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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.
For decades exposure was explained by habituation: stay in the situation, the anxiety curve peaks and falls, repeat until the peak stops arriving. That model built the ladder we still use, and the instruction to stay until distress halves comes straight from it.
What changed
Work on inhibitory learning, associated with Michelle Craske and colleagues, argued that the old fear association is never really erased. What exposure builds is a new, competing learning: I expected the worst, the worst did not happen, and I could handle what did. On that account, within-session anxiety reduction turns out to predict long-term outcome surprisingly poorly.
What it changes about a ladder
First, the useful question before a rung is not "how anxious will I be" but "what exactly do I expect to happen?", specific enough to be wrong. Afterwards, the question is whether it happened.
Second, variety beats a tidy sequence. Practising the same rung in different places, at different times, in a different order, produces learning that transfers better than a clean climb through a fixed list.
Third, tolerating the fear rather than waiting for it to disappear is an acceptable, sometimes preferable, endpoint for a practice.
In practice, build the ladder either way
The two models disagree about mechanism far more than they disagree about what to do on a Tuesday evening. Graded, repeated, deliberate contact with what is avoided, without the safety behaviours, is the intervention in both. The ladder is still the tool.
Build the ladder
Name the fear and Bia suggests the rungs. Free, and nothing about you is sent.