Home / Learn
How exposure hierarchies work
Eight short pieces on building a ladder that gets climbed: what belongs on a rung, how to take a 0 to 10 rating, how far apart the rungs should sit, and what to do when one of them is a wall.
What an exposure hierarchy actually is
A fear ladder is a list of things a person avoids, put in the order they can be faced. Here is what belongs on one and what does not.
Rating steps 0 to 10 without overthinking it
The 0 to 10 distress rating is the engine of an exposure hierarchy. How to take a rating that is actually useful.
Spacing the rungs: why gaps of one or two
A ladder with a five-point jump in it is not a ladder. How to find the holes and what to put in them.
When a step is too hard
What to do with a rung that has been on the plan for three weeks and has not been attempted.
How often to practise, and how long to stay
Pace, repetition and duration: the three settings that decide whether a hierarchy does anything.
Habituation, or learning something new?
The older model said wait for the anxiety to drop. The newer one says violate the prediction. Both change how you build a ladder.
The safety behaviours that hollow out a ladder
Why a rung can be completed every week for a month and change nothing.
Building a ladder with a child
What changes when the person climbing the ladder is eight, and the people holding it are a parent and a school.
Then build one
The builder asks Bia for a graded ladder for the fear you name, and you take it from there.