User:Ana L. Cortez/sandbox/exposureh

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In exposure therapy, an exposure hierarchy is a graded list of stimuli that will generate an escalating level of arousal, for the purpose of producing habituation.

Creating an exposure hierarchy is one of the first steps taken for treating anxiety disorders and phobias, in exposure therapy. The hierarchy may be created in advance of a session of exposure (a static hierarchy) or may arise extempore during the session in response to developments (a dynamic hierarchy). It is not yet known which, if either, of these methods produces the better outcome. Either way, the client and clinician collaborate to create an individualized list according to the situation or stimuli that causes the most fear and avoidance to situation/ stimuli that causes the least.

Exposure hierarchies can list various situations or stimuli that causes anxiety or can be narrowed to a specific anxiety disorder. For example, an exposure hierarchy that involves a particular anxiety disorder, like social anxiety disorder, can include situations such as: asking a stranger for directions, ordering food in a restaurant, and so on. This instrument is useful for both the clinician and client because it highlights the areas that need the most attention; mainly because they are unique to the client. Clinicians can also refer back to this list to record the process made during and after treatment. Additionally, exposure hierarchies can be rated by using the Subjective Units of Distress Scale.

Exposure hierarchy also resembles a ladder, clients go up step by step until they reach the situation that is considered as the most distressing. Each step on this graded list has specific tasks that a client must complete in order to move on to the next. These specific tasks are determined by the clinician, whom considers the severity of the client's anxiety and fear.