In Vivo vs In Vitro: What's the Difference?

Ever wonder about those little details that could make or break your licensure exam score? This episode dives deep into the crucial distinction between in vivo and in vitro therapeutic interventions—concepts that might seem mundane but could tip the scales in your favor come exam day.

We break down in vivo interventions, which take place in clients' natural environments where their challenges typically emerge. From the Latin meaning "alive" or "life," these approaches involve guiding clients through therapeutic processes in authentic contexts. Picture a therapist accompanying a client with agoraphobia to a Taylor Swift concert to practice coping skills amid genuine triggers, or meeting a family in their home to address actual family dynamics. The beauty of in vivo therapy lies in its immediate relevance to clients' daily experiences, allowing for direct practice with real-world challenges.

Contrasting this, we explore in vitro interventions—stemming from the Latin word for "glass-like," evoking the image of a test tube artificially containing substances. These approaches occur in controlled clinical settings using simulations, role-playing, or structured exercises. From virtual reality sessions simulating airplane travel for clients with flying phobias to role-playing job interviews in the safety of your office, in vitro methods offer a protected space for skill development before real-world application. We also cover similar techniques like imaginal exposure, systematic desensitization, and simulated exposure therapy that fall under this umbrella.

Whether you're preparing for your licensure exam or simply expanding your therapeutic toolkit, understanding these approaches enhances your ability to provide effective, context-appropriate interventions. And if you get the chance, take our advice and check out VR experiences of the International Space Station or Machu Picchu—both are pretty amazing ways to experience the power of simulated environments!

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This podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.

Chapters

• 0:00 Introduction to In Vivo vs In Vitro
• 0:29 Understanding In Vivo Interventions
• 1:39 Explaining In Vitro Approaches
• 3:12 Exam Preparation and VR Experiences

Transcript

Stacy Frost: 0:04

Hi there, we're here at Licensure Exam with the aim of offering you crucial insights that might help you gain those extra few points that might tip the scales in your favor. Today we have a not so interesting topic. That's a bit like those tires on your car they're not pretty, but you need them. Get ready to explore in vivo versus in vitro. In vivo interventions occur in the client's real world environment, where their difficulties usually occur. This approach involves therapy in settings within the client's daily life experiences, allowing for direct practice and exposure to actual triggers, stressors or challenging situations. You guide the client to practice skills in their natural environments, making the intervention highly relevant and immediately applicable to their lives. Vivo comes from the Latin meaning alive or life. So when you see the word in vivo, think it's the real thing. Here's some examples A therapist takes their client with agoraphobia to a Taylor Swift concert to practice coping strategies while experiencing real crowds and noise. Another example might be when a therapist meets with a family in their home to observe and modify actual family dynamics. And this is how you might see it in a narrative Session. Eight involved Sarah and her therapist shopping at Publix for sushi. Sarah practiced her breathing techniques while navigating crowded aisles, allowing her to immediately apply previously learned coping strategies. Question what technique is being used with Sarah? And the answer would be in vivo. You might also see techniques that are similar or the same as in vivo exposures, such as real-world exposure therapy, which is essentially identical to in vivo exposure. Both involve direct confrontation with feared situations in their natural environment rather than simulated conditions. Naturalistic exposure is another term for in vivo, emphasizing that the exposure occurs in natural, uncontrolled environments where the fear or problem behavior typically occurs. And environmental exposure therapy focuses specifically on exposing clients to ecological triggers in their actual settings, such as taking someone with contamination fears to public restrooms or someone with social anxiety to actual social gatherings. Field-based interventions is therapeutic work conducted in the field rather than in clinical settings, involving real-world practice of skills and coping strategies, and textual behavioral therapy, which you should be familiar with for the exam. That also emphasizes working within the actual context where problematic behaviors occur. The key similarity across all these approaches is that they involve therapeutic work in authentic real-world life environments rather than artificial or simulated conditions, making them essentially variations of the same core principle as in vivo exposure.

Stacy Frost: 2:55

And then there's in vitro, the root word in Latin which, unfortunately, all the boomers, linton included, had to take in high school is vitreous, meaning glass-like, so think of a test tube made of glass which artificially contains substances. In vitro interventions occur in controlled, artificial environments, typically within your office or clinical setting. These interventions use simulated conditions, role-playing or structured exercises that approximate real-world situations without the unpredictability and variables present in those kind of environments. The advantage of in vitro is that it enables careful monitoring, immediate feedback and gradual skill development in a safe and predictable environment, allowing for a smooth transition to real-world applications. For example, using virtual reality headsets VR in the therapy office to simulate being in a plane for a client who is afraid of flying would be considered in vitro. Rule playing job interview scenarios in session with you as the interviewer, to help your client practice responses and manage their anxiety.

Stacy Frost: 4:01

Here are some techniques that are very similar to in vitro interventions Imaginal exposure, where clients visualize feared scenarios while in the safety of your office, using detailed mental imagery to simulate real-world situations without actual environmental exposure. Systematic desensitization using a controlled, gradual approach, where clients practice relaxation while imagining increasingly anxiety-provoking scenarios in your office, in your office. Role-playing, which is one of my favorites, where you practice social interactions, conversations or challenging situations in group therapy, with you and other group members acting as different characters. Virtual reality therapy using VR technology in your office to create immersive but controlled simulations of feared environments. I personally like using VR, where I spend time in the International Space Station, but still haven't quite gotten the hang of moving around when there's no up or down.

Stacy Frost: 4:56

And finally, simulated exposure therapy is any form of exposure using artificial recreations of triggering situations, such as recorded sounds, videos or constructed scenarios in your office. Well, that's probably more than you wanted to know, but if either of these terms shows up on your licensing exam, you'll be better off for spending the last five minutes with me today. And if you do get a chance, check out Virol Technology visiting the International Space Station, or Machu Picchu in the mountains of Peru. Both are pretty amazing. And while you're there, remember it's in there.