The Exposure Session Record is a structured worksheet for recording exposure exercises and reflecting on learning.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
An editable Microsoft PowerPoint version of the resource.
The Exposure Session Record is a tool for recording clients’ use of exposure. The worksheet guides clients to identify a specific fear they are willing to confront, track their responses during exposure, encourage them to repeat exposures within a session, and to consolidate their learning afterwards. The worksheet is agnostic regarding whether the therapist takes an emotional processing (habituation) or inhibitory learning approach to exposure and is equally suited to capturing the relevant information succinctly.
Exposure therapy is an effective treatment for several anxiety disorders.
Intense and persistent fears of specific objects or situations.
Intrusive, distressing thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce anxiety.
A disorder that develops after exposure to a traumatic event, involving intrusive memories and avoidance.
Recurrent, unexpected panic attacks and persistent worry about having more attacks or their consequences.
Help the client identify a specific fear or situation they are willing to confront.
Elicit and clarify predictions about the feared outcomes.
Set up a suitable environment for exposure.
Facilitate the client's exposure to the fear-inducing stimulus.
Track initial, highest, and final fear levels during exposure.
Discuss the outcome with the client to reinforce learning.
Encourage repeated exposures to consolidate learning and reduce fear.
Exposure treatments are designed to reduce fear and anxiety by asking individuals to repeatedly face their fears, by either imagining or directly confronting them while remaining psychologically engaged (Magee, Erwin & Heimberg, 2009). Exposure aims to reduce the client’s fearful responses and reverse the patterns of avoidance that perpetuate the fear (Springer & Tolin, 2020). It is one the most effective interventions for overcoming fear (Kaczkurkin & Foa, 2022; Hofmann & Smits, 2008) and is the first-line treatment for some anxiety disorders (e.g., obsessive compulsive disorder: NICE, 2005).
The change processes underlying exposure are understood in different ways (e.g., Craske, 2015; McNally, 2007; Tryon, 2005), but the stages of exposure typically follow a consistent sequence. First, the client identifies a fear-related stimulus they are willing to confront. Next, they describe what they expect will happen when they face the feared situation, often predicting negative outcomes. The client then engages in prolonged exposure to the stimulus, remaining in contact with it without using distraction or avoidance strategies. Throughout the exposure, changes in the client’s fear levels are monitored, allowing both therapist and client to observe the emotional response in real time. After the exposure ends, the client and therapist reflect on what was learned - such as whether the feared outcome occurred or whether the stimulus was as threatening as initially believed. This process is then repeated, helping the client build tolerance and reduce fear over time.
