Cognitive Behavioural Therapy (CBT) Bundle (312 pages)

EXPOSURE & RESPONSE PREVENTION

Now that you have created your exposure hierarchy we can start to work towards engaging in these situations, while delaying any use of safety behaviours or compulsions. Response behaviors may for example included purging, or over exercising. When ready, follow the below steps.

Identify the situation/task you want to work on today. When you have identified the task also reflect on what your normal safety behaviours/compulsions are in relation to this task.

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Now, the goal is to engage in the identified situation and task, while refraining from engaging in your safety behaviours/compulsions. The goal is to not engage in these behaviours for at least 2 hours. If there is a huge amount of distress experienced in relation to this, you can gradually increase the delay in safety behaviours/compulsions, starting at a few minutes and working your way up to 2 hours. You can also break the task in to smaller steps if needed. Practice this at least once per day. When you get to a place where the anxiety and distress is down at a manageable level, you can move on to the next item on your exposure hierarchy and start working on this. The anxiety does not need to be zero before you move on to the next item on the list, however the next task should feel manageable (while of course challenging).

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Remember that this exercise will increase your level of anxiety in the short run. This is normal and expected. It is however recommended that you utilize other strategies to help with managing thoughts and feelings while practicing the exercise. Paced breathing and thought balancing are excellent exercises to combine with exposure.