Exposure Practice Form

Interactive client exposure tracking sheet

Timer: 00:00

1. Preparation Pre-Exposure Baseline

What am I afraid of? (i.e. what do I need to expose myself to?)

What do I fear will happen? (what is the worst that could happen?)

Likelihood of Feared Outcome

How likely is it that the feared outcome will happen? (1–10)

Expected Severity

How severe would it be if this happened? (1–10)

2. Exposure Practice (SUDS Graph) Subjective Units of Distress Scale (0–10)

Active Trial:

Add Data Point: min @ SUDS

| Click graph directly to plot points (0–15 min).

3. Reflection & Learning

What was the actual outcome of the exposure? What did you learn?

If you were to expose yourself again now:

Revised Likelihood

How likely is it that the feared outcome would happen? (1–10)

Revised Severity

How severe would it be if the feared outcome happened? (1–10)

Exposure Practice Form