What is an exposure lifestyle?
Exposure therapy is a psychological treatment developed to help people successfully confront their fears and anxieties head-on. The focus is on breaking the pattern of avoidance around fear by “exposing” people to the things they fear and avoid. At Kurtz Psychology, we promote an exposure lifestyle where children and parents are always looking for opportunities to practice exposures. This encourages parents to model bravery for their kids, while finding the moments to practice being brave every day, as a family.
Who benefits from an exposure lifestyle?
Everyone! While exposure therapy is an appropriate treatment for most anxiety disorders and phobias, we all experience anxiety in some form. Showing your children that you can face your fears and helping them to face their own helps build resiliency and promotes positive self-esteem.
How do we begin an exposure lifestyle?
An exposure lifestyle requires some thought. Sitting down first on your own, and then potentially with your child, to determine exactly what experiences result in fear or anxiety. (Hint: even talking about these experiences is an exposure!) We can rank them from easiest to hardest. Then, slowly but surely face them by working up our list. Once your child sees they can actually raise their hand in the virtual classroom and that it did not result in a negative experience, they will feel more confident in doing so again. Remember, exposures don’t “fix” anxieties and fears and those feelings may never disappear, but with repeated practice, we will feel more able to do what we need to, despite feeling anxious or fearful.
Great idea! There’s no way my child will be up for this…
The other key to a successful exposure is reinforcement. Remember, that your child is avoiding these experiences out of fear, so we want to provide support towards a more positive goal. By encouraging them to do difficult things and pairing those experiences with reinforcers, they will feel more motivated to continue. Eventually, you can remove some reinforcement as the behaviors become reinforcing on their own. Labeled praise is a great form of reinforcement that recognizes that your child was able to do something new, shows that you were proud, and it’s free! Think this: if your child finds it difficult to say “here” in morning meeting, you may use stickers or a favorite dessert to reward participation. They will start out needing something more exciting and eventually, they will feel reinforced by the ability to say “here” and the new behavior becomes habit. At that point, the special extra reward can be decreased until it is no longer needed.
But COVID-19?! How can we find ways to practice?
Again, a little bit of preparation and thought will support you in this. I encourage you to think about what your child struggles with and what that looks like in your current situation. Then think about the components that make up that experience. Is there a way to introduce an exposure (maybe not perfectly!) that relates to that experience? For example, if your child has difficulty separating from you at school, maybe practicing separation during a school virtual session is a first step to separating once you can return to the school building.
Below are some suggestions for practice during social distancing given a variety of child needs:
Separation Anxiety
- Practice being in different rooms for even a minute or two (you might even start by moving farther across the room first)
- Work on the nighttime routine to help your child stay in their own room through the night
- If attached to mom, have dad take over daily activities like bath time and bedtime to practice separation from mom
- Focus of praise: independence, separation, doing activities alone
Social Anxiety
- Video at-home dance parties to get used to being on-screen
- Set up a virtual sports activity with a friend. Who can keep a balloon in the air the longest?
- Play a virtual game with peers that pull for silly or incorrect answers. Fibbage & Quiplash can be funny, fun, and a great exposure for being wrong or coming up with an answer on the spot
- Focus of praise: doing activity in front of others, brave guessing, taking chances, participation
Selective Mutism
- Send questions and responses on video to a peer to answer and send back
- Play Guess Who over video. If each child has a board, they can take turns asking questions
- Do a show ‘n tell with extended family. Give family members a chance to ask forced-choice questions about the shared item
- Focus of praise: telling us, participation, sharing, using their voice, answering/asking questions
Specific Phobias
- Practice doing blood pressure, height, and weight as if in a doctor’s office
- Show pictures and videos of feared object and have child touch the picture (e.g. bugs, dogs, planes)
- Research feared objects to help your child know the facts and reduce irrational concerns
- Focus of praise: facing specific fears
As always, if you are feeling like you need professional support to best guide your child and family, please reach out to a professional. The clinicians at Kurtz Psychology are experts in the treatment of anxiety and have conducted treatment virtually for years before the COVID-19 pandemic. We are here for you and can provide payment plans, as needed.
