Exposure Practice Record

When to Use

Use to document each exposure practice, capturing predictions before, what actually happened during, and what was learned after. Essential for maximising learning from exposure exercises and building an evidence base against avoidance-maintaining beliefs. Applicable in depression when avoidance of activities, social situations, or challenges is a maintaining factor.

How to Introduce

Connect to the hierarchy: 'Each time you practise a step from your hierarchy, I'd like you to record what you expected to happen, what actually happened, and what you learned. This record helps us track your progress and builds evidence for the new, more helpful perspective.'

Adaptations

For clients who find written records burdensome, use a simplified three-column format or voice notes. For those who tend to discount positive outcomes, add a column for 'how I might dismiss this evidence' to make the discounting process explicit. Pair with the pleasure-predicting experiment format for depression-specific avoidance.

Avoid if the client is completing exposures without genuine engagement, going through the motions, as the record may give a false impression of progress. Not helpful if used to judge performance rather than capture learning. Ensure the client is not using the record as a safety behaviour.

Clinical Tips

The 'what I learned' column is the most important. If the client consistently writes 'it wasn't as bad as I thought,' help them articulate the more specific learning: what does this say about their predictions, their capabilities, or their beliefs? Cumulative review of multiple exposure records provides powerful evidence against avoidance-maintaining beliefs.