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In this toolkit, we provide sample challenge cards, or potential exposures, for some of the most commonly presenting anxiety disorders in youth: separation anxiety disorder, social anxiety disorder, generalized anxiety disorder, specific phobia of the dark, specific phobia of animals or insects, specific phobia of blood injection injury, and specific phobia of vomit. These can be directly translated into your sessions or be used to generate ideas for additional exposures.


Before each set of challenge cards, we also provide some tips and tricks that are specific to each disorder (although many tips may apply across disorders)


The included challenge cards are in the format of individual cards to allow for flexible use. In addition to simply serving as a resource for identifying various types of exposures, the physical challenge cards themselves can be incorporated into treatment. Several ways are described below, but feel free to use your creativity to come up with more!


  1. For youth for whom building a hierarchy is a challenge, the challenge cards can be cut up and youth can arrange them in order of “least  hard” to “most hard”

  2. The challenge cards could be arranged on a bingo board to play “Brave Bingo”. Youth can then earn a prize for completing 3 challenge tasks in a row. A template has been included in the supplemental materials section. Alternatively, you can select a handful of appropriate level challenges and have youth pick one at random.

  3. When patients near treatment termination, you can use the “Create your Own Challenge” cards to encourage youth to generate their own ideas for exposure.

Toolkit Contents​​




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