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Background
The use of exposure as a mode of therapy began in the 1950’s during the behavior therapy movement, a time when the psychoanalytic view dominated Western psychology and behavioral therapists first emerged. South African psychologists and psychiatrists, who brought their methods to England and the Maudsley Hospital training program, first used exposure as a mode of therapy to reduce pathological fears, such as phobias and anxiety-related problems.

One of the first psychologists to spark interest in resolving clinical problems from a behavioral point of view, Joseph Wolpe (1915-1997) sought consultation with other behavioral psychologists similar in methodology. James G. Taylor (1897-1973), working in the psychology department of the University of Cape Town in South Africa, was among the psychologists Wolpe sought discussion with. Although most of his work went unpublished, Taylor was the first recorded psychologist to use an exposure therapy treatment for anxiety, including methods of situational exposure with response prevention—a common exposure therapy technique still being utilized. Since the 1950’s and the behavior therapy movement, several modes of exposure therapy have proliferated, including systematic desensitization, flooding, implosive therapy, prolonged exposure therapy, in vivo exposure therapy, and imaginal exposure therapy.

Generalized Anxiety Disorder
There is profuse evidence that exposure therapy is an effective treatment for people with generalized anxiety disorder, citing specifically in vivo exposure therapy, which has greater effectiveness than imaginal exposure in regards to generalized anxiety disorder. The aim of in vivo exposure treatment is to promote emotional regulation using systematic and controlled therapeutic exposure to traumatic stimuli.

Specific Phobias
Exposure based therapies have also been found to be successful in treating specific phobias and are the most validated treatment known for phobias. Several published meta-analyses observed the success of a single-session of exposure therapy—specifically imaginal exposure, a one to three hour treatment session—in treating patients with specific phobias. Four years later at the post-treatment follow-up, 90% of patients retained a considerable reduction in fear, avoidance, and overall level of impairment, while 65% no longer experienced any symptoms of a specific phobia.

Post-Traumatic Stress Disorder
A type of exposure therapy has recently found efficacy in treating disorders extending further into the anxiety spectrum. Virtual reality exposure (VRE) therapy is a modern but effective treatment of posttraumatic stress disorder (PTSD), and has been tested on several active duty Army soldiers using an immersive computer simulation of military settings over six sessions. Self-reported PTSD symptoms of the active duty Army soldiers were greatly diminished compared to pretreatment reports, thus advocating exposure therapy’s effectiveness in reducing PTSD.