Baseer Maroof, LCSW · Raleigh, NC · Adults 21+
Exposure ladder builder
The single most useful skill for anxiety, in a tool. Plan your steps, write the prediction, test it, log what happened.
In short
- Exposure means facing what you fear on purpose, in planned steps, without your safety behaviours.
- A ladder lists those steps from easier to hardest, each rated 0–100 for how anxious it would make you (SUDS).
- Before each step, write what you fear will happen. Afterwards, check it. That gap between prediction and reality is what changes the fear.
- It’s best done with a therapist, especially for panic and trauma. This tool is for planning and logging.
Build your ladder
Exposure ladder builder
Your ladder saves on this device only. Nothing is sent anywhere.
Add a step
Or start from an example:
How to use it
Rate with SUDS
SUDS stands for Subjective Units of Distress: 0 is completely calm, 100 is the worst anxiety you can imagine. Rough numbers are fine. Aim for 6–10 steps spread from about 20 to 90.
Start where it’s hard but doable
Usually somewhere around 30–50. Too easy and nothing gets tested; too hard and you’re more likely to bail out early.
Before: write the prediction
Specific and checkable. “I’ll panic” is vague. “I’ll panic so badly I’ll have to leave the store within 5 minutes” can be tested.
During: drop the crutches
No water bottle, no rehearsed script, no standing by the door, no checking your phone. If you can’t drop them all at once, drop one per round.
After: compare and log
Did the feared thing happen? How bad was it really? What did you learn? Tap Do it on a step to log a practice.
Repeat, then mix it up
Do each step several times, in different places and on different days. You don’t have to go strictly bottom to top; mixing in harder steps can make the learning stronger. (Craske 2014)
What makes it work
From the inhibitory learning research on exposure.
Expectancy violation
Design each step to test a specific prediction as directly as possible. The bigger the surprise (“I was sure I’d faint and I didn’t”), the more the learning sticks. (Craske 2014)
Calm is not the goal
Fear going down during a session doesn’t reliably predict long-term results. Staying until you’ve learned something does. (Craske 2014)
Remove safety signals
Safety behaviours and “just in case” items let you credit them for getting through, instead of yourself.
Variability and context
Practise in different places, times and moods. Fear learned in one place can return in another; varied practice protects against that.
Deepened extinction
Combining feared cues once each has been practised alone (for example, a crowded store and a racing heart) strengthens the new learning.
Affect labelling
Naming what you feel during exposure (“I notice I’m scared, my chest is tight”) is one of the strategies the research team suggests.
Sources
All sources, linked3 references⌄
- Craske MG, Treanor M, Conway CC, Zbozinek T, Vervliet B (2014). Maximizing exposure therapy: an inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23. pmc.ncbi.nlm.nih.gov/articles/PMC4114726/
- Wolitzky-Taylor KB et al. (2008). Psychological approaches in the treatment of specific phobias: a meta-analysis. Clinical Psychology Review, 28(6), 1021–1037. pubmed.ncbi.nlm.nih.gov/18410984/
- Carpenter JK et al. (2018). Cognitive behavioral therapy for anxiety and related disorders: a meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 35(6), 502–514. pmc.ncbi.nlm.nih.gov/articles/PMC5992015/
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