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James Pretzer October 30th, 2011 09:04 PM

Helping clients get the most out of facing their fears
In a recent mailing from New Harbinger Publications, Martin Antony and Heather Hood make some suggestions for helping anxious clients get the most out of exposure sessions (i.e. facing their fears in manageable steps):
  1. Exposure sessions should be frequent, spaced close together, and repeated. Antony and Hood suggest that exposures be practiced daily in the beginning then gradually spaced out as treatment progresses.
  2. Prolonged exposure appears to result in better outcomes than exposures of a shorter duration. We usually recommend that clients persist at least until their anxiety peaks and levels off on its own. However, Antony and Hood say that recent research suggests that a decrease in self-reported anxiety during the exposure is not necessary for long-term fear reduction. Rather, exposures should last long enough for clients to learn that the feared outcome is unlikely to occur or that they can cope with the situation if what they fear does occur.
  3. Exposures should be planned, predictable, and under the client's control. To reduce the likelihood of escape or avoidance, plan exposure practices so that the client knows what is going to happen, when it is going to happen, and how long they will remain in the situation. Clients should never be forced or tricked into any exposure that they have not agreed to. Also, the client must be in control of when the exposure ends.
  4. Set your client up for success! The pace of exposure can be gradual, beginning with less anxiety-provoking situations to encourage compliance, increase the likelihood of success, and build confidence. However, exposures should also be challenging

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