There are 7 paragraphs. I would suggest that everyone go through the first five. Paragraph 6 is probably relevant for most kids but, as is true of all the exposures, if it isn’t triggering it is okay to skip it. The last paragraph is a bit of silliness but still may be triggering.
At first, there will be only a few sentences. Each time you move forward to a new page, additional sentences will be added until the paragraph is complete. Fill in the blanks with triggering words. Please switch the challenge words as well when practicing.
At this point, it will likely be clear which words are still challenging and which words don’t need additional practice. Focus on the challenging words/sentences. As with any exposure, don’t advance until you or your client notices either a meaningful drop in distress (SUDs) or a clear sense of being able to tolerate how it feels.
The paragraphs are arranged in a hierarchy as well. However, that varies from person to person. This is our best guess. The fourth paragraph switches to first person and is nearly always more challenging.
We are always open to feedback. We have tried to make them as universal as possible but adapting them to a particular person and situation may be necessary. If something is not covered, it may be a great exercise to have your client write their own paragraph. It can also be helpful for your client to record a paragraph and listen to it as homework.
Paragraph title
Paragraphs
Paragraph directions
Paragraphs
The following paragraphs will display a few sentences at a time. There may be a blank at first where a challenging word would go. Please insert the words that would be challenging as you practice. (Don’t avoid any words!)
P1 Title
Paragraph 1
P1 S1
I am with some friends and they are talking about how many people were getting sick from the stomach bug. They were joking about it but I was nervous. I hope they don’t notice and start teasing me.
P1 S2
I am with some friends and they are talking about how many people were getting sick from the stomach bug. They were joking about it but I was nervous. I hope they don’t notice and start teasing me. Suddenly, a person groans, leans over and _____. It happens again. We step back and everyone is grossed out.
P1 S3
I am with some friends and they are talking about how many people were getting sick from the stomach bug. They were joking about it but I was nervous. I hope they don’t notice and start teasing me. Suddenly, a person groans, leans over and vomits. It happens again. We step back and everyone is grossed out. I am in a panic but there is nowhere to go. Will I __________ next? I think I am getting ________.
P1 S4
I am with some friends and they are talking about how many people were getting sick from the stomach bug. They were joking about it but I was nervous. I hope they don’t notice and start teasing me. Suddenly, a person groans, leans over and vomits. It happens again. We step back and everyone is grossed out. I am in a panic but there is no where to go. Will I throw up next? I think I am getting nauseated. The vomit just stays there until we can finally leave.
P2 Title
Paragraph 2
P2 S1
I was invited to a party at a restaurant. I was anxious but went anyway. I ate some things. Maybe too much? I was doing okay but had to go to the bathroom. I was washing up when a person from the party burst into the bathroom. The person looked ____________.
P2 S2
I was invited to a party at a restaurant. I was anxious but went anyway. I ate some things. Maybe too much? I was doing okay but had to go to the bathroom. I was washing up when a person from the party burst into the bathroom. The person looked sick. I hurried to leave but before I could escape the person pushed open the door to the toilet, bent over and _________ loudly.
P2 S3
I was invited to a party at a restaurant. I was anxious but went anyway. I ate some things. Maybe too much? I was doing okay but had to go to the bathroom. I was washing up when a person from the party burst into the bathroom. The person looked sick. I hurried to leave but before I could escape the person pushed open the door to the toilet, bent over and vomited loudly. It was gross. Before I could get out the door the person _______ again.
P2 S4
I was invited to a party at a restaurant. I was anxious but went anyway. I ate some things. Maybe too much? I was doing okay but had to go to the bathroom. I was washing up when a person from the party burst into the bathroom. The person looked sick. I hurried to leave but before I could escape the person pushed open the door to the toilet, bent over and vomited loudly. It was gross. Before I could get out the door the person blew chunks again. I could hear the person coughing and gagging. I felt my stomach turn for the worse.
P3 Title
Paragraph 3
P3 S1
The stomach bug is bad right now. I just found out a lot of my friends are sick. I was just around them. Did someone cough or get too close? I feel really scared they passed it to me. Does someone in my family have it? Am I getting sick? I don’t feel right. If I have it then there is nothing I can do.
P3 S2
The stomach bug is bad right now. I just found out a lot of my friends are sick. I was just around them. Did someone cough or get too close? I feel really scared they passed it to me. Does someone in my family have it? Am I getting sick? I don’t feel right. If I have it then there is nothing I can do. At any moment I might start ______.
P3 S2a explanation
When you see ??? in the paragraph, name the first person that comes to mind. as you practice you can change it to someone else if that makes you anxious. (If it is the person helping you with this, tell them i said to not take it personally.)
P3 S3
The stomach bug is bad right now. I just found out a lot of my friends are sick. I was just around them. Did someone cough or get too close? I feel really scared they passed it to me. Does someone in my family have it? Am I getting sick? I don’t feel right. If I have it then there is nothing I can do. At any moment I might start ___________. Is it coming? I wonder how much food I have in my stomach? Suddenly, I hear ??? (person you imagine) in the bathroom. ??? is __________ intensely into the toilet. I try to get as far away as I can, but I can still hear it!
P3 S4
The stomach bug is bad right now. I just found out a lot of my friends are sick. I was just around them. Did someone cough or get too close? I feel really scared they passed it to me. Does someone in my family have it? Am I getting sick? I don’t feel right. If I have it then there is nothing I can do. At any moment I might start vomiting. Is it coming? I wonder how much food I have in my stomach? Suddenly, I hear ??? in the bathroom. ??? is vomiting intensely into the toilet. I try to get as far away as I can, but I can still hear it! I can still hear ??? puking. I start to feel nauseated. Oh no, I think I am next. It could start any minute. I feel terrified. There is no way to escape, it is just a matter of time.
P4 Title
Paragraph 4
P4 humor
Need a bit of humor?
P4 S1
I feel sick to my stomach. I hate this. I try to do something to feel better. Still worse and worse. I want to cry. I want ??? (who comes to mind?) to help. I am afraid I am going to ____. I get hot and feel feverish.
P4 S2
I feel sick to my stomach. I hate this. I try to do something to feel better. Still worse and worse. I want to cry. I want ??? to help. I am afraid I am going to vomit. I get hot and feel feverish. I can feel sweat on my forehead and feel panicky. I am terrified thinking about __________. I’m fighting to control it. But the nausea is so terrible I can barely stand it.
P4 S3
I feel sick to my stomach. I hate this. I try to do something to feel better. Still worse and worse. I want to cry. I want ??? to help. I am afraid I am going to vomit. I get hot and feel feverish. I can feel sweat on my forehead and feel panicky. I am terrified thinking about throwing up. I’m fighting to control it. But the nausea is so terrible I can barely stand it. I can’t help it; I jump up and run into the bathroom. Will I make it? I kneel before the toilet.
P4 S4
I feel sick to my stomach. I hate this. I try to do something to feel better. Still worse and worse. I want to cry. I want ??? to help. I am afraid I am going to vomit. I get hot and feel feverish. I can feel sweat on my forehead and feel panicky. I am terrified thinking about throwing up. I’m fighting to control it. But the nausea is so terrible I can barely stand it. I can’t help it; I jump up and run into the bathroom. Will I make it? I kneel before the toilet. __________ rises in my throat but I try to hold it.
P4 S5
I feel sick to my stomach. I hate this. I try to do something to feel better. Still worse and worse. I want to cry. I want ??? to help. I am afraid I am going to vomit. I get hot and feel feverish. I can feel sweat on my forehead and feel panicky. I am terrified thinking about throwing up. I’m fighting to control it. But the nausea is so terrible I can barely stand it. I can’t help it; I jump up and run into the bathroom. Will I make it? I kneel before the toilet. Puke rises in my throat but I try to hold it. Suddenly everything pushes up and I ________ into the toilet. I _________ more.
P4 S6
I feel sick to my stomach. I hate this. I try to do something to feel better. Still worse and worse. I want to cry. I want ??? to help. I am afraid I am going to vomit. I get hot and feel feverish. I can feel sweat on my forehead and feel panicky. I am terrified thinking about throwing up. I’m fighting to control it. But the nausea is so terrible I can barely stand it. I can’t help it; I jump up and run into the bathroom. Will I make it? I kneel before the toilet. Puke rises in my throat but I try to hold it. Suddenly everything pushes up and I vomit into the toilet. I puke more. I gag and cough. I have a terrible taste in my mouth. It smells. Did I get some in my nose?
P5 Title
Paragraph 5
From this point forward, the entire paragraph will display without blanks. practice different words as needed.
P5 complete
I am listening to someone teach. I start to feel nauseated/queasy all of a sudden. I can feel the panic start and my insides are in knots. I need to get out of here. Should I stay or make a scene? Will I get in trouble? I am getting really sick, really fast. Uh oh, too late. I feel my stomach shudder and I spew/hurl vomit/puke all over my desk, my clothes, and the floor. I hear kids’ gasp. Someone yells, “That is gross!” They all move away. They make faces like they are disgusted. Are they thinking I am gross?
P6 Title
Paragraph 6
Bedtime situation
P6 Complete
It is getting close to bedtime. What if my stomach starts to hurt? It will probably hurt. Will that mean I am sick? Is it hurting now? Oh no, does this mean I will throw up/puke? What if I wake up in the middle of the night and barf/vomit all over? What if I have no warning and as soon as I wake I blow chunks/puke everywhere? I can just feel it coming right up my throat and out my mouth. I would hurl/vomit all over myself and the bed. The throw up/vomit would be all over everything. What if I just kept throwing up? What if it lasted a long time?
P7 Title
‘Paragraph’ 7
Okay, this next sort of poem/rhyme/thingy is just goofy. However, if you can do better, go for it.
P7 Complete
“I will hurl,” said the girl to the Earl who was speaking with the Duke.
“I will puke,” said the Duke, “if that girl near the Earl is going to hurl.”
“Do not disrupt this potluck with throw-up,” said the Duchess, “It will make a mess for the Marquess.”
Just then the bulbous Baron blew. Upon buttering the bread, he barfed. Everyone at the repast let out a loud gasp.
The Queen made a scene as she exclaimed, “For this party, we should’ve splurged but instead the Baron has purged.”
Quickly, the staff bustled about saying, “Here we are! We are on it; we will clean up this vomit.”
