When It Is Used
Use the hierarchy after assessment and before selecting ERP practice targets.
Exposure Hierarchy
Exposure Hierarchy is a collaborative planning tool for therapists and clients in OCD ERP. It helps list feared situations, thoughts, images, objects, or stimuli, rate anticipated distress or difficulty, and order targets into a graduated exposure sequence.
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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.
Manual Ordering
The practitioner can override numeric sort because sequencing may reflect readiness, context, or treatment planning, not rating alone.
Draft And Final States
Unrated targets can be saved in draft, but the hierarchy cannot be marked ready until required ratings are present.
Important Limits
The tool does not generate exposure ideas, infer readiness automatically, track SUDS during practice, or score treatment outcome.
What information does each exposure target need?
Each ready target needs at least a description and a valid distress or difficulty rating; response-prevention notes can be added when needed.
Can the therapist reorder items manually?
Yes. The therapist can manually order items so clinical sequencing remains explicit alongside ratings.
Can unrated targets be saved?
Yes. Unrated targets can remain in draft but are not included in a finalized ranked sequence.
Does the hierarchy generate exposure tasks?
No. The tool organizes client-specific targets entered by the therapist and client; it does not invent exposure content.