begins to trigger a new, positive conditioned response (CR), replacing the original fear.

Example of Exposure Therapy for Phobia of Rabbits

Given the following case study, propose a therapeutic intervention based on the principle of confronting a feared situation in a safe environment to reduce the associated anxiety. Explain the psychological mechanism that is expected to lead to a reduction in fear.

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