In Vivo and Imaginal Exposure: Ongoing Sessions

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ID: 337750
2026
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Abstract
Abstract This chapter describes the ongoing implementation of imaginal and in vivo exposure across approximately nine or more treatment sessions and outlines session structure, required materials, assessment procedures, collaborative weighing, and systematic homework review to monitor eating disorder fears and behaviors. It explains that repeated imaginal exposure strengthens inhibitory learning, reduces fear, and involves structured processing using Subjective Units of Distress Scale (SUDS) data to consolidate learning and evaluate treatment progress, while exposures also function as assessment tools. The chapter also introduces the identification and focus on hot spots in imaginal exposures. Flexibility within fidelity when adapting exposure delivery or session quantity and guidance for tailoring treatment to individual client needs while maintaining core therapeutic mechanisms are emphasized. It addresses common clinical challenges, including low anxiety activation, cognitive avoidance, safety behaviors, and rumination, and clarifies conditions that optimize exposure effectiveness and explains how to identify progress. Finally, the chapter outlines homework expectations, including repeated imaginal exposure practice, in vivo exposure completion, and safety behavior reduction to work toward the client’s treatment goals.
Reference Key
openalex_W7224670329 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Cheri A. Levinson, Rachel M. Butler
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Journal Oxford University Press eBooks
Year 2026
DOI
10.1093/med-psych/9780197816875.003.0008
URL
https://doi.org/10.1093/med-psych/9780197816875.003.0008
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