Client compliance with exposure treatments for posttraumatic stress disorder

Clients with posttraumatic stress disorder (PTSD) do not wish to "relive" their trauma, but exposure based treatments try to ensure that they do. While such treatments have proven efficacy in controlled outcome studies, how acceptable are they in routine clinical practice? The attempted clinical application of two such exposure treatments is briefly reported here. In the first, only 1 of 14 clients completed the image habituation procedure for homework in the manner described by its authors. In the second (N = 37), only 57% complied with an audiotape exposure treatment, and compliance was related to initial symptom severity and to severity of comorbid depression. Exposure based treatments are not 'treatment of choice' for some clients.