Purpose π―
Help clients track both distress and willingness during ERP so treatment does not become solely focused on anxiety reduction.
Letβs Talk About It π£οΈ
During an ERP exercise, track both:
- Distress: βHow uncomfortable is this?β
- Willingness: βHow willing are you to allow the discomfort without performing the ritual?β
Discuss:
- What happened to distress over time?
- What happened to willingness over time?
- What did the client learn about allowing discomfort?
- What response prevention skill was practiced?
Ask:
- Can discomfort be present while you still choose not to ritualize?
- What helped you stay willing?
- What did OCD predict would happen?
If the Conversation Gets Stuck π‘
- Are we trying to make anxiety disappear, or practicing a different response?
- What would willingness look like for the next minute?
- What value makes this practice worth doing?
Telehealth / Whiteboard Version βοΈ
Create a two-line tracking chart for SUDS and willingness. Mark ratings at the beginning, middle, and end of the exercise.
Why This Works π±
Tracking willingness helps clients practice acceptance of uncertainty and discomfort rather than measuring success only by reduced anxiety.
Clinical Pearl π§
A successful ERP exercise is not defined only by lower distress. Success can include approaching the trigger, allowing uncertainty, and preventing rituals.
Documentation Language π
Therapist utilized SUDS and willingness tracking during ERP to help client monitor distress, practice willingness, and strengthen response prevention skills without relying solely on anxiety reduction.
Clinical Focus: ERP Tracking, Willingness, Distress Tolerance