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Method of Factors

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The Method of Factors is a Cognitive behavioral therapy technique for generating an exposure hierarchy for the treatment of a phobia. While it is not documented in the literature it is in use among therapists.

The steps are as follows:

  1. Identify a behavior that is being avoided - for example, touching snakes, going into public places. This should be chosen so that the subject agrees that, for them to be able to do it, the phobia would have to have been successfully dealt with.
  2. Identify a number of factors that would make the task harder or easier. For a snake phobia this might include the size of the snake, its color; how close it is; whether it's in a vivarium, on a table top on the floor. For going out in public it might include time of day; who is accompanying you; how crowded the venue is; and so on.
  3. For each factor identify a number of levels, i.e. variants of the factor that are associated different levels of arousal. Thus, for a snake phobia, four levels of the 'realism' factor might be (1) rubber snake (2) photo of a snake (3) stuffed snake (4) live snake. Another factor, 'closeness' might have levels (1) behind glass (2) on a table five metres away (3) on a table half a metre away (I'm touching the table (4) I'm touching the snake.
  4. On a set of filing cards write every possible permutation of the levels (one per card)
  5. Sort the cards into order of aversiveness (this can be done by recursive pairwise comparison with the stack so far).
  6. The stack of cards now constitutes a very fine-grained hierarchy.

The full procedure, using filing cards, is rarely now used; but the description above can be used to motivate a subject's understanding of the concept of hierarchy, and to help them grade their exposure by asking themselves "what factor can I now vary to increase my arousal?"


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