Prompting and fading in the exposure treatment of compulsive checking

Compulsive checking can be treated effectively through the use of in vivo exposure with response prevention. However, the clinical application of these procedures can become quite complex. The therapist must help teach the client new coping skills for managing anxiety. However, many compulsive clients report a substantial reduction in the urge to check whenever accompanied by another adult. Therefore, the therapist must not be so intrusive as to reduce the impact of the exposure. Treatment procedures used with two clients are described to show how prompting can be useful for facilitating the early stages of exposure and how fading is essential in promoting self-control. Portable electronic communication devices were used to bridge the gap between therapist-assisted and self-controlled exposure sessions. Therapy was successful in reducing the frequency of checking behaviors and the subjective urge to check.