Praxical.Psych
Planning

Exposure hierarchy and log

Build a graded list of feared situations and record what actually happens on exposure.

Anxiety, OCD, PTSD and phobia treatment, from the first exposure session onward.7 fieldsExposure TherapiesBehavior TherapiesCognitive Therapy

How this document is used well

Contemporary exposure practice has moved away from habituation within a session as the criterion of success. Inhibitory learning theory holds that the mechanism is the development of a new, competing association — "this was not as dangerous as I predicted, and I could tolerate it" — rather than the extinction of the old one. That changes what you optimise for.

Old habituation modelInhibitory learning model
Stay until anxiety halvesStay until the prediction has been tested
Strictly graded ascentVariable and shuffled difficulty strengthens learning
Avoid all distress spikesSome distress is necessary; the goal is tolerance, not comfort
Safety behaviours faded lateDropped early — they block the disconfirmation
Single-context practiceDeliberately multiple contexts, to reduce renewal of fear

Complete it

Nothing you type leaves this browser. Do not enter real patient information.

Shows why each item is asked
Setting up
Rationale explained and agreed?*

Exposure without a rationale the patient accepts is experienced as cruelty and predicts dropout.

Hierarchy
Hierarchy items

Aim for 10–15 items spanning the full range.

Exposure log
Completed exposures

3 required fields outstanding: The feared outcome, stated precisely; Safety behaviours to be dropped; Rationale explained and agreed?

Educational use only

Praxical.Psych is a teaching tool. It is not medical, clinical, psychological or legal advice, not a diagnosis, not treatment, not supervision, and not a credential. Nothing here creates a clinician–patient or solicitor–client relationship. Every patient, case, transcript and simulated session is fictional. Clinical and legal requirements vary by jurisdiction and change over time — verify anything that bears on a real decision against your own regulator, statute and current professional guidance, and consult a qualified professional.

Do not enter real patient information. If you or someone else is in crisis: US & Canada 988 · UK & Ireland 116 123 · Australia 13 11 14 · elsewhere findahelpline.com · immediate danger, your local emergency number.

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Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
  • Praxical.Psych is not therapy, not a substitute for supervision, and not a credential. Competence to practise comes from training, supervised hours and licensure.
  • Scores from the instruments here are for learning how they behave. They are not a diagnosis and not a risk assessment, and must not inform a decision about a real person.
  • Do not enter real patient information. Everything you type stays in this browser, but that is not the same as a compliant clinical record system.
If you are in crisis

In the US and Canada, call or text 988. In the UK and Ireland, call 116 123 (Samaritans). Elsewhere, find a local line at findahelpline.com. In immediate danger, use your local emergency number.

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