So you have constructed an in vivo hierarchy in collaboration with your client. You have identified a variety of exercises across a wide range of SUDs ratings that appear to target the client’s core fears. You have proactively discussed the use of safety behaviors and asked your client to refrain from using them during the in vivo exercises. You’ve specifically instructed them not to use the breathing retraining exercise they’ve been learning when they do in vivo homework.
Blog posts with the tag "Clinical Skills"
Developing the in vivo hierarchy with a client is an important step in implementing effective Prolonged Exposure (PE) treatment, but it is often given less attention by novice therapists because the more anxiety provoking and dramatic aspects of the upcoming imaginal exposure draw the focus of both the therapist and the client. However, the in vivo exposures address important avoidances in the client’s real life that may not be addressed in imaginal exposure, and are instrumental in making it possible for the client to participate fully in his or her own life.