You should assign in vivo exposures for homework. Under normal circumstances, they should not be conducted in-session.
In general, it's best to assign two hierarchy items per week.
It's usually best to start in vivo homework with situations of moderate SUDS rating, ideally around 40.
The goal of early homework assignments is to build confidence.
a. These assignments should be a good challenge, but things the patient is likely to complete successfully.
b. Items that the patient can already somewhat manage, or where he will have support from someone else, make good choices.
Explain the procedure for in vivo exposure to the patient:
In vivo exposures typically take 30-45 minutes, but they can last longer if necessary.
Ideally, the patient should stop when his anxiety has decreased significantly (perhaps by about fifty percent).
If the patient feels bored during the exposure, that is a good sign!
The patient should keep a log of SUDS ratings during the exposure.