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

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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.

Episode Transcript

Stacy Frost (00:00):
Hi there, we're here at Licensure Exam with the
aim of offering you crucialinsights that might help you
gain those extra few points thatmight tip the scales in your
favor.
Today we have a not sointeresting topic.
That's a bit like those tireson your car they're not pretty,
but you need them.
Get ready to explore in vivoversus in vitro.

(00:20):
In vivo interventions occur inthe client's real world
environment, where theirdifficulties usually occur.
This approach involves therapyin settings within the client's
daily life experiences, allowingfor direct practice and
exposure to actual triggers,stressors or challenging
situations.
You guide the client topractice skills in their natural

(00:41):
environments, making theintervention highly relevant and
immediately applicable to theirlives.
Vivo comes from the Latinmeaning alive or life.
So when you see the word invivo, think it's the real thing.
Here's some examples Atherapist takes their client
with agoraphobia to a TaylorSwift concert to practice coping
strategies while experiencingreal crowds and noise.

(01:03):
Another example might be when atherapist meets with a family
in their home to observe andmodify actual family dynamics.
And this is how you might seeit in a narrative Session.
Eight involved Sarah and hertherapist shopping at Publix for
sushi.
Sarah practiced her breathingtechniques while navigating
crowded aisles, allowing her toimmediately apply previously

(01:25):
learned coping strategies.
Question what technique isbeing used with Sarah?
And the answer would be in vivo.
You might also see techniquesthat are similar or the same as
in vivo exposures, such asreal-world exposure therapy,
which is essentially identicalto in vivo exposure.
Both involve directconfrontation with feared

(01:46):
situations in their naturalenvironment rather than
simulated conditions.
Naturalistic exposure isanother term for in vivo,
emphasizing that the exposureoccurs in natural, uncontrolled
environments where the fear orproblem behavior typically
occurs.
And environmental exposuretherapy focuses specifically on
exposing clients to ecologicaltriggers in their actual

(02:08):
settings, such as taking someonewith contamination fears to
public restrooms or someone withsocial anxiety to actual social
gatherings.
Field-based interventions istherapeutic work conducted in
the field rather than inclinical settings, involving
real-world practice of skillsand coping strategies, and

(02:31):
textual behavioral therapy,which you should be familiar
with for the exam.
That also emphasizes workingwithin the actual context where
problematic behaviors occur.
The key similarity across allthese approaches is that they
involve therapeutic work inauthentic real-world life
environments rather thanartificial or simulated
conditions, making themessentially variations of the
same core principle as in vivoexposure.
And then there's in vitro, theroot word in Latin which,

(02:54):
unfortunately, all the boomers,linton included, had to take in
high school is vitreous, meaningglass-like, so think of a test
tube made of glass whichartificially contains substances
.
In vitro interventions occur incontrolled, artificial
environments, typically withinyour office or clinical setting.
These interventions usesimulated conditions,
role-playing or structuredexercises that approximate

(03:17):
real-world situations withoutthe unpredictability and
variables present in those kindof environments.
The advantage of in vitro isthat it enables careful
monitoring, immediate feedbackand gradual skill development in
a safe and predictableenvironment, allowing for a
smooth transition to real-worldapplications.
For example, using virtualreality headsets VR in the

(03:39):
therapy office to simulate beingin a plane for a client who is
afraid of flying would beconsidered in vitro.
Rule playing job interviewscenarios in session with you as
the interviewer, to help yourclient practice responses and
manage their anxiety.
Here are some techniques thatare very similar to in vitro
interventions Imaginal exposure,where clients visualize feared

(04:03):
scenarios while in the safety ofyour office, using detailed
mental imagery to simulatereal-world situations without
actual environmental exposure.
Systematic desensitizationusing a controlled, gradual
approach, where clients practicerelaxation while imagining
increasingly anxiety-provokingscenarios in your office, in
your office.
Role-playing, which is one ofmy favorites, where you practice

(04:25):
social interactions,conversations or challenging
situations in group therapy,with you and other group members
acting as different characters.
Virtual reality therapy usingVR technology in your office to
create immersive but controlledsimulations of feared
environments.
I personally like using VR,where I spend time in the
International Space Station, butstill haven't quite gotten the

(04:47):
hang of moving around whenthere's no up or down.
And finally, simulated exposuretherapy is any form of exposure
using artificial recreations oftriggering situations, such as
recorded sounds, videos orconstructed scenarios in your
office.
Well, that's probably more thanyou wanted to know, but if
either of these terms shows upon your licensing exam, you'll

(05:10):
be better off for spending thelast five minutes with me today.
And if you do get a chance,check out Virol Technology
visiting the International SpaceStation, or Machu Picchu in the
mountains of Peru.
Both are pretty amazing.
And while you're there,remember it's in there.