The Facing Your Fear exercise helps children and young people organize feared situations into a ladder, facilitating a structured approach to exposure therapy.
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.
Graded or graduated exposure is a traditional way of overcoming fears and phobias. The therapist helps the client to draw up a list of feared situations which are then faced in order of increasing difficulty. Graded exposure is helpful because its simple rationale tends to make it acceptable to clients leading to greater adherence. This exercise has been designed specifically for children and young people.
This resource helps therapists guide children and young people through exposure therapy effectively.
Provides a roadmap for addressing fear-inducing stimuli like animals or heights.
Helps break down and prioritise obsessions for step-by-step exposure.
Facilitates exposure to feared social situations.
Determine the specific fear the client wishes to overcome.
Develop a comprehensive list of feared stimuli.
Order the list of stimuli.
Use the ladder to guide exposure sessions.
Use the stars to positively reinforce progress at each stage.
Graded or graduated exposure is a traditional way of overcoming fears and phobias. The therapist helps the client to draw up a list of feared situations which are then faced in order of increasing difficulty. The traditional ‘rule’ for exposure was that the client was to be encouraged to remain in the feared situation until fear had habituated to some degree (often by about 50%). Graded exposure is helpful because its simple rationale tends to make it acceptable to clients leading to greater adherence. Graded exposure builds upon success: therapists can build upon positive feelings associated with successfully overcoming fears lower down the hierarchy.
Clinicians should note that modern approaches to exposure have de-emphasized the importance of hierarchies in favour of exposure schedules including tasks which violate the client’s expectancies, or which increase the variability of the exposure (Craske et al, 2014). For example, as an alternative to a traditional exposure setup a behavioral experiment may be conducted where the client expresses the belief “If I go near the spider it will jump on my face” and then tests that prediction. Varying the stimuli, durations, intensity, times, and contexts of exposure has also been demonstrated to increase the effectiveness of exposure and should be considered if clients are willing.
