Exposure Therapy for Co-occurring Addiction/PTSD & OCD

If you’re living with post-traumatic stress disorder (PTSD) or obsessive-compulsive disorder (OCD) alongside substance use disorder, you’ll need specialized treatment to help you begin the recovery process. Your treatment plan utilizes various types of therapy and may include exposure therapy, a research-backed treatment method that’s particularly helpful for people living with anxiety-based disorders, like PTSD and/or OCD in addition to their substance use disorder.1 Explore more about exposure therapy, different types of exposure therapy, and how it can support those who are living with PTSD/OCD and addiction or call us to get started with addiction treatment in Atlanta.

What Is Exposure Therapy?

Exposure therapy is a psychological treatment method that helps people confront and reduce fears, anxiety, and avoidance behaviors that interfere with daily life. It is commonly used to treat conditions such as phobias, panic disorder, generalized anxiety disorder, obsessive compulsive disorder, and post traumatic stress disorder.1,2 People who live with these disorders often avoid the objects, situations, or sensations that cause distress. Although avoidance may feel helpful in the moment, it can strengthen fear over time and make symptoms more difficult to manage.2

Exposure therapy addresses this cycle by gradually and safely exposing a person to the feared object, activity, or situation while supported by a trained therapist.1,2 This exposure can occur in different ways, such as real life experiences, guided imagery, or virtual reality, depending on the person’s needs.1 As the individual practices facing what they previously avoided, they begin to build confidence, reduce fear responses, and learn healthier ways to tolerate distress.1,2

During sessions, therapists work to create a supportive and controlled setting where patients can process their reactions and learn skills to manage anxiety more effectively.1 Over time, exposure therapy can weaken the negative associations linked to a feared stimulus and help people feel more capable of confronting challenges in their daily lives.1,2

Types of Exposure Therapy

While exposure therapy may seem intense at first, it’s important to remember your therapist moves at your pace and only introduces exercises when you’re ready. When your therapist decides that exposure therapy for OCD or exposure therapy for PTSD is a good fit for your treatment plan, they’ll talk with you about the type of exposure therapy that makes the most sense for your needs.

There are several different types of exposure therapy addiction treatment, including:

• In vivo exposure: During in vivo exposure, your therapist will support you as you confront your fear in real-life situations. For example, someone who is afraid of dogs might be instructed to look at a picture of a dog with a therapist’s guidance.2
• Psychodrama group therapy, inspired by improvisational theater, enables individuals to relive stressful situations or practice for future challenges with the support and feedback of group participants.3
• Imaginal exposure: Rather than re-experiencing the event in real life, imaginal exposure instructs the person to reimagine an anxiety-inducing event from the past.2
• Virtual reality exposure: Technology can be used to create or recreate an experience (such as driving a car) that evokes anxiety or fear.2
• Interoceptive exposure: This type of exposure therapy works to bring on internal physical sensations that are not harmful, but still create a sense of fear and anxiety. For example, purposely increasing your heart rate or inducing dizziness.2

Some types of exposure therapy may be brief in duration. Prolonged exposure therapy, on the other hand, is often used to treat PTSD and goes on over time, gradually increasing in intensity as needed.2

How Does Exposure Therapy Work for Addiction?

Exposure therapy works by gradually exposing individuals to triggers in a calm and safe environment. For people living with anxiety-based disorders, like PTSD, exposure therapy can offer a safe space to develop healthy coping mechanisms for issues that might otherwise be addressed with substance use.4

For example, during an imaginal exposure session, the patient spends 30 to 45 minutes retelling the traumatic event in detail, including thoughts, emotions, and sensory experiences. The therapist guides the patient through this process, helping them remain present with the memory rather than avoiding it. With in vivo exposure therapy, the patient and therapist may work together to practice entering safe but feared places like crowded places.4 

Before and after these exposure therapy sessions, patients typically record their level of distress and their level of cravings for substances as well. Patients eventually notice that exposing themselves to these feared situations or places in small amounts gradually decreases their fear, and they typically notice reduced cravings as distress decreases.4 The goal is for the person with co-occurring PTSD to practice utilizing healthy coping mechanisms — instead of engaging in substance use — to manage the stress associated with the trigger.

Exposure Therapy & Co-occurring Disorders

Exposure therapy can be used to treat co-occurring addiction and mental health disorders by providing the person with healthy, sustainable coping mechanisms that are easily applicable in real life.2 Exposure therapy allows the person to practice using healthy coping skills in a safe, controlled, and supportive environment.2 This can help them turn to these skills — rather than to substance use — when triggered in the real world, breaking the cycle of fear and anxiety that can lead to continued addiction.2,5

Benefits of Exposure Therapy During Addiction Treatment

Many people seeking help for addiction also live with anxiety disorders or trauma-related conditions like PTSD or OCD.2,5 Because anxiety symptoms and substance use often influence one another, treating anxiety through evidence-based methods such as exposure therapy can play an important role in supporting overall recovery.2 Exposure therapy helps individuals gradually face feared situations or memories in a safe, structured environment, reducing the need to rely on substances to manage distress.2,5

There are many benefits of using PTSD and/or OCD exposure therapy for addiction, including:2

• Changing negative associations: Exposure therapy helps weaken the fear-based associations that keep people stuck in avoidance patterns. By gradually confronting safe but difficult situations or memories without substances, individuals learn that distress and cravings naturally decrease over time.
• Improving confidence: Some people living with anxiety disorders may also struggle with self-esteem or confidence in their ability to cope, especially if they’re also experiencing substance use disorder. Exposure therapy for alcohol addiction and/or drug addiction treatment helps to show people that they can overcome their fears without substances.
• Creating a sense of power and control: Exposure therapy for drug addiction treatment shows individuals that they can safely experience and tolerate distress without avoiding it. This increased sense of control can support healthier coping choices during recovery from substance use.
• Symptom reduction over time: Many people experience long-lasting reductions in fear and anxiety after completing exposure therapy, which can lessen the emotional triggers that previously contributed to substance use.

Does Insurance Cover Exposure Therapy?

Yes, mental health treatment, including substance abuse treatment, is covered as part of the Affordable Care Act. The amount of exposure therapy and substance abuse treatment hours, and the exact amount of coverage, will depend on your individual insurance plan.6 If you’re unsure exactly what your insurance plan covers, reach out to the team at Empowered Recovery Center today to verify your benefits.

Exposure Therapy and Addiction Treatment in Kansas City

At Empowered Recovery Center in Kansas City, our team is here to help you get the treatment you need to begin your sobriety journey. When you reach out to our rehab admissions team, we’ll talk with you about our various levels of addiction treatment and help you decide which option is the right fit for you. We offer co-occurring diagnosis and treatment, as well as other types of addiction care, to meet your needs. Our exposure therapy program offers a psychodrama group to help you process your emotions with others who are living similar experiences.

We understand that learning more about paying for addiction treatment is an important part of moving forward in your recovery journey. We’ll walk you through payment options, including how to use your health insurance to cover the cost of rehab. Reach out to our team today to learn more about how we can help you get started on your sobriety journey.

References

1. Harvard Health Publishing. (July 15, 2024). Exposure therapy: What is it and how can it help? Retrieved November 9, 2025, from https://www.health.harvard.edu/mind-and-mood/exposure-therapy-what-is-it-and-how-can-it-help
2. American Psychological Association. (2017). What is exposure therapy? Retrieved November 9, 2025, from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy
3. López-González MA, Morales-Landazábal P, Topa G. (Apr 22, 2021). Psychodrama group therapy for social issues: A systematic review of controlled clinical trials. International Journal of Environmental Research and Public Health, 18 (9): 4442. Retrieved November 10, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC8122755/
4. Killeen TK, Back SE, Brady KT. (Oct 1, 2011). The use of exposure-based treatment among individuals with PTSD and co-occurring substance use disorders. Journal of Dual Diagnosis, 7 (4): 194-206. Retrieved November 10, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC3646384/
5. Smith JP, Book SW. (October 2008). Anxiety and substance use disorders: A review. Psychiatry Times, 25 (10): 19-23. Retrieved November 10, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC2904966/
6. HealthCare.gov. (n.d.). Health benefits & coverage. Retrieved November 10, 2025, from https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/