Ordering And Clinical Review
The system can sort by rating, but the practitioner can confirm sequence collaboratively when clinical sequencing differs from numeric order.
Avoidance Hierarchy
The Avoidance Hierarchy is a CBT/ERP worksheet for practitioners planning graded exposure with a client. It helps the practitioner and client list feared or avoided places, situations, or stimuli, rate anticipated distress, and order items from least to most challenging.
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Tool guide
Learn more about this tool
Use this background section to understand when the tool fits, how practitioners use it, and what to consider before sharing it with clients.
What It Does Not Track
The hierarchy does not record exposure completion, actual distress during exposure, response-prevention adherence, or treatment progress.
Is this an exposure log?
No. It is a planning worksheet for ranking avoided situations before exposure work.
Can items have the same rating?
Yes. Ties can remain visible, and the practitioner can confirm the sequence collaboratively.
What happens to items without ratings?
Items without ratings remain draft or unranked until a distress rating is added.
Does the hierarchy generate exposure instructions?
No. It organizes avoided situations into a ladder; the practitioner decides how to use it in treatment.