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At posttreatment follow-up (after an average of 4 years), 90% of these patients still had significant reduction in fear, avoidance, and overall level of impairment and 65% no longer had a specific phobia.

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In addition, we provide practical guidelines for clinicians who wish to use exposure-based therapies and empirical evidence to guide their decision making.Using exposure to internal cues, a patient with panic disorder can run in place to experience physiological sensations (eg, heart palpitations) that elicit anxious reactions, a patient with generalized anxiety disorder (GAD) can purposefully induce worry thoughts, a patient with PTSD can revisit traumatic memories, and a patient with OCD can intention-ally evoke intrusive and aversive thoughts.With or without relaxation One of the earliest variations of exposure therapy was systematic desensitization, in which patients engage in imaginal exposure to feared stimuli while simultaneously undergoing progressive muscle relaxation.For patients who completed the study, 86% in the exposure group improved on a measure that examined the frequency and severity of obsessions and compulsions compared with 48% in the clomipramine group and 79% in the combined-treatment group.Several others have also demonstrated the efficacy of exposure-based treatments or treatment components for patients with GAD, so-cial anxiety disorder, and PTSD.Here we review a handful of the most influential studies that demonstrate the efficacy of exposure therapy.

We also discuss theoretical mechanisms, practical applications, and empirical support for this treatment and provide practical guidelines for clinicians who wish to use exposure therapy and empirical evidence to guide their decision making.

Exposure therapy is defined as any treatment that encourages the systematic confrontation of feared stimuli, which can be external (eg, feared objects, activities, situations) or internal (eg, feared thoughts, physical sensations).

The aim of exposure therapy is to reduce the person’s fearful reaction to the stimulus.

Because of the apparent importance of interoceptive exposure (ie, learning to tolerate uncomfortable physical sensations), relaxation exercises aimed at decreasing these sensations may actually attenuate the outcome of therapy, in much the same way as does the use of as-needed short-acting benzodiazepines.

examined the effects of single-session in vivo exposure (that lasts 1 to 3 hours) for patients with specific phobias.

Over a quarter of the people in the US population will have an anxiety disorder sometime during their lifetime, and available research literature suggests that exposure-based therapies should be considered the first-line treatment for these disorders.