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Exposure Session Record

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.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

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Languages this resource is available in

  • Arabic
  • English (GB)
  • English (US)
  • French
  • Italian
  • Spanish (International)
  • Turkish

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Introduction & Theoretical Background

Exposure methods share the common feature of confrontation with frightening, yet realistically safe, stimuli.

(Rothbaum & Schwartz, 2002)

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). Exposure-based interventions have been incorporated into several therapies, most notably cognitive behavioral therapy (CBT), and can take several forms.

  • In-vivo exposure: The client confronts their fear in real life. These fears may include objects, situations, bodily sensations (‘interoceptive

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Therapist Guidance

“We’ve talked about how exposure can help people overcome their fears and what it involves. I’m glad you’re willing to try it for yourself. Remember that exposure works best when it is graded, prolonged, repeated, and without distraction. Have you ever seen a bodybuilder strengthen a muscle? When they do a session in the gym they will work out a particular muscle group with many repetitions (reps) of an exercise. They’ll stop when the muscle is tired. Exposure is like working out a muscle – instead of a session in the gym you’ll do a session of facing your feared situation, and within that session you’ll do multiple reps until you habituate and your fear has reduced. Before we start your exposure, I’d like to show you an Exposure Session Record. We can use this tool to develop exposure exercises that will help you face your fears and monitor what

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References And Further Reading

  • Craske, M. (2015). Optimizing exposure therapy for anxiety disorders: an inhibitory learning and inhibitory regulation approach. Verhaltenstherapie, 25, 134-143. DOI: 10.1159/000381574.
  • Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69, 621-632. DOI: 10.4088/JCP.v69n0415
  • Marks, I. M. (1972). Perspective on flooding. Seminars in Psychiatry, 4, 129–138.
  • Marks, I. M. (1975). Behavioral treatments of phobic and obsessive-compulsive disorders: A critical appraisal. Progress in Behavior Modification, 1, 65–158. DOI: 10.1016/B978-0-12-535601-5.50010-X.
  • McNally, R. J. (2007). Mechanisms of exposure therapy: how neuroscience can improve psychological treatments for anxiety disorders. Clinical Psychology Review, 27, 750-759. DOI: 10.1016/j.cpr.2007.01.003.
  • National Institute for Clinical Excellence (2005). Obsessive-compulsive disorder and body dysmorphic disorder: Treatment. Clinical Guideline [CG31].
  • Rothbaum, B. O., & Schwartz, A. C. (2002). Exposure therapy for posttraumatic stress disorder. American Journal of Psychotherapy, 56, 59-75. DOI: 10.1176/appi.psychotherapy.2002.56.1.59
  • Springer, K. S., &

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