# PWR-167 — Fear extinction and courage: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 13 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Basic stationery or digital tools — a licensed-clinician-led exposure or fear-learning plan.; Written hierarchy, real-danger screen, consent/stop signal, clinician contact and emergency plan.; A trial sheet for prediction, subjective fear, body response, approach, safety behaviours, learning and later context. Space: Desk / seated Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context This lesson teaches the full method used in a licensed-clinician-led fear-learning plan: verify real safety, define a chosen function, build a graded step, predict fear channels, approach without flooding, stay for the agreed learning window, record what happened and test context only when approved. Fear is relearned, not erased, and courage can include leaving danger. Target outcome: In a clinician-approved plan, the learner completes one agreed low-level approach step, records fear channels and safety behaviour, and follows the stop and review rules. ### Authority and setup conditions - Prepare a licensed-clinician-led exposure or fear-learning plan using one low-level step selected from an individual hierarchy - Before the first fear extinction and courage attempt, write the exact result you will score: Safe chosen approach and function across contexts with fear channels recorded. - The licensed clinician assesses diagnosis, trauma, medical risk, dissociation, suicidality, current safety and whether exposure is indicated. - The learner chooses the functional goal and may pause or withdraw; no flooding or surprise cue. ### Required or supplied materials - a licensed-clinician-led exposure or fear-learning plan. - Written hierarchy, real-danger screen, consent/stop signal, clinician contact and emergency plan. - A trial sheet for prediction, subjective fear, body response, approach, safety behaviours, learning and later context. ## 1. Separate fear from real danger Use the clinician’s screen to identify actual hazards, consent limits and emergency needs. Cancel the exercise if the situation is not objectively safe. Why: Fear reduction is never the goal when protective action is needed. Success check: Learner and clinician agree the cue is safe enough and the emergency route remains available. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Learner and clinician agree the cue is safe enough and the emergency route remains available.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Name the chosen function Write what the learner wants to do despite fear, such as stand near a closed lift for one minute, and why it matters. Why: A values-linked function is a better target than a zero-fear score. Success check: The goal is concrete, chosen and achievable without entering danger. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The goal is concrete, chosen and achievable without entering danger.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Select one graded step Choose a low-level hierarchy step within the clinician-set range and define start, duration, distance and stop conditions. Why: A precise dose prevents an approach from turning into flooding. Success check: All four dose features are written before exposure. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “All four dose features are written before exposure.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Predict separate channels Before approaching, predict subjective fear, body activation, urge to escape and ability to complete the step. Why: Fear channels can change differently and prediction error can support learning. Success check: Four predictions are recorded without requiring a low number. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Four predictions are recorded without requiring a low number.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Approach at the agreed pace Begin only on the learner’s signal. Move to the declared position and keep normal safety supports unless the clinician explicitly plans otherwise. Why: Voluntary, graded approach preserves control and valid learning. Success check: The learner reaches the planned point without surprise escalation. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner reaches the planned point without surprise escalation.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Stay for the learning window Remain for the agreed interval while naming present facts and allowing fear. Do not extend to force fear to fall. Why: New learning can occur even if self-reported fear stays high. Success check: The interval ends as planned with orientation and consent intact. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The interval ends as planned with orientation and consent intact.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Record outcome, not bravery Afterward, record actual fear channels, completion, safety behaviours and what was learned about the prediction. Why: Observed outcome and function matter more than a courage label. Success check: The note compares prediction with outcome and avoids moral judgement. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The note compares prediction with outcome and avoids moral judgement.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Plan context only with clinician Repeat the same step or vary one context feature only after review. Expect fear may return in a new place and keep the safety screen. Why: Extinction learning is context-dependent and return of fear is not failure. Success check: Any context change is pre-approved and logged as a new condition. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Any context change is pre-approved and logged as a new condition.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.