Cognitive-behavioural therapy: An information guide - CAMH ...

CBT approaches to behavioural change
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with beetles rates situations involving beetles—from mildly distressing
to most distressing.
Table 5. Hierarchy of feared situations: Example
FEARED SITUATION
(mildly distressing to most distressing)
DISTRESS
(10–100)
View cartoon drawing of beetles, then touch it 10
View photo of real beetles, then touch it 20
Stand in room with small beetles, walk within five feet 30
of beetles
Walk within one foot of small beetles 40
Stand in room with large beetles, walk within five feet 50
of beetles
Walk within one foot of large beetles 60
Touch small beetles with finger 70
Allow small beetles to crawl on arm 80
Touch large beetles with finger 90
Allow large beetles to crawl on arm 100
At first you will complete exposure tasks with the help of the
therapist. Later, as you progress, you will be asked to do them on
your own as homework between sessions. The rate at which you
progress in treatment will depend on the severity of your fear and
on your ability to tolerate the discomfort associated with arousing
your anxiety. Exposure tasks need to be repeated and last long
enough (usually not less than 30 minutes) to result in optimal
improvements. You learn that anxiety comes down naturally when
you remain in the fear-provoking situation long enough.