Free Safety Behaviour Drop Plan: Hierarchical Reduction Worksheet
Avoidance · CBT · Research-supported
A structured worksheet for planning the gradual, hierarchical elimination of safety behaviours — listing each behaviour, the function it serves, the feared consequence of dropping it, and a stepwise reduction plan paired with specific exposure exercises.
Underlying mechanism: Hierarchical elimination of safety behaviours in anxiety treatment
What it helps with
- Making the full range of a client's safety behaviours visible, including subtle ones that are easy to overlook (carrying items, rehearsing, positioning oneself near exits).
- Ranking behaviours by how difficult they would be to drop, so the plan starts with the most achievable one.
- Pairing each drop with a specific exposure exercise, so dropping a safety behaviour is tested rather than simply endured.
- Distinguishing genuine coping strategies, which should be kept, from safety behaviours that maintain the threat belief.
How clinicians use it
- Used from session 3–4 of an anxiety protocol, after psychoeducation about safety behaviours and before active exposure.
- Built collaboratively as a full inventory first, then ranked and sequenced rather than tackled all at once.
- Tracked using the Expectancy Violation Worksheet to record outcomes after each drop.
Clinical Implementation Guide
- List every safety behaviour before ranking any of them — subtle ones (posture, scripted phrases, checking a phone) are easy to miss if ranking starts too early.
- Start with the lowest-difficulty item, and confirm a successful drop before moving to the next.
- Pair every drop with a named exposure exercise from the client's existing hierarchy, so the two worksheets work together rather than in parallel.
What the worksheet looks like
| Safety Behaviour | Function | Feared Consequence of Dropping | Drop Difficulty (1-10) |
|---|---|---|---|
| Carrying a water bottle everywhere "in case of panic". | Feeling of control over physical symptoms. | I'll panic and have nothing to help me. | 3 |
| Rehearsing sentences before speaking in meetings. | Reduces fear of saying something wrong. | I'll stumble over my words and look incompetent. | 6 |
| Sitting near the exit at every social event. | Feels like an escape route is guaranteed. | I'll be trapped if I panic. | 8 |
Clinical cautions
Never drop all safety behaviors at once. Reduce hierarchically. Ensure each drop is paired with an exposure that allows the client to test their feared prediction. Distinguish safety behaviors from genuine coping strategies.
References
- Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic. Cognitive Therapy and Research, 15(1), 23-48.
- Rachman, S., et al. (2008). The safety behaviour factor in anxiety. Journal of Cognitive Psychotherapy, 22(1), 3-12.
Part of
Systematic Exposure Protocol