Don't do most difficult exposure first

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A key component of Exposure and Response Prevention (ExRP) therapy is gradual and intentional implementation of exposure activities.

More specifically, when introducing a new client to ExRP, it's crucial to avoid doing too much too soon. If you start with the most difficult exposure first, it could backfire and have the opposite effect of the intended goal.

When you think of someone learning to drive a car, you don't throw them on the highway the moment they get behind the steering wheel. Rather, you usually take them to an empty parking lot where they can start out slow and easy. You give them time to level up their driving skills, and wait until they are practiced enough to manage the increased demands of driving on the freeway.

Similarly, when beginning ExRP with a client, you want to start with an easier exposure and then gradually increase the intensity.

For instance, for someone who has Harm OCD and is afraid to be around knives, you would NOT want to ask them to hold a knife for the first exposure practice. This would be too much too soon, and it could result in treatment ambivalence.

Instead, you might start by looking at photos of knives. Over time, you would eventually work your way up to the client holding a knife, but only after taking gradual steps toward increasing the intensity of exposures.

In order for ExRP to be effective, it's so important to follow the guidelines and protocols for treatment. Trying to rush a client through the process could actually lead to more harm than good and be on the lookout for when they try to do this themselves!