Traditionally, clients are physically exposed to the object of their fear, such as a dog or snake. If the fear is of something that cannot be brought to the office, such as an elevator or airplane, the therapist might accompany the client to a nearby location. This is time-consuming and expensive, and some therapists assign these visits as homework rather than physically accompanying the client.
In imaginal exposure, visualization techniques are used to help the client vividly imagine the feared object or situation. Cognitive-behavioral methods are then used to reduce the client’s anxiety and encourage healthier coping skills.
Imaginal exposure is often successful, but some clients have difficulty putting their new behaviors into practice. In these cases, active-imaginal exposure, in which the client actually walks through the new behaviors while imagining the feared situation, may be more beneficial. If this exposure is still not sufficient, the next step may be actual exposure to the object of their fear.
