Implementing In Vivo Exposure for PTSD: How to Create an Exposure Hierarchy
Associate Vice-Chair of Clinical Research, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
Director, Emory Healthcare Veterans Program
Director, Emory Trauma and Anxiety Recovery Program
Paul A. Janssen Chair in Neuropsychopharmacology
- Ask what the patient needs to learn, then construct a hierarchy.
- Rate their SUDS now, toward the end, and at the end of therapy.
- Choose items that the patient can stay in long enough for their anxiety to decrease.
Video 8: In vivo exposure: How to i66mplement it.
Ask yourself, “What does the patient need to learn?” Then construct a hierarchy to help them learn that. You’ll rate their SUDS associated with each item now, again towards the end of therapy, and again at the end of therapy.
Foa, E., Hembree, E. A., Rothbaum, B. O., & Rauch, S. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences - Therapist guide (2nd ed.). Oxford University Press. Rothbaum, B. O., Foa, E., Hembree, E. A., & Rauch, S. (2019). Reclaiming your life from a traumatic experience: Client workbook (2nd ed.). Oxford University Press.
These are some examples of in vivo exposure hierarchies. I’ll read the items and give you the SUDS ratings. Staying at home alone in the middle of the day: 50.