Prolonged Exposure Therapy
in person for Lubbock, TX and virtually for all of Texas
Prolonged Exposure is one of the most rigorously researched and effective treatments for PTSD available. It works by helping you gradually face trauma-related memories and situations you've been avoiding — so they lose their power over your daily life.
Accepting new clients --- Most Insurances Accepted
IS THIS RIGHT FOR YOU?
Who Is Prolonged Exposure For?
PE was developed specifically for PTSD and trauma. It may be right for you if:
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You have been diagnosed with PTSD or experienced a traumatic event that continues to affect your life
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You avoid people, places, thoughts, or feelings that remind you of the trauma
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You have intrusive memories, nightmares, or flashbacks related to a traumatic experience
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Your world has become smaller since the trauma — things you used to do now feel unsafe or impossible
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You feel emotionally numb, detached, or disconnected from your life
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You've tried to push the trauma out of your mind — and it keeps coming back
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You want a structured, evidence-based approach to trauma rather than open-ended talking
PE is one of the most effective treatments for PTSD ever studied. Most people see real, lasting improvement — not just symptom reduction, but a reclaimed life.
THE APPROACH
How Prolonged Exposure Works
PTSD is maintained largely by avoidance. When we avoid trauma reminders — the places, people, sensations, and thoughts associated with the trauma — we get temporary relief. But avoidance also prevents the brain from learning that these reminders are not actually dangerous, and it keeps the traumatic memory from being fully processed and integrated. Prolonged Exposure directly addresses this cycle.
PE has two core components. In vivo exposure involves gradually approaching real-world situations, places, or activities you've been avoiding because they feel dangerous or triggering — even though they are objectively safe. This is done systematically, starting with less distressing situations and working up. Imaginal exposure involves revisiting the traumatic memory itself — narrating it aloud in session in a structured, therapist-guided way. This repeated, deliberate engagement with the memory allows the brain to process what it couldn't process in the moment of trauma, reducing its emotional charge over time. Between sessions, clients listen to recordings of their imaginal exposures as homework, which accelerates processing. PE also includes psychoeducation about PTSD and how trauma affects the brain, and breathing retraining as a foundational coping skill.
PE is a structured, short-term treatment — typically 8–15 weekly sessions of 90 minutes. It was developed by Dr. Edna Foa at the University of Pennsylvania and has been studied in dozens of randomized controlled trials across combat veterans, survivors of sexual assault, accident survivors, and many other trauma populations. It is endorsed by the VA/DoD, the APA, and international trauma guidelines as a first-line treatment for PTSD. At Flatland Counseling, PE is offered by therapists who are specifically trained in the protocol and experienced in working with trauma.
Evidence-Based Care
Prolonged Exposure is endorsed by the VA/DoD, the American Psychological Association, and the WHO as a first-line treatment for PTSD — with decades of rigorous research behind it.
60–70% of PTSD patients no longer meet diagnostic criteria after completing a full course of Prolonged Exposure therapy
THE PROCESS
What to Expect
Step 1: Reach Out
We'll match you with a therapist trained in Prolonged Exposure. Let us know PE is specifically what you're looking for — we'll prioritize that match.
Step 2: Your First Session
PE always begins with psychoeducation and breathing training before moving into exposure work. Your therapist will ensure you have the skills and the therapeutic relationship needed to work with traumatic material safely.
Step 3: Start Making Progress
Over 8–15 sessions, most people experience significant reductions in PTSD symptoms — fewer intrusions, less avoidance, and a growing sense of safety in their own life again.
COMMON QUESTIONS
Frequently Asked Questions
Will I have to re-live my trauma? -- PE does involve revisiting the traumatic memory — but in a structured, controlled way that's quite different from re-living it or being re-traumatized. You'll narrate the memory aloud with your therapist present, who will guide you through the process and help you stay within a manageable range of distress. Over multiple repetitions, the memory becomes less overwhelming — more like a regular memory and less like a live threat. Many people find this process challenging but transformative.
How is Prolonged Exposure different from EMDR? -- Both PE and EMDR are first-line, evidence-based treatments for PTSD with strong research support. The key differences: EMDR uses bilateral stimulation (eye movements or taps) during trauma processing and typically requires less verbal narration of the traumatic event. PE relies on repeated verbal narration and in-vivo exposure without bilateral stimulation. Both are effective — research shows comparable outcomes. The choice often comes down to client preference, therapist training, and the nature of the trauma. At Flatland Counseling, we offer both.
Do I have to do homework? -- Yes — between-session practice is a core part of PE. This includes listening to the recording of your imaginal exposure session and completing in vivo exposure assignments. This homework is where a significant part of the processing happens. Your therapist will prepare you for it and problem-solve any obstacles.
How many sessions does PE take? -- PE is typically completed in 8–15 weekly sessions of approximately 90 minutes. It is one of the more time-efficient trauma treatments — producing significant results in a relatively short, structured course of treatment.
Is PE right for complex or developmental trauma? -- PE was developed primarily for single-incident PTSD (a discrete traumatic event). For complex or developmental trauma — abuse, neglect, or multiple traumatic experiences over time — the preparation and stabilization phase is typically extended, and PE may be combined with other approaches. Your therapist will assess your history and determine the appropriate treatment plan.
Can PE be done via telehealth? -- Yes. PE has been delivered effectively via telehealth, including in VA studies with veterans. The structure of the protocol translates well to an online format. In vivo exposures are actually often more practical via telehealth, since they happen in real-world settings. We offer telehealth PE to clients anywhere in Texas.
Is PE effective for military veterans and combat trauma? -- Yes — PE has the strongest evidence base for any psychotherapy with combat veterans and is a VA/DoD-approved first-line treatment for military PTSD. At Flatland Counseling, we welcome veterans and first responders and have therapists experienced in working with combat and occupational trauma.
What makes PE different from just "talking about" the trauma? -- The difference is structure, repetition, and deliberate engagement with avoidance. In open-ended trauma talk, conversations about trauma can stay at a surface level or skip around without systematic processing. PE involves returning to the same traumatic memory repeatedly, in a specific format, until its emotional charge reduces — which is a fundamentally different mechanism from general discussion. The in vivo exposure component also directly addresses avoidance in ways that conversational therapy typically doesn't.
How do I get started? -- You can reach out through our contact page or click the Get Started button to request an appointment. Taking that first step is often the hardest part — I'm glad you're here.
CONDITIONS WE TREAT
Issues We Treat with Prolonged Exposure
PE is used primarily for PTSD and trauma-related conditions at Flatland Counseling.