Exposure Exercise Brainstorming WorksheetJun 24, 2013
Although it always seems easy enough when I read treatment manuals on exposure-based therapies, I’ve found in practice that it can be time consuming in session to come up with ideas for exposure-based exercises. Perhaps in part because exposure involves confronting uncomfortable experiences, even really motivated clients can have difficulty coming up with suggestions on the spot. Moreover, most exposure manuals budget for 60-120 minute sessions, whereas a practicing therapist more frequently must make do with the 45-minutes permitted by insurance companies.
Recently, a light bulb went off: Why not simply ask clients to come up with ideas for exposure exercises outside of session? Worst case scenario is that they don’t do it, and we’re back to where we started. At the very least, the assignment primes clients to think about possible exposure exercises between sessions.
For this reason, I revised a fear hierarchy worksheet I had come up with for an online exposure training I completed last year.
Because I work from an Acceptance and Commitment Therapy (ACT) perspective, I call the worksheet: Valued Living Plan. It’s written in ACT language but could be used with other approaches.
In session, I describe exposure to clients, talk about the purpose and what makes a good exposure exercise, and give them the worksheet to complete between sessions. I’m still experimenting with it but am hoping it saves valuable in-session time for other things, such as in-session in vivo or imaginal exposure.
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