OT Exposure Therapy

Exposure Therapy and OT

After an emotionally difficult experience you may find it challenging to fully participate at work, at home or in social situations.  Exposure therapy is a treatment Occupational Therapists use to increase a client’s ability to function after trauma.  OTs use exposure therapy to address anxiety, fear and discomfort so that you can actively engage in you community and life again.

What is Exposure Therapy?

Exposure therapy helps clients improve their ability to differentiate between safe and unsafe situations.  With an OT’s help, they can reduce the physical, emotional, cognitive and social symptoms of trauma.  Early intervention along with repetition empowers clients to better manage their response to triggers.

When someone experiences anxiety about specific people, places or things, they often avoid those situations.  While this can reduce the discomfort in the short term, longer-term solutions are better.  Interrupting the cycle of fear, through exposure therapy, allows a person to better recognize which beliefs are accurate and which have become overrun by emotions and difficult memories.

How is Exposure Therapy done?

  1. Education: Discuss how avoidance behaviours fuel anxiety.
    • Which safety habits does the client use in order to reduce anxiety in the triggering situation?
    • What thoughts and beliefs about the situation may be inaccurate or not helpful?
  2. Develop a structured plan to overcome the anxiety. 
    • The OT and their client develop an exposure hierarchy by grading all the aspects about the situation that causes anxiety.  They assign each a score that ranges from 0/10 (no anxiety) to 10/10 (most anxiety ever). 
    • Based upon these scores, the OT and client develop a step-by-step plan to address each aspect of anxiety.  Initial sessions should work through less anxious tasks and later sessions should address those that cause more anxiety.
    • In the final sessions, the client aims to manage their anxiety effectively so that they can engage in the formerly stressful situation with a calm and clear mindset. 
  3. During each session: Consider how long to continue with the session before it is complete.
    • Researchers suggest that the client and OT stay in the situation until their level of fear drops by 50%.  If the client considered their anxiety to be a 8/10 initially, they should wait until it is a 4/10 before concluding that exposure step.

Meet Kadie: A Case Study in Exposure Therapy

After an isolated and traumatic event occurred during her work as a social worker, Kadie feared her safety whenever she came near the site of the incident.  Jennifer MacDonald, a senior therapist with OT Works! started working with Kadie after she had been off work for 6 months.  They used a team-based approach to organize the exposure plan with the rest of Kadie’s healthcare team and social network.  They had one-on-one sessions that gradually reintroduced her back into her work role.  At discharge, Kadie was able to return to work independently, equipped with the tools and skills to work effectively without tirelessly worrying about her safety.  With exposure therapy, Kadie built up confidence in her ability to manage feelings of anxiety.

How can OT Works! help?

Our occupational therapists are experienced in exposure therapy.  They have helped many clients face their fears and reduce their anxiety.  Our clients are able to return to their daily activities and enter unfamiliar situations equipped with the tools that are gained from exposure.  All of our therapists are certified with the College of Occupational Therapists of British Columbia (COTBC) and many have additional training in mental health treatment.

If you or anyone you know could benefit from exposure therapy, contact us at referrals@ot-works.com or 604.696.1066 ext. 1000.  We can connect you with one of our therapists and make recovery more attainable for everyone.

Additional Resources

To learn more about exposure therapy, check out these resources: