Most insurance plans will cover either all or a portion of the treatment.
Navigation:
- Overview
- How Does Prolonged Exposure Therapy Work?
- Am I Eligible for Prolonged Exposure Therapy?
- Prolonged Exposure Therapy and Substance Use Treatment: What’s the Connection?
- Does Insurance Cover Prolonged Exposure Therapy?
Overview
Prolonged exposure (PE) therapy is a proven, evidence-based treatment for trauma-related mental health challenges, particularly post-traumatic stress disorder (PTSD). It is a type of talk therapy that helps individuals gradually confront trauma-related memories, emotions, and safe situations they have been avoiding.
Since trauma and addiction commonly overlap, prolonged exposure therapy can be an especially valuable component of behavioral health treatment. If you or a loved one is struggling with trauma-related alcohol or drug use, prolonged exposure therapy can help you confront, process, and manage traumatic experiences while supporting recovery from substance use disorders.
How Does Prolonged Exposure Therapy Work?
Prolonged exposure therapy is a structured, evidence-based treatment rooted in cognitive behavioral therapy (CBT). Patients work with a trained practitioner to identify traumatic experiences that continue to disrupt their lives and develop a treatment plan for addressing them. The process involves education about trauma, techniques for managing distress, and independent exercises that reinforce the skills and insights gained during therapy.
Before exposure exercises begin, therapists conduct an initial assessment and establish a supportive environment built on trust, collaboration, and patient empowerment.
While each treatment plan varies according to the patient’s needs and trauma history, the two primary types of exposure used in PE therapy include:
- Imaginal Exposure – During imaginal exposure, patients revisit and describe traumatic memories in detail under the guidance of a trained therapist. Patients typically describe the experience in the present tense to help process the associated thoughts and emotions. With the patient’s consent, these sessions may be recorded so they can listen between appointments, further process their emotions, and reinforce the skills learned during therapy.
- In Vivo Exposure – In vivo exposure involves gradually confronting safe situations, places, or activities that patients have avoided because they associate them with traumatic experiences. Patients work with their therapists to identify these situations and develop structured exercises to complete between sessions. Exposure occurs progressively, allowing patients to build confidence, reduce avoidance, and develop healthier responses to trauma-related distress.
Prolonged exposure therapy is typically administered over approximately three months, with eight to 15 weekly individual sessions. Sessions generally last 60 to 90 minutes, although the duration may vary depending on the patient’s needs and treatment plan.
Am I Eligible for Prolonged Exposure Therapy?
While eligibility depends on each patient’s clinical needs and personal circumstances, prolonged exposure therapy may be particularly beneficial for individuals who:
- Avoid distressing memories, thoughts, emotions, or situations associated with trauma.
- Have been diagnosed with post-traumatic stress disorder (PTSD).
- Experience disruptions in daily life, relationships, or emotional well-being related to traumatic experiences.
- Are willing to participate in structured trauma-focused therapy and complete exercises between sessions.
Experiences that may lead someone to seek prolonged exposure therapy include natural disasters, physical or sexual assault, family dysfunction, relationship-related trauma, traumatic loss, serious illness or injury, and military combat. Traumatic experiences can also contribute to the development or worsening of alcohol and drug use disorders.
Prolonged Exposure Therapy and Substance Use Treatment: What’s the Connection?
One of the primary goals of addiction treatment is to help patients identify and address the underlying factors that contribute to substance use. Research suggests that approximately 40 to 50 percent of individuals with PTSD experience a co-occurring substance use disorder. Prolonged exposure therapy helps patients process traumatic experiences, reduce avoidance behaviors, and develop healthier coping strategies that can support long-term recovery.
For individuals experiencing both PTSD and substance use disorders, prolonged exposure therapy may be incorporated into an integrated treatment plan that addresses both conditions. Trauma-focused therapy does not necessarily need to wait until substance use treatment is completed, although the appropriate timing depends on the patient’s clinical needs and stability.
Because prolonged exposure therapy often requires several weeks or months, patients may need to continue treatment after leaving a residential rehabilitation program. A rehab facility’s case manager or clinical team can help coordinate ongoing therapy, outpatient services, and other forms of continuing care to support recovery.
Does Insurance Cover Prolonged Exposure Therapy?
Private insurance, Medicare, and Medicaid may cover prolonged exposure therapy when it is considered medically necessary and provided by an eligible mental health professional. Coverage varies depending on the insurance provider, specific plan, treatment setting, and applicable requirements.
Prolonged exposure therapy may be covered as part of a comprehensive addiction treatment program or as a standalone outpatient mental health service. Some insurance plans require prior authorization, referrals, or treatment from an in-network provider.
If you have a specific rehabilitation facility in mind, contact an admissions representative to discuss your coverage options and request an insurance benefits verification. The admissions team can also explain the facility’s clinical services, whether prolonged exposure therapy is available, and what out-of-pocket expenses may apply.
