What is the theory behind this Hierarchy of fear worksheet?

Hierarchy of fear is constructed during exposure therapy for treatment of phobias as part of Behavior Therapy. It is a systematic list of fear inducing stimuli (E.g. Objects and situations). It works by gradually exposing clients to feared stimuli to overcome the fear.

How will the worksheet help?

This worksheet will help your clients create a hierarchy of fear by ranking different aspects of the feared stimulus from the least fearful to most fearful aspect. Exposure to the feared stimulus reduces the fear by creating familiarity and minimizing the avoidance of that stimulus.

How to use this worksheet?

Rank different aspects of the feared stimulus from the least fearful to most fearful. Think of all the steps you have to follow before completely getting exposed to the feared stimulus. Rate each step with intensity of fear towards it on a scale from 0-10. Arrange your ranking in descending order. Start with the least fearful step and rate the intensity of fear after each exposure.

Hierarchy of fear worksheet (Graded Exposure)

Sample Hierarchy

T0	Hierarchy of Fear	T1	T2	T3	T4
10	Public speaking on graduation day
9	Practice in front of family members
8	Practice your prepared speech in front of the camera
7	Ask a question during your class
6	Make a conversation with a stranger in a gathering
5	Accompany your friend/family member to a social gathering and make a conversation to an acquaintance
4	Ask any stranger about the route to a distant building
3	Ask any passerby for time
2	Go to a nearby shop and the shopkeeper a question about any product
1	Imagine a situation where you are talking in front of some people

T0: Ranking before exposure
T1: Ranking after first exposure
T2: Ranking after second exposure
T3: Ranking after third exposure
T4: Ranking after fourth exposure

Create your hierarchy

T0	Hierarchy of Fear	T1	T2	T3	T4
10
9
8
7
6
5
4
3
2
1

References

Kim, D., Bae, H., & Chon Park, Y. (2008). Validity of the subjective units of disturbance scale in Emdr. Journal of EMDR Practice and Research, 2(1), 57–62. 

Norberg, M. M., Newins, A. R., Jiang, Y., Xu, ., Forcadell, E., Alberich, C., & Deacon, B. J. (2018). The scarier the better: Maximizing exposure therapy outcomes for Spider Fear. Behavioural and Cognitive Psychotherapy, 46(6), 754–760. 

You can download this worksheet here.