Introduction & Theoretical Background
[The fear ladder] has long been a standard tool in cognitive behavior therapy (CBT) and considered to be an integral component of any exposure-based treatment.
(Katerelos et al., 2008)
Exposure treatments are designed to reduce fear and anxiety by asking individuals to repeatedly face their fears, by either imagining or directly confronting them while remaining psychologically engaged (Magee, Erwin & Heimberg, 2009). Exposure aims to reduce the client’s fearful responses and reverse the patterns of avoidance that perpetuate the fear (Springer & Tolin, 2020). It is one the most effective interventions for overcoming fear (Kaczkurkin & Foa, 2022; Hofmann & Smits, 2008), and is the first-line treatment for some anxiety disorders (e.g., obsessive compulsive disorder: NICE, 2005).
Exposure-based interventions have been incorporated into several therapies, most notably cognitive behavioral therapy (CBT), and can take several forms.
- In-vivo exposure: The client confronts their fear in real life. These fears may include objects, situations, bodily sensations (‘interoceptive exposure’), and