Clinicians, we recommend you have experience using exposure and response prevention with minors before beginning this. If that is not available, become as familiar as possible with the process. We cover much of that on this site but additional resources are easily available.
If you are going to go through these steps without a counselor, please have an adult with you. Do NOT jump ahead until you have practiced each step enough to feel confident you can handle that step. If you get too anxious, step away and do something else. Once you feel calmer, come back to the step and practice again.
There is an older child/teen version below the child version. It has only the words and no graphics. Instead of words with blanks, the letters are scrambled on the first slide.
There are approximately 16 total word(s). We may make occasional changes to these steps and the totals can change so please consider the count as an estimate in case we forget to change the total. The first image will have some letters blanked out (or scrambled in the teen version). It may be helpful to try to guess the word(s) before revealing all the letters. That can be a ‘soft’ exposure for many people. For example, if the word is puppy, the first image may be p__py or yppup.
All exposures need repeating. This is no exception and repetition will apply to all the steps that follow. I typically ask my client what they would like to do as far as who says the word(s) first. If my client is very anxious then we might say it just once each to start. Then gradually increase the number of times. I continue the word(s) until it is apparent the child is tolerating it or the S.U.D.s (Subjective Units of Distress) number has dropped appreciably. Go to this page for an explanation of SUDs. During the intake, your client may have used certain words to describe throwing up. However, do NOT underestimate the level of anxiety that might be associated with these words, even the words your client has used.
I encourage whoever is using this for exposure to start slow. Better to have too little anxiety than too much. It is important for your client to grow in confidence through these steps. A gentle but persistent process is encouraged.
Click or tap the image and it will change to fill the page and the images will fit the device you are using. If you don’t, the images may not display correctly. This will be true of the following steps as well.
Child Version
Older Child/Teen Version
Please ignore the page numbers on the slides. They are wrong and we will edit them out eventually.
