--- title: "Exposure Hierarchy Builder (AI) for Anxiety and OCD" url: "https://www.ellomind.com/ai-tools-for-psychologists/exposure-hierarchy/" description: "Free exposure hierarchy builder for therapists. Create a graded fear ladder with SUDS ratings for anxiety, phobias or OCD. Works in ChatGPT, Claude or any AI assistant." --- Client materials # Exposure hierarchy builder Build a graded exposure hierarchy, a step-by-step fear ladder with SUDS ratings, for anxiety, phobias or OCD, ready to work through with your client. **For use within your clinical plan.** Exposure works best when you plan and pace it with the client. This drafts a ladder to adapt; the decisions on pacing, safety and readiness stay with you. Copy prompt Download as .md ## About this tool A good exposure ladder breaks a fear into steps small enough to face one at a time. Drafting eight to twelve well-spaced steps by hand takes time, so this tool proposes a graded hierarchy with SUDS estimates that you then adapt and pace with your client. Exposure and ERP are clinical procedures. This drafts a ladder to work from; the decisions on pacing, safety and readiness stay with you, and each step should be agreed with the client. ## How to use it 1. 1 Copy the prompt above, or download it as a file. 2. 2 Open your AI assistant (Claude, ChatGPT, Gemini, or any LLM). 3. 3 Paste the prompt, then describe the fear or the exposure target. 4. 4 Adapt the steps and pacing, and agree each step with your client before starting. ## The prompt Copy it, or download it as a file to keep or to save as a reusable prompt in your assistant. You help me build a graded exposure hierarchy for a client. You are a drafting aid for a qualified professional, not a clinician, and this supports exposure work that I plan and supervise. I will describe the fear or target, for example a specific phobia, social anxiety, or an OCD theme for ERP. Produce a fear ladder: - 8 to 12 steps from easiest to hardest, each a concrete, specific situation the client could actually do. - A SUDS estimate (0 to 100) for each step, rising gradually with no large jumps. - For OCD/ERP, frame steps as facing the trigger while resisting the compulsion, and never suggest reassurance-seeking as a step. - Keep steps realistic, safe and legal, and adaptable to the client's context. Add a one-line reminder to move at the client's pace, stay in each step until anxiety falls, and agree each step together. If the target is unclear or could involve real danger, ask me before generating. Fear or exposure target: Copy prompt Download as .md ## What it looks like Target Fear of driving on highways after a minor accident. Fear ladder Fear ladder (SUDS estimates): 1\. Sit in the parked car, engine off (15). 2\. Sit with the engine running in the driveway (25). 3\. Drive around a quiet local block (35). 4\. Drive a familiar route with a passenger (45). 5\. Drive the same route alone (55). 6\. Drive a quiet service road near the highway (65). 7\. Enter the highway for one exit, passenger present (75). 8\. One exit alone (85). 9\. Several exits in light traffic (90). 10\. A longer highway drive alone (95). Move at the client's pace, stay with each step until anxiety eases, and agree each step together. Exposure is a clinical procedure. This drafts a ladder to adapt, not a protocol to apply as is. Pacing, safety and readiness are your clinical decisions. ## Frequently asked questions What is a SUDS rating? + Subjective Units of Distress, a 0 to 100 self-rating of how anxious a situation feels. Rating each rung of the ladder helps you and the client order the steps and see progress as distress falls. Can I use this for OCD and ERP? + Yes. Describe the OCD theme and the tool frames steps as facing the trigger while resisting the compulsion, without reassurance-seeking. As with all exposure, plan and pace it within your clinical work. Is the ladder ready to use as is? + Treat it as a draft. The steps and SUDS estimates are a starting point to adapt to your client, and every step should be agreed with them and paced by you. ## More free tools for psychologists [Privacy De-identify client notes](/ai-tools-for-psychologists/de-identify-client-notes/) [Documentation Progress note (SOAP, DAP, BIRP)](/ai-tools-for-psychologists/progress-note-writer/) [Formulation Case formulation (5Ps and CBT)](/ai-tools-for-psychologists/case-formulation/) [Treatment planning Treatment plan (SMART goals)](/ai-tools-for-psychologists/treatment-plan/) [Assessment AI MSE note writer](/ai-tools-for-psychologists/mse-note-writer/) [Report writing Referral letter](/ai-tools-for-psychologists/referral-letter/) [Supervision Supervision note](/ai-tools-for-psychologists/supervision-note/) [Consent Informed consent form generator](/ai-tools-for-psychologists/informed-consent-form/) [Client materials Psychoeducation handout](/ai-tools-for-psychologists/psychoeducation-handout/) [Compliance DPDP & RCI compliance check](/ai-tools-for-psychologists/dpdp-rci-compliance-check/) [Client materials CBT thought record](/ai-tools-for-psychologists/cbt-thought-record/) [Client materials DBT skills handout](/ai-tools-for-psychologists/dbt-skills-handout/) [Client materials Behavioural activation schedule](/ai-tools-for-psychologists/behavioural-activation-schedule/) [Professional development Reflective practice log](/ai-tools-for-psychologists/reflective-practice-log/) [Practice operations Boundary & cancellation messages](/ai-tools-for-psychologists/boundary-message-templates/) [Practice operations Clinical message drafter](/ai-tools-for-psychologists/clinical-message-drafter/) A drafting aid for qualified professionals, not a diagnosis, clinical decision, or legal advice. Never paste identifiable client data into a general AI assistant. If you or someone you are with is in crisis, contact a [crisis helpline](/crisis-helpline/) right away. [Back to all tools](/ai-tools-for-psychologists/)