Display Patient Information Leaflets

Exposure and Habituation

Posted Friday, 11 August 2023

Date issued: June 2023

Review date: June 2025

Ref: C-534/EL/Clinical Psychology/Exposure and Habituation

All CWP interventions are based on CBT. They usually last between 6-8 sessions and progress continues after the end of intervention, especially when new ideas and skills are practised at home
The sessions can be with your child and/or you, face to face or via video and/or telephone call
Attending regular sessions is important for change

It is a suitable evidence-based intervention for young people who are experiencing mild to moderate traits of simple phobia, panic, separation anxiety and social anxiety.
It is used for children and young people who are avoiding something that causes fear e.g. going to sleep on your own, being near dogs or asking the teacher a question. The child is gradually exposed to the fearful event without avoiding or escaping from it. Anxiety symptoms reduce and they will learn that they don’t need to be scared after all.
Exposure is graded (easy to more difficult), prolonged (getting longer each time, repeated (so you get practice) and without distraction (learning that you can cope with the anxious feeling).

Learn about the “Fight, Flight and Fear” response and how it makes us avoid things that we feel scared or worried about, leading to being stuck in a “cycle of anxiety”
Learn about the difference between “safety behaviours” and “coping strategies”
Create a hierarchy or “fear ladder”, which is a step-by-step plan which encourages the young person to take small steps towards an ultimate goal eg be able to stroke a dog or join a new club
Make plans about the next step to take, which could be completed during the session or as a home task

As with all our interventions, it is really important that the child or young person practices the techniques at home. As a caregiver, it would be great if you helped facilitate these tasks
Do provide gentle (but not pressured) reminders for the young person to practice being in the situations they were avoiding e.g. stay in the park where there are dogs
Try not to accommodate or enable the unwanted behaviours, sometimes family members or carers of people with anxiety become too involved in reassurance giving or encouraging avoidance of certain activities e.g. “everything will be OK”
Normalise feelings of anxiety and model the brave behaviours that you want the young person to try. For example, with anxiety about dogs, you could talk about the dogs that you see, encourage getting closer to them or even asking the owner if you can pet the dog!
Although we understand it can be very tempting, it is important not to ‘rush’. If your child independently chooses to do more, that is fantastic!

Celebrate your young person’s attempts as well as successes, no matter how big or small
Remember it is a journey for the young person and with you beside them, they can achieve great things!

“Helping your child with fears and worries” by Creswell and Willetts
Search on YouTube for “Graded Exposure” by Dr Paul stone or “Kids book read aloud: Scaredy Squirrel” by Melanie Watt
Go to www.youngminds.org.uk >young person >mental health conditions >phobias