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The least anxiety-provoking situations are ordered at the bottom of the hierarchy while the most anxiety-provoking situations are at the top. Exposure hierarchies typically consist of 10-15 items and will guide the client’s exposure practices. [1] An abbreviated example of an exposure hierarchy is pictured in Image 1.
Flooding, sometimes referred to as in vivo exposure therapy, is a form of behavior therapy and desensitization – or exposure therapy – based on the principles of respondent conditioning. As a psychotherapeutic technique, it is used to treat phobia and anxiety disorders including post-traumatic stress disorder .
Exposure and response prevention (also known as exposure and ritual prevention; ERP or EX/RP) is a variant of exposure therapy that is recommended by the American Academy of Child and Adolescent Psychiatry (AACAP), the American Psychiatric Association (APA), and the Mayo Clinic as first-line treatment of OCD citing that it has the richest ...
The goal of the therapy is for the individual to learn how to cope with and overcome their fear in each level of an exposure hierarchy. The process of systematic desensitization occurs in three steps. The first step is to identify the hierarchy of fears. The second step is to learn relaxation or coping techniques.
A person's belief in themselves of being able to cope increases, especially when moving up the exposure hierarchy and having confirmatory experiences of coping from the lower levels. [13] A high self-efficacy is shown to enhance the extinction of an unwanted behavior. [19]
The America’s Got Talent judge, who has a deep fear of germs associated with his OCD, recalled trying to control his family’s behavior in order to make himself more comfortable, and even built ...
The imaginal exposure typically occurs during the therapy session and consists of retelling the trauma to the therapist. For the in vivo exposure, the clinician works with the client to establish a fear and avoidance hierarchy and typically assigns exposures to these list items as homework progressively.
When OCD becomes severe, this leads to more interference in life and continues the frequency and severity of the thoughts the person sought to avoid. [21] Exposure therapy (or exposure and response prevention) is the practice of staying in an anxiety-provoking or feared situation until the distress or anxiety diminishes.