Creating an Exposure Hierarchy - Therapist Aid
Creating an Exposure Hierarchy
Reminders of trauma can trigger uncomfortable emotions, painful memories, and debilitating symptoms. It's normal to want to avoid these reactions. Over time, however, avoidance causes these reactions to worsen. Exposure is a technique to combat avoidance. During exposure, you'll purposefully face trauma reminders in a safe and controlled way.
Talk about my trauma
Example Exposure Activities
Go to the location of my trauma
Go somewhere that reminds me of my
trauma
Participate in an activity that reminds
me of my trauma
Hold an object that reminds me of my
trauma
Watch a TV show or movie that reminds me of my trauma
Read a book related to my trauma
Listen to music that reminds me of my
trauma
Write the story of my Mentally review the Draw or paint trauma
trauma
story of my trauma
reminders
Prepare food that reminds me of my
trauma
Play a video game that reminds me of
my trauma
Listen to someone talk about a similar
trauma
Wear something that reminds me of my trauma
Look at appropriate images that remind
me of my trauma
Qualities of Good Exposure Activities
Safe. While activities will be uncomfortable for you, they should never be unsafe.
Controllable. Activities should not depend on other people or events. For example, "be approached by a stranger" or "watch news about a hurricane near me" are not within your control.
Specific. The activity "walk a dog" is too vague. What dog will you walk? Where? A better activity would be "ask my neighbors to walk their dog for 30 minutes in our neighborhood."
Repeatable. Ensure you'll be able to do each activity at least four times.
Tip: Include activities with a range of distress ratings. You'll work your way up from those with lower ratings to those with higher ratings.
? 2019 Therapist Aid LLC
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Exposure Hierarchy
An exposure hierarchy is a tool to rank trauma reminders that cause you distress, and that you typically avoid. You'll create your hierarchy by ranking situations from least to most distressing on a scale of 0-100, where 0 is "no distress at all" and 100 is "the most distress imaginable."
Example Activity Read three news articles about car accidents.
Distress Rating
25
For 30 minutes, listen to the music that was playing during my car accident.
60
Drive on the road where I had my car accident.
100
Activity
Distress Rating
? 2019 Therapist Aid LLC
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