A step-by-step behavioral technique for reducing fear and avoidance. The client builds a hierarchy of feared situations, starts with manageable steps, enters the situation without usual avoidance or safety behaviors, and stays long enough to learn that anxiety can rise and fall.
Step-by-step guide
- Identify avoided situations.
- Build an exposure hierarchy from 0 to 100 anxiety.
- Choose a moderately difficult but doable item.
- Define safety behaviors to reduce or drop.
- Enter the situation and stay until learning occurs.
- Record anxiety before, during and after.
- Repeat and move gradually up the hierarchy.
When to use
- Specific phobias
- Social anxiety
- Agoraphobia
- Avoidance after panic
- OCD and PTSD when protocol-appropriate
Key phrases
Avoidance teaches the brain that the situation is dangerous. We will approach it in steps so the brain can learn something new.
Follow-up questions
What would be a 40 out of 100 step?
What safety behavior usually keeps the fear alive?
What did you learn after staying in the situation?
Alternative phrasings
The goal is not zero anxiety. The goal is new learning.
We go gradually, but we do go toward the fear.
Warnings
- ⚠️ Do not force exposure without consent.
- ⚠️ Avoid steps that are too large early on.
- ⚠️ Track safety behaviors; otherwise exposure may not work.
- ⚠️ Use trauma-specific protocols for PTSD.
Source: Wolpe, 1958; Foa & Kozak, 1986
Materials are informational and educational and summarize publicly available scientific sources. They are not medical or psychological advice, are not intended for self-diagnosis or self-treatment, and do not replace consultation with a qualified professional.