Imaginal Exposure

This video demonstrates a short rationale for hot spots, selection of hot spot portions of the memory, and implementation of the first hot spot. After a break, processing focuses on cognitions related to guilt and responsibility for the trauma. Processing in this clip is informal, and the therapist is not at this point challenging the client’s cognitions directly, but frequently restates and emphasizes details and cognitions that lay the groundwork for processing in future sessions.

This video demonstrates the rationale for imaginal exposure, instruction and set-up for the first imaginal exposure, and implementation of imaginal exposure. The client is well engaged even though this is the first exposure and the therapist responses and prompts are accordingly minimal, though she maintains occasional supportive statements and calm, solicitous voice tone to maintain connection with the client. After a break, processing at the end of the clip focuses on validating the client’s efforts and normalizing distress reactions to the memory. The therapist also discusses using the imaginal recording for homework.​

This video demonstrates imaginal exposure when the client presentation is predominantly numb or anhedonic. To help the client increase engagement, the therapist increases verbal prompts and focuses the client’s attention on important details, emotions and cognitions that are present in the memory of the event.

This video demonstrates the rationale for imaginal exposure to the trauma memory. Following the rationale, the therapist provides specific instructions and set-up prior to implementing imaginal exposure. One iteration of the trauma narrative is shown followed by a break in the dialogue. The video resumes at the end of imaginal exposure and is followed by brief emotional processing.​

This video demonstrates the rationale for imaginal exposure as presented in session 3, followed by a portion of the client’s imaginal exposure of a combat related trauma. One iteration of the narrative is shown followed by a break in the dialogue after which, the video resumes at the end of imaginal exposure. Imaginal exposure is followed by emotional processing.​

This video demonstrates a way to discuss the function of anger in PTSD, and the importance of helping the client look beyond the anger to work with other emotions that may be present as well. Both the imaginal exposure and the processing demonstrate increased therapist activity that occurs in later sessions as the therapist prompts and focuses the client’s attention on important details and cognitions.