Exposure therapies are categorized as exposure-based; what is the difference between in vivo and imaginal exposure?

• A. In vivo uses real situations; imaginal uses vivid imagination to confront feared stimuli
• B. In vivo uses real situations; imaginal uses real life
• C. In vivo uses imagination; imaginal uses real life
• D. In vivo uses video simulations; imaginal uses physical practice

Answer: (A)

The main idea is that exposure-based therapies differ in how the feared stimulus is presented: real-life encounters versus imagined scenarios. In vivo exposure involves facing the real situation or object in the actual world, so the person encounters the feared stimulus directly and learns that the anxiety decreases with exposure. Imaginal exposure uses vivid imagination to confront the feared stimulus, often with therapist guidance, without a real encounter. This distinction is why the best description says in vivo uses real situations and imaginal exposure uses imagination to confront the feared stimulus.