A combination of prolonged exposure has sometimes been used in combination with stress inoculation training to treat adult trauma victims suffering from posttraumatic stress (Foa et. al., 1991). This combined approach involves an initial 2-hour evaluation followed by eight weekly sessions (1.5 – 2.0 hours each) that include: (1) education about the normal reactions to assault, (2) breathing training, (3) three types of relaxation training, (4) reliving the assault (imaginal exposure), (5) confronting current feared, but safe, situations (in vivo exposure), (6) cognitive restructuring regarding attributions and beliefs about the assault, (7) assertiveness training via role-play, (8) covert modeling and (9) guided self-dialogue. Following the end of each session, homework is assigned which involves instructing the patient to listen daily to the audio recording of the session and to record their subjective units of distress (SUDS) on a homework sheet, which is then brought to the next therapy for review.
Mervin Smucker, Ph.D., is an international trauma consultant and author of numerous articles and books on trauma and cognitive-behavioural therapy interventions.