BackToSchoolPlan › Learn › Why the 0 to 10 rating matters more than the list
Why the 0 to 10 rating matters more than the list
Most parents can list what their child is avoiding. Far fewer can say which part of it is hardest, and that is the part that decides where to start.
The 0 to 10 rating comes from Joseph Wolpe, who needed a way to order exposure steps and settled on asking the person. It is subjective on purpose. There is no external measure of how frightening a hallway is, and the person avoiding it is the one with the information.
What the numbers are for
Two things. First, order: the list sorts itself, and the next thing to try is whatever sits lowest and is still being avoided. Second, pattern: once enough steps carry a number, the steps that rate highest usually have something in common. That commonality is often more useful than the list itself, because it points at what the fear is actually about.
A parent who arrives at an appointment saying "he will not go to school" and a parent who arrives saying "every step where he cannot reach me rates 8 or above, and the classroom steps rate 3" are asking two different questions. The second one is answerable.
Who should give the number
Either. If your child is with you and willing, their number is the more accurate one. If they are not, your estimate is enough to get an order, and the first attempt at a step will correct it. Do not average the two into one number; if you disagree sharply about a step, that disagreement is worth noticing.
A step rated 10
A 10 does not mean the step is wrong. It means it belongs at the top of the ladder and something smaller has to come first. Split it: shorter, quieter, earlier, with someone, from further away. If the smaller version is still a 10, split it again.
Sources for this page
- Wolpe, J. (1958). Psychotherapy by Reciprocal Inhibition. Stanford University Press. The origin of the 0 to 10 subjective units of distress rating and of ordering exposure steps by that rating. The ladder in this tool is that idea, unchanged.
- Kearney, C. A., & Silverman, W. K. (1993). Measuring the function of school refusal behavior: The School Refusal Assessment Scale. Journal of Clinical Child Psychology, 22(1), 85-96. The four functions: avoiding distressing situations, escaping social or evaluative situations, getting attention, and pursuing something more rewarding elsewhere. The theme grouping in this tool covers the first two in more detail, because those are the ones a ladder can move.