When Exposures Feel Confusing: How to Design Targeted, Effective, and Compassionate Exposures - 3 hours

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• CE Hours Included: 3 (please see below for details)
• Format: On-Demand Webinar (“Asynchronous”, Non-Interactive) ~ At your leisure this recorded video is to be viewed at your own pace. You may pause, rewind, and fast forward at any point during the videos. You are in complete control of how you view this workshop. It also comes with a PowerPoint and references. There is a quiz at the end to ensure viewing and required by all CE approval organizations.
  • NOTE: Your certificate will be dated when you complete the course - Click here for more detailed information on the best way to do this: https://www.theknowledgetree.org/p/help
• Investment: $87 (provides lifetime access!)
• Presented by: Michael Stier, LCPC, LPC, NCC (see bio below)
• Date of Recording: October 9, 2026
• Instruction Level: Intermediate
• Target Audience: Psychologists, Counselors, Social Workers, Marriage & Family Therapists
• This workshop is not yet available; by pre-registering, you will receive immediate access when it becomes available in October.

Learning Objectives:

After completing this workshop in its entirety, you will be able to:

• Describe the theoretical differences between habituation theory and inhibitory learning theory and how each informs the implementation of exposure-based interventions.
• Analyze emotional avoidance and safety behaviors that maintain anxiety and OCD symptoms and interfere with exposure-based treatment.
• Apply inhibitory learning principles to construct individualized exposure menus that target avoidance and promote meaningful therapeutic learning.

Workshop Description:

This presentation will help clinicians reduce confusion and increase confidence when designing exposure-based interventions for OCD and anxiety disorders. Although exposure therapy is one of the most effective psychological treatments available, many clinicians struggle to determine what the exposure should target, how to identify the core fear, and how to create interventions that are both therapeutically effective and compassionate. Participants will learn a practical framework for conceptualizing and developing exposures that align with evidence-based principles while remaining individualized to each client's presentation. Through numerous case examples and clinical scenarios, attendees will gain concrete strategies for translating theory into practice and making more precise treatment decisions when faced with complex or ambiguous clinical presentations.

The training will also emphasize the role of identity, culture, lived experience, and contextual factors in exposure design. Exposure exercises are learning experiences whose meaning and impact can vary significantly based on a client's background, rather than relying on standardized menus or assumptions about what a client should fear. Participants will learn how to develop culturally responsive exposures that are informed by each client's unique background. Practical examples will illustrate how to adapt exposure interventions across diverse presentations while maintaining fidelity to evidence-based treatment principles, ultimately enhancing engagement, therapeutic alliance, and clinical outcomes.

Workshop Agenda:

• Section 1: The History and Science of Exposure Therapy (30 mins)
  • Why clinicians avoid assigning exposures and the consequences of ERP underutilization.
  • Behavioral foundations of exposure therapy, including classical conditioning and Mowrer's two-factor theory.
  • Understanding the habituation model and how it shaped exposure therapy for decades.
  • Reviewing the inhibitory learning model and the principle of expectancy violation.
  • Comparing habituation and inhibitory learning approaches and examining how each model influences clinical decision-making.
• Section 2: Emotional Avoidance as the Core Clinical Target (30 mins)
  • Defining emotional avoidance and its role in maintaining anxiety and OCD.
  • Examining overt avoidance, subtle avoidance, and cognitive avoidance strategies.
  • Understanding safety behaviors and how they interfere with exposure-based learning.
  • Learning to identify avoidance patterns when designing treatment plans and exposure hierarchies.
• Section 3: Busting the Myths of ERP (30 mins)
  • Exploring the origins of common misconceptions about exposure therapy.
  • Addressing the myth that ERP is cruel, harsh, or traumatizing.
  • Examining the misconception that anxiety must decrease during exposures for treatment to work.
  • Understanding why complete menus are not required before beginning treatment.
  • Discussing ERP within trauma-informed frameworks and addressing the myth that clients must be fully "ready" before beginning exposures.
• Section 4: When Exposures Go Wrong — Harmful Uses and Misapplications (30 mins)
  • Understanding how coercive or poorly paced exposures can undermine treatment.
  • Identifying therapist accommodation and avoidance that interfere with effective ERP.
  • Recognizing the impact of safety behaviors during exposures.
  • Examining the consequences of inadequate psychoeducation and rationale development.
  • Reviewing ethical considerations and common pitfalls in exposure-based treatment.
• Section 5: Setting Up and Debriefing Exposures (40 mins)
  • Using inhibitory learning principles to design effective exposures.
  • Identifying feared predictions and developing expectancy-violating experiences.
  • Building variability and flexibility into exposure exercises.
  • Conducting post-exposure debriefs that consolidate learning while avoiding reassurance-seeking.
• Section 6: Cultural Considerations and Wrap-Up (20 mins)
  • Examining cultural influences on OCD, anxiety, rituals, and avoidance behaviors.
  • Differentiating cultural and religious practices from compulsive behaviors.
  • Developing culturally responsive exposure hierarchies and treatment rationales.
  • Understanding the therapist's role in managing personal discomfort, assumptions, and cultural biases during ERP implementation.

Presented by: Michael Stier, LCPC, LPC, NCC

Michael Stier is a Licensed Clinical Professional Counselor (LCPC) in Illinois, an LPC in Georgia and Missouri, and a National Certified Counselor (NCC) specializing in OCD and related disorders. He currently serves as the Director of Education and Training at Anxiety Specialists of Atlanta, overseeing evidence-based treatment interventions. Michael is also faculty for the Behavioral Therapy Training Institute (BTTI) through the International OCD Foundation (IOCDF). He co-authored The Complete Guide to Overcoming Health Anxiety and developed the associated Overcoming Health Anxiety website, which provides evidence-based information and support for individuals with health anxiety, as well as their families and loved ones.

3 "Asynchronous" CE Hours Included - Details by License Type Below:

• PSYCHOLOGISTS: The Knowledge Tree, A Summit Professional Education Company is approved by the American Psychological Association to sponsor continuing education for psychologists. The Knowledge Tree, A Summit Professional Education Company maintains responsibility for this program and its content. For more detailed information on the current CE ruling in Georgia, or if you are licensed in another state or country, please click here.
• COUNSELORS: The Knowledge Tree, A Summit Professional Education Company has been approved by the National Board for Certified Counselors (NBCC) as an Approved Continuing Education Provider (ACEP), ACEP No. 7153. Programs that do not qualify for NBCC credit are clearly identified. The Knowledge Tree, A Summit Professional Education Company is solely responsible for all aspects of the programs.
  • GA: Counselors in GA will receive 3 Core Hours for completing this course. Please click here for more detailed information.
• SOCIAL WORKERS: The Knowledge Tree, a Summit Professional Education Company, provider #2470, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 1/14/2026-1/14/2027. Social workers completing this course receive 3 clinical continuing education credits.
  • GA: Social Workers in GA will receive 3 Core Hours for completing this course. Please click here for more detailed information.
• MARRIAGE & FAMILY THERAPISTS: TKT has applied for approval for this workshop through the Georgia Association for Marriage & Family Therapy (GAMFT). If you are licensed in another state or country, please click here for more detailed information.

We are an approved vendor for the U.S. Department of Veterans Affairs for easy reimbursement of educational expenses for VA employees.