What Is Prolonged Exposure Therapy? A PTSD Treatment Option in Abilene, TX
What is Prolonged Exposure (PE) therapy for PTSD? Learn how PE works, what sessions include, why avoidance keeps PTSD going, and how PE-trained care is offered for adults at Brain & Heart Healing in Abilene, TX.
By Stacy Reynolds, LMFT-Associate, LCDC-Intern, supervised by Lisa Powell, Ph.D., LMFT-S, Brain & Heart Healing | Abilene, Texas
Prolonged Exposure (PE) is a structured, evidence-based talk therapy for PTSD that helps you gradually face trauma memories and safe situations you have been avoiding.
Avoidance can ease fear in the short term and keep PTSD stuck over time.
PE usually includes education, a calming breathing skill, in vivo exposure (real-life steps), imaginal exposure (revisiting the memory with support), and processing.
You stay in control of the pace. PE is not forced, rushed, or done without consent.
PE as offered here is an adult protocol. For children and teens, trauma care draws on TF-CBT and other developmentally appropriate options.
Stacy Reynolds is trained in Prolonged Exposure (PE) Therapy for PTSD through the Center for Anxiety & Behavior Therapy.
What PTSD Can Feel Like Day to Day
PTSD is more than a hard memory. It can shape sleep, relationships, work, and where your body feels safe.
Many people notice:
Avoidance. You skip places, people, conversations, or activities that stir the trauma. You may fill the day so no quiet is left for the memory to surface.\
Reminders. A sound, smell, date, news story, or tone of voice pulls you back. The body reacts as if the danger is still here.
Sleep that does not rest. Nightmares, light sleep, or waking already braced for the day.
A smaller life. The map of “where I can go” and “what I can handle” shrinks. Relief in the moment costs range over months and years.
If that sounds familiar, you are not weak or dramatic. Avoidance is a common trauma response. It is also one of the main ways PTSD stays locked in place.
Why Avoidance Keeps PTSD Going
Right after something overwhelming, avoiding reminders makes sense. Your nervous system is trying to keep you safe.
The problem is longer-term avoidance. When you never stay with a safe reminder long enough for your brain to learn “this is not the trauma happening again,” fear stays attached to the cue. The memory stays raw. Unwanted thoughts and nightmares often fill the space you tried to wall off.
[The National Center for PTSD](https://www.ptsd.va.gov/understand_tx/prolonged_exposure.asp) puts it plainly: avoiding trauma-related feelings and situations can help in the moment and get in the way of recovery over time. [The American Psychological Association](https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure) describes the same pattern: most people want to avoid trauma reminders, and that avoidance can reinforce fear.
PE was built to interrupt that cycle carefully, with a therapist, at a pace you help set.
What Prolonged Exposure Therapy Is
Prolonged Exposure is the gold standard of PTSD treatment and is a specific form of cognitive behavioral therapy. It teaches you to gradually approach trauma-related memories, feelings, and situations you have been avoiding, so those cues lose some of their power and daily life can open back up.
PE is recommended in major clinical guidance for PTSD in adults, including the APA Clinical Practice Guideline for the Treatment of PTSD. The VA’s National Center for PTSD also describes PE as one of the trauma-focused therapies with strong support for PTSD.
PE is individual therapy. You meet one-to-one with your clinician. It is not a group class and not a single “breakthrough” session.
Important scope note for this practice: PE, as Stacy is trained to offer it, is an adult protocol. Brain & Heart Healing serves ages 6-99 overall. For children and teens with trauma, care draws on TF-CBT and other developmentally appropriate approaches, not adult PE.
What Happens in PE
PE is structured. Sessions build on each other. Exact length and order depend on your history, goals, and readiness. Public descriptions from APA and the VA commonly describe a course of roughly weekly sessions over about three months, often in the range of about 8-12 sessions, with enough time in session to do exposure work and process it. Your plan is individualized. No fixed number of sessions is promised here. The number of sessions depends heavily on the client's dedication and willingness to do homework. The more dedicated they are to homework, the faster they can move through PE.1. Education
Early work covers how PTSD works, why avoidance makes sense in the short term, and how PE is meant to help. You get a clear map of what treatment involves before you begin deeper exposure.
2. Breathing skill
You learn a simple breathing technique to help manage anxiety. You can use this tool in session and between sessions. It won't “erase” hard feelings. It helps you stay present enough to do the work.
3. In vivo exposure (real life, step by step)
Together, you build a list of people, places, or activities you have stayed away from since the trauma- situations that are safe but feel threatening because of the association. You practice approaching them gradually, starting with manageable steps and building as you gain confidence.
Homework matters here. Practice between sessions is part of how PE works.
4. Imaginal exposure (the memory, with support)
In session, you revisit the trauma memory in a structured way, often describing it in the present tense with your therapist’s guidance. The goal is not to re-traumatize you. The goal is to process the memory so it becomes less overwhelming and less in charge of the rest of your life. Many PE protocols include listening to a recording of that imaginal work between sessions.
You and your clinician talk through privacy and how recordings are handled.
5. Processing
After imaginal work, you and your therapist talk through what came up: fear, anger, sadness, meaning, and what your body did. Processing helps the emotional material settle and integrate rather than stay stuck as raw alarm. Throughout, your clinician tracks distress, checks pace, and keeps the relationship a steady place to do hard work.
What PE Is Not
Not forced. You won’t be pushed into the hardest step on day one. Graduated practice is part of the design.
Not rushed. Session length and the course of care leave room to approach and process the material. APA notes that sessions often need enough time (commonly discussed in the 60-120 minute range in protocol literature) for exposure and processing.
Not done without consent. Fit, readiness, and goals factor into the decision. PE is one option among others.
Not a guarantee. PE is strongly supported for many adults with PTSD. It doesn't promise a specific outcome or a fixed number of sessions for everyone.
Not the only trauma path. Some people need more stabilization first. Some prefer or do better with another approach. That conversation belongs in the room with your clinician.
Is PE Right for Me?
A good fit conversation usually covers:
Adult PTSD presentation. PE here is for adults. Child and teen trauma care uses other tools.
Readiness and safety. Active crisis, certain medical or dissociation needs, or other clinical factors may mean you start with grounding, skills, or a different plan before trauma-focused PE.
Willingness to practice between sessions. PE includes homework (in vivo steps and often listening to session recordings).
Your goals. Sleep, relationships, driving a certain route, sitting with a memory without shutting down: clarity helps you and your clinician choose.
Other options at Brain & Heart Healing
PE is one path. Care here also draws on tools such as:
CBT: thoughts, behaviors, and patterns that keep distress going
ACT: values, psychological flexibility, and making room for hard internal experiences
DBT-informed skills: emotion regulation, distress tolerance, and interpersonal effectiveness
TF-CBT: structured trauma care for children and teens
Gottman Method / EFT-informed couples work: when the wound lives in the relationship too
EMDR: uses guided bilateral stimulation while clients recall distressing memories to reprocess them safely
No single method fits every story. [Individual therapy at Brain & Heart Healing](https://www.brainandhearthealing.com/individual-therapy) is built around fit, not a brochure protocol applied to everyone.
Getting Started in Abilene (and Texas Telehealth)
Stacy Reynolds, LMFT-Associate, LCDC-Intern, is trained in Prolonged Exposure (PE) Therapy for PTSD through the Center for Anxiety & Behavior Therapy, supervised by Lisa Powell, Ph.D., LMFT-S.
Stacy’s clinical focus includes trauma and PTSD, relational trauma, couples work, co-occurring substance use concerns, and court-involved clinical services. Hours are typically Monday through Thursday. Sessions are available in person in Abilene and by telehealth across Texas when clinically appropriate.
Next steps:
Read more about individual therapy.
Book a Session for a consultation and intake.
Or call / text (325) 261-3663. Office: 500 Chestnut Street, Suite 203, Abilene, Texas 79602. Enter through the South 6th Street doors (not the Chestnut Street side). Take the elevator to the 2nd floor, turn left; Suite 203 is on the left.
A Steady Word Before You Decide
Facing what trauma taught you to avoid is hard work. You do not have to do it alone, and you do not have to decide PE is “the” answer before you talk with a clinician. A consultation is a place to ask questions, name what you are ready for, and choose a path that fits your history and goals.
Your story matters. And so do you.
References
American Psychological Association. (n.d.). Prolonged Exposure (PE). APA Clinical Practice Guideline Resources. https://www.apa.org/ptsd-guideline/treatments/prolonged-exposureFoa, E. B., Hembree, E. A., & Rothbaum, B. O. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences (2nd ed.). Oxford University Press.Foa, E. B., & Rothbaum, B. O. (1998). Treating the trauma of rape: Cognitive-behavioral therapy for PTSD. Guilford Press.National Center for PTSD. (n.d.). Prolonged Exposure (PE) for PTSD. U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/understand_tx/prolonged_exposure.asp
Stacy Reynolds, LMFT-Associate, LCDC-Intern, is supervised by Lisa Powell, Ph.D., LMFT-S. This article is for education only and does not constitute therapy, diagnosis, or professional mental health advice. Brain & Heart Healing, PLLC does not provide 24-hour crisis services. If you are experiencing a mental health emergency, please do not wait for a reply. Instead, use one of the following resources: Call 911 | Call or text 988 (Suicide & Crisis Lifeline) | Call the Betty Hardwick 24-hour crisis line at 800-758-3344 | Go to the nearest emergency room.