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(p. 95) Exposure and Cognitive Restructuring: Ongoing Exposure 

(p. 95) Exposure and Cognitive Restructuring: Ongoing Exposure
(p. 95) Exposure and Cognitive Restructuring: Ongoing Exposure

Debra A. Hope

, Richard G. Heimberg

, and Cynthia L. Turk

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date: 25 February 2020

After the first in-session exposure, treatment enters a middle phase in which sessions (typically five to six in the recommended 16-session treatment program) revolve around the routine of in-session exposures and review and assignment of in vivo exposures for homework. Exposures are guided by the client’s Fear and Avoidance Hierarchy. For clients to benefit from this treatment, they must begin to engage in anxiety-provoking activities in their daily lives. It is essential that the therapist encourage this by carefully assigning and reviewing homework for in vivo exposure. At the beginning of each session, the therapist reviews the client’s completed Be Your Own Cognitive Therapist Worksheet and comments on aspects that show progress or use of cognitive restructuring skills. At a minimum, clients should engage in at least one in vivo exposure every week. As treatment progresses, this rate should increase if possible.

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