What is In Vivo Exposure Therapy?

In many different kinds of anxiety disorders, a person's apprehension is triggered by a specific thing, place, or situation. In Vivo Exposure Therapy is a form of Cognitive Behavior Therapy that is used to reduce the fear associated with these triggers. There are two different kinds of Exposure Therapy, including:

  • Flooding — this type of Exposure Therapy involves rapid exposure to feared situations.

  • Systematic Desensitization, also known as Progressive Exposure — this involves gradual exposure coupled with relaxation exercises when anxiety levels become too great.

How In Vivo Exposure Therapy Works

With the typical anxiety disorder, the patient suffers from disquieting signals in their brain that tell them something bad will happen as a result of a certain action or situation. For example, a person with Obsessive Compulsive Disorder may be convinced that they must wash their hands five times every time they use the bathroom. Perhaps they have a concern about germs and, in their mind, washing their hands less than five times will ensure they're going to get sick. The intention of exposure therapy is to train the patient's brain into a more accurate train of thought, so their anxiety system ceases to give misinformation.

This training is done through example. The patient is guided by the therapist into a situation where they will face their fears and anxieties without performing any rituals or the avoidance tactics they might normally use.

Challenges and Rewards

Because this therapy takes such a direct approach to breaking the patient's anxiety, it can be difficult for a person to endure. Many patients feel like their anxiety is increasing with every second they're in the exposed situation. Because of this, therapists are trained to judge when the patient is at the point that they can no longer handle the stress that may go along with this treatment.

On the positive side, through In Vivo Exposure Therapy the patient begins to understand that the "consequences" of their anxieties are not reasonable. Using the above example, the sufferer of Obsessive Compulsive Disorder may be guided to wash their hands only once after using the bathroom, instead of five times. Over the course of treatment, they come to understand that they will not get sick from washing their hands less than five times. The patient becomes conditioned to the situation they have feared and it no longer provokes their anxiety.

Anxiety Disorders That May Require In Vivo Exposure Therapy Include:

  • Obsessive-Compulsive Disorder

  • Panic Disorder

  • Post Traumatic Stress Disorder

  • Social Anxiety Disorder

  • Simple Phobias