AreasWorry and anxietyFacing it a step at a time

Five minutesComing and goingCBTWorry and anxiety

Let the person facing it choose the first step, and let them choose an easy one. A rung somebody picked gets climbed. A rung assigned to them gets argued about.

Ask which one they would be willing to have a go at this week, not which one they ought to be able to manage. The answer usually sits somewhere in the low to middle part of the ladder, and that is fine. The first step is not there to be impressive. It is there so the week ends with them having done something they were not sure they could do.

Before you use this

Facing a fear in steps works, and it works best with someone guiding the ladder. Read this as an explanation of how it works, and take the steps themselves to a therapist.

Qur’an and Sunnah

We shall be sure to guide to Our ways those who strive hard for Our cause (Quran 29:69). The striving comes first and is met, however modest the step being taken.

وَٱلَّذِينَ جَٰهَدُواْ فِينَا لَنَهۡدِيَنَّهُمۡ سُبُلَنَاۚ وَإِنَّ ٱللَّهَ لَمَعَ ٱلۡمُحۡسِنِينَ

But We shall be sure to guide to Our ways those who strive hard for Our cause: God is with those who do good

Qur’an 29:69read it in the library

Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.

What the research says

Across seventy five studies of childhood anxiety treatment, the amount of exposure a programme contained was more strongly tied to improvement than the anxiety management components were. What matters most is that steps keep happening, which argues for choosing rungs that will actually get climbed over the most impressive one available. Those studies measured how much exposure was delivered, not who chose it.

Whiteside SPH, Sim LA, Morrow AS, Farah WH, Hilliker DR, Murad MH, Wang Z. (2020). A Meta-analysis to Guide the Enhancement of CBT for Childhood Anxiety: Exposure Over Anxiety Management.. Clinical child and family psychology review doi

Strength of evidence: one line of research. A single study, or a theoretical account.

Why it works

Doing it because you chose to leaves you with the memory of having done it rather than of having been made to.

This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.

Near this one

More on worry and anxiety

Let the person facing it choose the first step, and let them choose an easy one. A rung somebody picked gets climbed. A rung assigned to them gets argued about · Inshirah