Exposure Hierarchy Builder
Plan and track your exposures: list graded steps, set each one up, and record your anxiety before and after so you can see your fear loosen its grip over time.
About this tool
Where a fear ladder ranks the situations, the exposure hierarchy builder is for doing the work: planning each exposure, carrying it out, and tracking what happens. Exposure therapy is the most effective treatment for anxiety disorders, and its power comes from repetition and from how you record the experience, not from a single brave moment.
Each exposure has a setup. You decide the specific situation, how long you will stay, and what to do without (safety behaviors like leaving early, distracting, over-preparing, or needing a companion all blunt the learning). Then you rate your anxiety on the SUDs scale (Subjective Units of Distress, 0 to 100) right before you start. You stay in the situation, riding the anxiety rather than fighting it, and notice what actually happens. Afterward you rate your SUDs again and write down what you learned.
Two things make exposures stick. First, repeat each step several times: anxiety drops faster and lower across repetitions, and the new sense of safety generalizes. Second, focus on what you learned, not just on whether you felt calm. The most durable change comes from your brain registering that the feared outcome did not happen and that you coped even when you were anxious. Over a series of planned, recorded exposures, the before-ratings fall, the situations you avoided become ordinary, and your world opens back up.
- Abramowitz JS, Deacon BJ, Whiteside SPH. Exposure Therapy for Anxiety: Principles and Practice. 2nd ed. Guilford Press; 2019.
- Craske MG, Treanor M, Conway CC, Zbozinek T, Vervliet B. Maximizing exposure therapy: an inhibitory learning approach. Behav Res Ther. 2014;58:10-23.
Exposure Hierarchy Builder FAQ
What is an exposure hierarchy?
It is a planned set of graded steps for facing a fear, from least to most distressing. The builder helps you set up each exposure, drop safety behaviors, and track your anxiety before and after so you can see progress.
Why rate SUDs before and after?
SUDs (Subjective Units of Distress, 0 to 100) let you see that anxiety rises and then falls during an exposure, and that your before-ratings drop across repetitions. That visible decline is strong evidence the fear is loosening its grip.
What are safety behaviors and why drop them?
Safety behaviors are subtle ways of avoiding within a situation: leaving early, distracting, over-preparing, needing a companion. They feel protective but prevent your brain from learning the situation was safe, so they keep the fear alive.
How many times should I repeat each exposure?
Until the step feels routine and your before-rating has clearly dropped, often several repetitions. Spacing them out and varying the context makes the gains more durable. Then move up to the next rung.