Avoidance & Graded Exposure

Use effective CBT strategies to overcome anxiety and avoidance

We try to avoid the situations, people, places and/or even thoughts, which are likely to distress us. This avoidance helps prevent us becoming distressed in the short-term, but it is one of the main factors which keeps the problem going over a long time. Avoidance also interferes greatly with our everyday lives.

Avoidance makes our lives much more restricted, which makes us feel even worse.

To overcome our problem, we need to overcome the avoidance.

Write down all the things (e.g. situations, people, places, tv/radio/newspapers/internet, thoughts) that you try to avoid. Once you have your list, write a number from 0-10 alongside each item, according to how distressing that item is (10 is most feared or distressing, and 0 is least feared or distressing).

Feared situation, people, places, media etc.

Distress rating 0 - 10

Now write out the list again, with the most feared or distressing item at the top of the list, and the least feared or distressing item at the bottom of the list.

Feared situation, people, places, media etc with most feared, distressing or avoided at the top.

Distress rating 0 - 10

In starting to overcome the avoidance, take the least feared or distressing item and think about how you can start to face this trigger. You might want to break it down into smaller steps. Write down what you need to do, including any steps. You could also write down reminders of your coping strategies (e.g. STOPP, breathe, positive coping statements , re-focus etc).

Feared situation

Steps I need to take to face the feared situation

Coping strategies I can use during the feared situation

Do the same process for each item on the list, repeating each step frequently and stay in the situation in spite of the anxiety (use your coping strategies to help you). Gradually and slowly work your way up from the least feared to the most feared situation.