You know the cycle. Fear triggers avoidance. Avoidance feeds the fear. Your world gets smaller while anxiety gets stronger.
Exposure therapy breaks this pattern by teaching your brain what’s actually safe. You learn that feared consequences are unlikely to come true and that your anxiety will go down naturally over time, with the overarching goal being to reduce or eliminate avoidance of objectively safe situations.
This isn’t about forcing you into terrifying situations. It’s about gradual, systematic progress with a therapist who knows exactly how to guide the process. Most people see meaningful change faster than they expected.
The Anxiety and OCD Institute brings together nationally recognized researchers, published clinicians, and advocates—many with lived experience of the conditions we treat. This combination gives us unique insight into what actually helps.
We’ve shaped international OCD treatment guidelines and written foundational books for the field. But what sets us apart in Dallas isn’t just credentials—it’s our commitment to meeting you exactly where you are, whether that’s through secure telehealth or in-person sessions.
Our approach is fully transparent about the process, fees, and what to expect. No surprises, no guesswork.
First, we’ll work together to understand what’s driving your specific fears and avoidance patterns. You’ll learn about causes of anxiety and factors maintaining it, understand how your thoughts contribute to the anxiety process while learning to respond to thoughts in a more adaptive manner, and engage in gradual and systematic exposure to situations which provoke anxiety, with treatment tailored to each client.
The exposure work starts small and builds systematically. Exposures can be conducted as imaginal, where you are asked to imagine a feared situation, in vivo, or real life exposure, and interoceptive, which involves confronting feared bodily sensations. Your therapist guides every step, adjusting the pace based on your progress.
Between sessions, you’ll practice the skills you’re learning. This isn’t homework for homework’s sake—it’s how you build confidence in real-world situations. Research consistently demonstrates that skills learned in context are more effectively retained and applied, so when you learn to manage symptoms in the actual environments where they occur, you build genuine confidence and capability that transfers seamlessly to daily life.
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Beyond traditional exposure methods, we offer innovative approaches like virtual reality exposure therapy. Research shows VRET has a large effect size versus waitlist and is an effective and equal medium for exposure therapy. This technology is particularly valuable for PTSD, social anxiety, and specific phobias.
Dallas residents benefit from both virtual and in-person treatment options. Treatment is available wherever you need it most, whether in your home, in school, or out in the community. Our team includes specialists in prolonged exposure for PTSD, social anxiety treatment, and specialized phobia interventions.
We also offer intensive four-day treatment programs for those who need more concentrated intervention. This accelerated approach can be especially helpful when weekly sessions haven’t provided the breakthrough you need.
Most people see significant reduction in fear or anxiety relatively quickly, ranging from just a few sessions to 10 sessions, with phobias typically treated within 5 to 10 sessions of exposure-based therapy on average. However, the timeline varies based on the complexity of your specific situation and how long avoidance patterns have been in place.
For OCD, the recommended dose for Exposure and Response Prevention is 17 to 20 sessions, with sessions typically lasting 60 to 120 minutes and held once or twice weekly. Your therapist will give you a clearer picture after the initial assessment, but many people notice changes in their anxiety responses within the first few weeks of consistent exposure work.
Research shows virtual reality exposure therapy has a large effect size versus waitlist and a medium to large effect size versus psychological placebo conditions, with no significant difference between VRET and in vivo conditions. Studies suggest that VRET may be as effective as active comparators for PTSD patients.
VR offers unique advantages: complete control over exposure intensity, the ability to repeat scenarios exactly, and access to situations that might be difficult to create in real life. Therapists can control different aspects of the patient’s experience during exposure, thus permitting gradual, repeatable, individualized exposure while minimizing the risk of patient distress and maximizing the chance of patient success. It’s particularly effective for PTSD, social anxiety, and specific phobias.
Exposure therapy is a type of CBT that is the most effective for anxiety and obsessive-compulsive related disorders and is often referred to as the “gold-standard” of psychological treatments for these issues. Unlike traditional talk therapy that focuses mainly on discussing problems, exposure therapy involves actively confronting feared situations in a controlled, gradual way.
Research indicates that Exposure and Response Prevention (ERP) is the best treatment for OCD, over and above medication, working by changing responses to intrusive thoughts and the behaviors that maintain anxiety over time. The key difference is that you’re not just talking about your fears—you’re systematically learning that they’re manageable through direct experience.
Yes, exposure therapy principles can address multiple anxiety conditions simultaneously, especially when they share common avoidance patterns. New trials have compared VRET to diverse anxiety and related disorders including social anxiety disorder, posttraumatic stress disorder, and panic disorder, with studies testing VRET for specific phobias, social anxiety, PTSD, and panic disorder.
Our team is trained to work with complex presentations where someone might have OCD alongside social anxiety, or PTSD with specific phobias. We customize the treatment approach based on your specific combination of symptoms and how they interact with each other. This comprehensive approach often leads to broader improvements across multiple areas of anxiety.
In the first two sessions, we gather information and provide an explanation of PTSD, common reactions to trauma, treatment rationale, and teach a breathing retraining technique. You won’t be thrown into intense exposure work immediately—the initial sessions focus on understanding your specific fears, triggers, and avoidance patterns.
Your therapist will explain how exposure therapy works, address any concerns you have about the process, and begin building a hierarchy of feared situations from least to most anxiety-provoking. Treatment is tailored to each client, with their specific type of anxiety and their own experiences influencing the content of each component of treatment. You’ll also learn coping skills and relaxation techniques that will support you throughout the exposure work.
When OCD disrupts your relationships, work, or daily routine, you need more than standard therapy—you need focused care, as Intensive Outpatient Treatment provides a format for expedited symptom reduction that is not available in weekly therapy visits. Consider intensive treatment if weekly therapy hasn’t provided the progress you need after several months.
Signs you might benefit from intensive exposure therapy include: significant withdrawal from normal activities, inability to work or attend school regularly, family relationships strained by accommodation of your anxiety, or when avoidance has become so extensive that it controls most of your daily decisions. Our fourteen-day, 37-hour intensive program offers a customized treatment plan that adapts to your home, your triggers, and your daily patterns, functioning as an advanced IOP that delivers high-impact care designed to create lasting behavioral change.
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