Exposures
What is the goal of exposure therapy?
Face your fears in order to gain back your life
What are Safety Behaviors?
Any behavior to reduce, escape, or neutralize anxiety
(e.g., avoidance, reassurance, checking, distraction, fleeing, fixing, etc.)
What is Response Prevention?
What to do instead of engaging in Safety Behaviors
Ways to prevent typical response from occurring
What’s the difference between a Lapse and Relapse?
Lapses are a temporary return to pre-treatment behaviors.
Relapses are more long-term and severe regression of pre-treatment behaviors.
How do BAs interrupt the cycle of depression?
Depression > Inactivity > Depression > Inactivity...
Give an example of an exposure task for you.
Exposure Task
What should you do instead of using Safety Behaviors?
Engage in Response Prevention // Following RP Guidelines
Name one way to limit the use of safety behaviors.
Delay
Opposite Action
Reduce
Alternative Action
Act despite feelings
Name three aspects of good sleep hygiene
Maintain a regular sleep schedule
If you can't sleep, get out of bed and complete boring tasks
Move phone away from head/pillow
Wait until you are sleepy before going to bed
Avoid caffeine after lunch, avoid alcohol and nicotine
Use sleeping pills cautiously
Exercise regularly
Associate bedrooms with sleep (avoid other activities)
Give two examples of BAs you are working on
Name Two BAs
Name one reason why you could end an exposure
Habituated to fear / SUDS has dropped naturally
Ah-ha! moment / New learning
Give a specific example of your most common safety behavior.
Example of SBs
What’s the purpose of the Response Prevention loop?
Interrupt mental compulsions
(Reduction in anxiety is an added benefit, but not guaranteed)
What’s the difference between reassurance seeking and information seeking?
An information-seeker asks questions once to be informed, accepts qualified answers, consults experts, seeks truth, and gathers only necessary information to make decisions.
A reassurance-seeker repeatedly asks questions to feel less anxious, challenges or repeats answers, consults unqualified people, seeks specific answers, demands certainty, and endlessly seeks information without deciding.
Choose a 5-minute active behavioral activation task for everyone to complete right now!
BA Task
Why is it important to stay in the feared situation during exposures?
Break the cycle of avoidance / anxiety
(Leaving early reinforces that it is dangerous)
What do you reinforce if you use safety behaviors while doing an exposure?
Anxiety / Feared situation is truly dangerous.
Cannot handle hard things.
Have to use SBs to cope.
Cannot tolerate discomfort or anxiety.
Give a specific example of your most difficult response prevention guideline to follow.
Most Difficult RPG
Name 3 qualities of a good Worst Case Scenario
Vivid and visual
Without Safety Behaviors
Provokes anxiety
1-2 pages long
Write new worry script daily
What are the two big categories of activities?
Pleasure and Mastery Activities
What’s the difference between in-vivo, imaginal, and interoceptive exposures?
In-Vivo: Direct confrontation with feared object, situation, or activity in real life
Imaginal: Mentally confronting feared thoughts, images, or memories by vividly imagining them
Interoceptive: Target physically sensations of anxiety or panic through exercises
Everyone name their most difficult-to-break Safety Behavior
Safety Behavior
Name a skill that we do not recommend to use for coping with OCD / Anxiety
Relaxation techniques (deep breathing, progressive muscle relaxation, etc.)
Grounding exercises
Thought stopping (stop or suppress intrusive thoughts)
Distraction
What’s the difference between an Intrusion Loop and Response Prevention Loop?
Intrusion Loop:
Naturally occuring intrusive thoughts to provoke anxiety
Response Prevention Loop:
Only purpose is to interrupt mental compulsions (sometimes it brings down anxiety, but that is not the intent!)
Made up of two parts: Statement of uncertainty, and statement of self-efficacy
Finish this phrase:
A__ D______ F_______!
ACT DESPITE FEELINGS!!