Prolonged Exposure Therapy Worksheet

What is the theory behind this Prolonged Exposure Therapy Worksheet?

Prolonged Exposure Therapy is an intervention used in Cognitive Behavioral therapy to gradually expose individuals with Post Traumatic Stress Disorder to their trauma related cues so they gradually learn to stop reacting to them. Avoidance of these cues increases their fear and maintains their PTSD. When they gradually confront them, they realise that these cues no longer represent the presence of any threat like in the past. 

How will the worksheet help?

The worksheet will help clients with PTSD to practise imaginal exposure of their trauma memories at home. It will help them record their distress levels using the Subjective Unit of Distress Scale (SUDS) after repeatedly listening to the audio recording of their own vivid narration of the traumatic event as recorded in therapy sessions. . 

How to use the worksheet?

This Imaginal Exposure Homework worksheet is to be used at least once daily along with in-vivo exposure homework assignments. Instruct the client to rate their SUDS levels as indicated in the worksheet after listening to their audio recording. Remind them to use breathing exercises when it gets too overwhelming. 

Prolonged Exposure Therapy Worksheet

Listen to your audio recording of the traumatic event at least once daily. Remember to find a comfortable space and position. Make good use of breathing exercises to calm yourself down when it gets too overwhelming. 

In the comment section mention any relevant details about how you felt during the exercise and if you have noticed any changes in your fear and anxiety. Total time taken must include any pauses that you had to take while listening to the audio. 

DateSUDS before exposureSUDSat the highest levelSUDSafter exposureTotal timeTakenComments

Subjective Units of Distress Scale (SUDS)

100Highest distress/fear/anxiety/discomfort that you have ever felt
90 Extremely anxious/distressed
80 Very anxious/distressed, can’t concentrate
70 Quite anxious/distressed, interfering with performance
50 Moderate anxiety/distress, uncomfortable but can continue to perform
30 Mild anxiety/distress, no interference with performance
20 Minimal anxiety/distress
10 Alert and awake, concentrating well
0Totally relaxed

You can download this worksheet here.

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