Published in Journal of Traumatic Stress, this study highlights the importance of emotional processing in prolonged exposure therapy. Processing follows imaginal exposure (where the client recounts a detailed account of a past traumatic event) and enables a client to make meaning of the event and gain improved perspective. Key study findings were that client engagement during imaginal exposure was not related to symptom ratings, but client shifts in perspective during processing were correlated with next-session PTSD and depression symptoms, with a higher level of processing predicting lower next-session PTSD severity. This highlights the importance of processing and suggests that belief change during processing after imaginal exposure is a key mechanism of change in prolonged exposure therapy.
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