2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Brief Summary

• Basic premise: repeated exposure to trauma-related thoughts, feelings, and situations can help reduce the power they have to cause distress
• Essence of therapy: Prolonged Exposure Therapy consists of imaginal exposures, which involve recounting the traumatic memory and processing the revisiting experience, as well as in vivo exposures in which the client repeatedly confronts trauma-related stimuli that were safe but previously avoided.
• Length: approx. 8-15 sessions

Treatment Resources

Editors: Denise Sloan, PhD; Alexandra Greenfield, MS

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals

Books Available for Purchase Through External Sites

• Prolonged Exposure Therapy for Adults, Therapist Guide
• Prolonged Exposure Therapy for Adults, Client Workbook
• Prolonged Exposure Therapy for Adolescents, Therapist Guide

Training Materials and Workshops

• Description of Prolonged Exposure Therapy (Veterans Administration’s National Center for PTSD)
• Beck Institute for Cognitive Behavior Therapy

Measures, Handouts and Worksheets

• PTSD Symptom Scale – Interview for DSM-5 (PSS-I-5); Manual for PSSI-I-5
• PTSD Symptom Scale – Self-Report for DSM-5 (PSS-SR-5)
• Child Posttraumatic Stress Scale – Interview for DSM-5 (CPSS-I-5); Manual for CPSS-I-5
• Child Posttraumatic Stress Scale – Self-Report for DSM-5 (CPSS-SR-5); Scoring Key for CPSS-SR-5
• Posttraumatic Cognitions Inventory (PTCI); Subscales for PTCI; Scoring Key for PTCI
• Prolonged Exposure Therapy for PTSD: Teen Workbook (Chrestman, Gilboa-Schechtman, & Foa)

Smartphone Apps

• PE Coach, available for free on iTunes
• PTSD Coach, available for free on iTunes

Video Demonstrations

• Dateline story on Prolonged Exposure (2004)

Video Descriptions

• Edna Foa on emotional processing theory in an intensive workshop at the Center for the Treatment and Study of Anxiety (2013)

• Edna Foa on the “Biting Dog” Model for structuring exposures in an intensive workshop at the Center for the Treatment and Study of Anxiety (2013)

• Al Jazeera segment on PE for adolescents with sexual trauma

Clinical Trials

• Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: a randomized control comparison with treatment as usual (Nacasch et al., 2011)
• A randomized controlled trial of exposure therapy and cognitive restructuring for posttraumatic stress disorder (Bryant et al., 2008)
• A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims (Foa et al., 1999)
• Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training (Talyor et al., 2003)
• Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics (Foa et al., 2005)
• A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims (Resick et al., 2002)
• Concurrent naltrexone and prolonged exposure therapy for patients withcomorbid alcohol dependence and PTSD: A randomized clinical trial (Foa et al., 2013)
• Prolonged exposure vs supportive counseling for sexual abuse–related PTSD in adolescent girls: A randomized clinical trial (Foa et al., 2013)
  
   

Meta-analyses and Systematic Reviews

• Prolonged exposure therapy: past, present, and future (Foa, 2011)
• Prolonged exposure therapy for post-traumatic stress disorder review of evidence and dissemination (McClean & Foa, 2011)
• A meta-analytic review of prolonged exposure for posttraumatic stress disorder (Powers et al., 2010)