Exposure Therapy: Up Close and Virtual

The last year has seen a flourishing of online therapy as a way to deliver mental health treatment. I have reviewed the benefits of this approach elsewhere.


In this blog, I wanted to focus on using virtual therapy platforms for exposure therapy and exposure and response prevention (ERP) work. As will be described, exposure therapy conducted using online therapy is extremely effective.


When we engage in exposure (the “E” in ERP) therapy, therapists will work with clients to face situations that cause undue distress. These situations can involve a multitude of triggers, such as certain places, people, words, names, colours and not doing things in a way that feels “just right”. Upon facing these distressing situations, clients will then be supported by their therapists to not engage in compulsions, rituals or avoidance behaviours that would often provide them with a decrease in anxiety (“RP” - response prevention). Together, these elements make up E + RP which equates to Exposure and Response prevention work.


Exposure therapy is used across a large variety of mental health presentations - most notably the anxiety disorders (social anxiety, panic disorder, phobias, generalized anxiety disorder) and exposure and response prevention is often discussed with specific reference to obsessive and compulsive disorder. More and more research is showing us that exposure therapy can be thought of as a transdiagnostic approach - meaning that it is beneficial for many different psychological presentations.


What we have learned in the past year and a half is that doing exposure therapy in a virtual environment provides therapists with an opportunity to work with clients in a manner that we have never been able to before.

What we have learned in the past year and a half is that doing exposure therapy in a virtual environment provides therapists with an opportunity to work with clients in a manner that we have never been able to before.


The most unique element is that therapists can work with clients in their home environment, which tends to be one of the most triggering places for people. Although therapists are often extremely creative at bringing elements of one’s home into the office, it is not something that needs to be done any longer once we are working together virtually. My clients can literally take me with them to all the different places in their life that are triggering there are no more boundaries!


I can travel with you into your kitchen, bedroom and even your bathroom in a manner that is discreet, comfortable (video off as needed) and completely therapeutic. Therapists can travel on subways with clients for social anxiety exposures, we can go into crowds together (panic disorder exposures) and we can visit several areas in your home throughout the course of a session. We can even travel to other countries and visit churches, malls, and other faraway places that may hold elements of emotional contamination or other specificities unique to a particular client. Therapy is no longer defined by my office walls - only by where technology can take us. And we know now that is pretty far!


We also know that virtual therapy has been found to be highly effective so clients can be confident that the work they are doing virtually is as effective as the work we were doing together in our office.

We also know that virtual therapy has been found to be highly effective so clients can be confident that the work they are doing virtually is as effective as the work we were doing together in our office.


We are truly at a pivotal moment in the landscape of mental health treatment, where we can break the traditional limits of what we once knew. We can travel to places together, with endless possibilities in the spirit of enhancing therapeutic work and long term recovery.


We look forward to continuing to serve you, virtually, at Forward Thinking Psychological Services. We can’t wait to start this journey with you. Please do not hesitate to reach out - our virtual door is always open!

What happens next: Getting Started.