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🪜 OCD · Free printable tool

Exposure Hierarchy Builder

The ladder at the heart of ERP therapy: your feared situations ranked from 0 to 100, so you can climb them one rung at a time.

Exposure and response prevention (ERP) is the best-evidenced treatment for OCD. It starts with a list: situations that trigger the obsession, rated by how much anxiety they cause (SUDS, 0 to 100). You start around 30 to 40, stay in the situation without the compulsion until the anxiety drops, then move up. This sheet prepares that list for you or with your therapist.

A4 PDF · 2 pages · sent by email with a direct link · no account needed
Related screening test: OCD →
Exposure Hierarchy Builder

What is inside

  • ✓The obsession this ladder is about (the feared thought or 'what if')
  • ✓The compulsions I usually do in response (checking, washing, asking, mental review...)
  • ✓My ladder (fill in, then re-order from easiest to hardest)
  • ✓SUDS 0-100 · Situation or trigger (precise: where, what, with whom) · Compulsion I will NOT do · Done (date)
  • ✓Support: my therapist's instructions / who I tell about my progress

How to use it

  • 1Print it, or open it on a tablet and fill it with a stylus.
  • 2Use it for one week before judging it. New habits need a few repetitions.
  • 3Bring it to your doctor or therapist: a filled sheet says more than memory.

This tool supports self-management. It is not a diagnosis and does not replace professional care.

Other tools for OCD

📒 Compulsion & Reassurance LogEvery check, wash, count and 'are you sure?' for a week. You cannot reduce what you do not measure. 🃏 Tolerating Uncertainty CardPhrases to read instead of checking. Cut it out, keep it in your wallet or on your lock screen.

See all tools →