Exposure Therapy for Addiction/PTSD & OCD

Exposure therapy is a type of Cognitive Behavioral Therapy (CBT) that helps people confront and overcome their fears. It is commonly used to treat a range of mental health disorders, including anxiety, panic disorders, phobias, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).  

The theory behind exposure therapy is that avoiding feared objects, situations, or activities might provide short-term relief, but over time, this avoidance can make the fear stronger and more disruptive in one’s life. By gradually exposing individuals to that which they fear most under the guidance of a trained therapist, exposure therapy helps people learn that their fears are manageable and not quite as dangerous as they believed.  

Exposure therapy allows people to build new and more realistic beliefs, becoming more comfortable with the experience of fear. This therapy helps break the cycle of avoidance and anxiety, foster emotional resilience, and improve the patient’s quality of life.^1,2

Types of Exposure Therapy  

Exposure therapists can tailor the exact approach of therapy based on the patient’s specific fear or anxiety as well as their needs, symptoms, and circumstances. The main types of exposure therapy include:^1,2   

• Imaginal Exposure, or vividly imagining feared situations, is often used to treat patients living with PTSD. This type of therapy allows the patient to confront their fears in a controlled environment. 
• In Vivo Exposure involves the patient facing their fears in real-life situations, such as crossing a bridge to treat a fear of heights, or attending a social engagement to treat social anxiety. 
• Interoceptive Exposure triggers panic-like sensations in the patient to reduce their fear and physical symptoms. 
• Used to treat anxiety disorders, Interoceptive Exposure works by intentionally inducing the physical sensations associated with anxiety and panic to desensitize patients. By experiencing these sensations without fear, the patient reduces their tendency to avoid them. 
• Virtual Reality Exposure (VRE) utilizes Virtual Reality (VR) to simulate feared situations. 
• Also known as Systematic Desensitization, Graded Exposure works by gradually placing the patient in a feared situation or in the presence of a feared object. In this way, patients learn to tolerate increasing levels of discomfort and deliberately challenge their fears. 
• Flooding directly exposes the patient to their most feared situations or stimuli without any attempt to reduce anxiety. The goal is to extinguish the patient’s fear response by showing them that the feared situation or object is not dangerous. 
• Prolonged Exposure therapy has the patient confront their traumatic memories and feelings, helping them to process their trauma and reduce its impact on their lives. 
• Systematic Desensitization combines exposure with relaxation techniques. 
• Psychodrama involves role-play to enable patients to reenact the feared or traumatic events in their lives in a therapeutic setting. Psychodrama allows the patient to engage in emotional processing and create new neural pathways. Empowered Recovery Center in Atlanta offers a psychodrama group as part of its therapy programs. 

Exposure therapy for addiction begins with the therapist learning the patient’s specific fears. They then create a treatment plan to gradually face these fears in a structured way.  

Early exposure therapy sessions often involve talking through one’s difficult experiences via imaginal exposure, or else performing real-life tasks that trigger the patient’s fear through in vivo exposure.  

Therapists also teach coping tools like deep breathing or mindfulness to manage anxiety during exposures. Over time, the emotional impact of these triggers is reduced, decreasing the patient’s urge to use substances as a means of self-medication.^1,2   

Exposure Therapy & Co-occurring Disorders  

Anxiety disorders are a common risk factor for the development of an SUD. Symptoms of anxiety, like fear, nervousness, and a sense of impending doom, often emerge in people who have used or abused drugs and alcohol over an extended period, or in people in the midst of drug or alcohol withdrawal. Such symptoms can alter the presentation of an SUD. In a similar way, SUDs can alter the presentation and course of an anxiety disorder.³   

When a person is living with both an anxiety disorder and a SUD, they receive what is known in medical circles as a “dual diagnosis.” Dual diagnoses are common, as many people turn to alcohol or drugs as a means of self-medication or to escape the symptoms of their anxiety.  

Therapies that address both the patient’s mental health disorder and their SUD at the same time have proven to be generally more effective than therapies that treat one disorder at a time. Exposure therapy for PTSD, anxiety, and addiction enables people to confront the fears that fueled their past substance use, thereby treating their problematic substance use as well.⁴

Exposure therapy can be easily integrated into addiction treatment. By exposing themselves to their fear and anxiety “triggers” in a controlled setting, patients can reduce their emotional reactivity and gain greater control over their behavior.  

Exposure therapy is not appropriate for everyone in recovery, and should not be utilized during detox. However, under the guidance of trained professionals as part of a comprehensive, trauma-informed treatment plan, this therapy can lead to lasting change and a reduced risk of relapse. Common benefits of exposure therapy and addiction treatment include:^5,6  

• Reduces fear “triggers” over time 
• Weakens previously learned associations between feared objects, activities, or situations and bad outcomes 
• Improved emotional regulation, including impulsivity 
• Effectively treats co-occurring PTSD and anxiety symptoms 
• Increases tolerance of discomfort 
• Increases sense of control and confidence 

Yes, most insurance plans cover exposure therapy. Under the Patient Protection and Affordable Care Act, behavioral health treatments, including addiction treatment, counseling, and therapies like exposure therapy, are covered as essential health benefits.  

Before seeking treatment, it’s a good idea to contact your insurance plan and ask about coverage of specific addiction treatment services. You will also want to ask about the exact number of therapy hours your plan covers, as there may be limits. The admissions team at Empowered Recovery Center can also answer any questions you might have about using insurance to pay for rehab. We can even verify your benefits. 

At Empowered Recovery Center in Atlanta, we understand that breaking free from SUD and co-occurring mental health disorders requires not just a commitment but also the proper support. That’s why our rehab programs, including a psychodrama group powered by principles of exposure therapy, are built to create lasting change within the patient.  

Whether you’re in need of the structure of a partial hospitalization program (PHP), the flexibility of an intensive outpatient (IOP) program, or the ongoing support of outpatient (OP) care, we can help you find the treatment option that’s right for you. Plus, we include a full year of free recovery coaching to help you stay on track after treatment ends.  

Wondering about the cost? Our admissions team is here to walk you through your options when it comes to paying for rehab. If you’re ready to begin your recovery journey, reach out today to learn how we can support you.  

References  

1. Cleveland Clinic (2023). Exposure Therapy. Cleveland Clinic’s Health Library. Retrieved June 9, 2025, from https://my.clevelandclinic.org/health/treatments/25067-exposure-therapy 
2. Harvard Health Publishing (2024). Exposure therapy: What is it and how can it help? Harvard Medical School. Retrieved June 9, 2025, from https://www.health.harvard.edu/mind-and-mood/exposure-therapy-what-is-it-and-how-can-it-help 
3. U.S. National Library of Medicine (2010). Anxiety Disorders with Comorbid Substance Use Disorders: Diagnostic and Treatment Considerations. National Institutes of Health. Retrieved June 10, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC2921723/ 
4. U.S. National Library of Medicine (2011). The Use of Exposure-Based Treatment Among Individuals With PTSD and Co-occurring Substance Use Disorders: Clinical Considerations. National Institutes of Health. Retrieved June 10, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC3646384/ 
5. American Psychological Association (2017). What is Exposure Therapy? American Psychological Association. Retrieved June 11, 2025, from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy 
6. Addictive Behaviors (2005). Differences in impulsivity and sensation seeking between early- and late-onset alcoholics. Addictive Behaviors: An International Journal. Retrieved June 11, 2025, from https://www.sciencedirect.com/science/article/abs/pii/S0306460305001024?via%3Dihub 

If you or a loved one is struggling with a mental disorder or needs support, or wonder if you need rehab, it may be time for them to consider cognitive behavioral therapy in Atlanta. Having negative thoughts and behaviors on a daily basis is not normal. Your body and mind struggle with stressful behavior.

Change the way you perceive your reality through CBT. Talking with a professional therapist about the difficulties you face will help you understand your situation better. As a result, you will find ways to cope and develop positive thoughts and behavior. Contact Empowered Recovery Center today to begin your journey to recovery and a more satisfying, and rewarding life.