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Creating an Exposure Hierarchy

Triggers for anxiety and trauma can ignite uncomfortable emotions, painful memories, and other debilitating symptoms. Avoiding these triggers is a normal—but often harmful—response. Avoidance may give relief from the most acute symptoms of anxiety and trauma, but cause these same symptoms to worsen over time.

Using exposure therapy, clients face their triggers in a safe way. The Creating an Exposure Hierarchy worksheet will guide clients through the planning stages of this intervention using education, examples, and hands-on practice.

Before presenting this worksheet to your client, be sure to discuss the relationship between trauma, avoidance, and exposure. Because exposure therapy can seem daunting, it is important that clients understand the rationale for its use.

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1. Foa, E. B., Hembree, E., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences, Therapist Guide (Treatments that work). New York: Oxford University Press.

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