Fear is an adaptive and natural emotional response that is rooted in safety. Fear has had an important role in our survival by helping us know when something may be dangerous. For some, fear can become disproportionate and arise in situations where they are not at risk of being harmed. This can disrupt everyday life, especially for those who experience related mental health disorders. Keep reading to learn 8 Overcoming Fear Activities to do With Your Clients in Therapy Sessions.
Fear can be triggered by a range of perceived threats. This can include things we see, hear, think about, or feel within our bodies. When we experience a trigger, the amygdala activates a fear response pathway. Once this is done, adrenaline and cortisol are released so that the sympathetic nervous system can activate the fight-or-flight response. Our brain then determines how we should respond to the threat.
Triggers for this fear response can vary from person to person. Examples of common triggers include public speaking, heights, enclosed spaces, dark spaces, spiders, snakes, financial instability, and the loss of control. When fear becomes persistent, irrational, or impairs functioning, it may be linked to a mental health disorder. Common disorders associated with fear include phobias, panic disorder, Post-Traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), and Obsessive-Compulsive Disorder (OCD).
Clients who struggle with fear may experience a rapid heartbeat, sweating, shaking, dry mouth, nausea, muscle tension, dizziness, or feel cold when triggered. They may also experience concentration difficulties, irritability, hypervigilance, catastrophizing, and intrusive thoughts. These symptoms can lead to maladaptive responses like avoidance, aggression, substance abuse, emotional numbing, and self-harming behaviors. When fear is persistent, clients may find themselves struggling at work or school, within personal relationships, and making decisions. These are examples of presenting problems you may find among clients who are seeking treatment for fear-related concerns.
How Activities Can Help Your Clients Overcome Fear
You can use fear-related activities in individual and group therapy sessions. This can help you provide a safe and nurturing environment for clients to safely express their emotions and fears. Over time, they can experience a decrease in the physical symptoms associated with fear as they develop effective coping strategies.
Fear-related activities can help your clients increase their self-awareness by being mindful of the changes that arise in their thoughts, emotions, and behaviors when they are triggered. With increased self-awareness, they can begin responding to their triggers before they manifest into something bigger. Strategies like mindfulness can help them learn to stay in the present moment rather than getting lost in their worry and fears. This change can improve their functioning at work, school, within relationships, and in other areas of their lives.
Consider incorporating the overcoming fear worksheets available with TherapyByPro for your group and individual sessions. These worksheets can help facilitate participation and guide activities focused on your clients’ difficulties. The added benefit to using worksheets is that they can provide your client with a resource at home to remind them of coping skills and strategies that you spoke about in sessions. Examples of popular fear-related worksheets include:
- Fear Worksheet Bundle
- Problem Solving for Fear Worksheet
- Challenging Fearful Thoughts
- 100 Questions About Fear to Ask Clients in Therapy Worksheet
Overcoming Fear Activities for Your Clients
Fear is a universal emotion that can affect children, teens, and adults. The way you work with clients who struggle with fear will vary based on their age, development, and the severity of their symptoms. Overcoming fear activities can often be tailored to each client, ensuring that you are addressing the difficulties they experience. Continue reading for examples of fear activities that can be personalized for children and adults.
- Making monster spray is an activity that can be used with children who experience bedtime-related fears. This can include fear of the dark, nightmares, and being alone. You can provide your client with a spray bottle and have them decorate a label for this bottle. Water can be used in the bottle, with essential oils if you choose. You can use role-playing to practice using their monster spray before bedtime, encouraging them to say aloud that they’re safe and in control. You can check in with them or their parent/guardian during subsequent sessions about their use of the monster spray.
- A feelings thermometer can be a valuable tool for clients, including children, who struggle to verbalize their emotions. With this activity, you will create a visual scale ranging from 1 to 10. You will help your client identify different levels of fear, such as calm and very scared. You can use the scale to learn about the intensity of the triggers they experience so that you can teach appropriate coping skills. You can also use this scale as a check-in tool to gauge their level of fear during therapy sessions.
- Another fear activity for children is having them draw their fear. This can be helpful for those who experience phobias or fear the unknown. After providing the necessary materials, ask your client to draw what they are afraid of. Once they are done, you can explore their emotional reactions to the image and talk about how they can alter the image to make it less scary. This could mean changing the colors or size of what they fear. This can help them feel as though they have control and can cope with their identified fear.
- Creating an exposure hierarchy is a common activity with clients struggling with phobias and avoidance behaviors. For this activity, you can ask your client to list their feared situations in order from least to most distressing. You can then help your client learn and practice coping strategies that would allow them to progress through their hierarchy with the use of exposure. Ensure that you have time to process their experience with this activity so that they are not ending their session in distress.
- Progressive muscle relaxation can be a helpful overcoming fear activity that clients can incorporate into everyday life. This activity can be used with clients who experience panic symptoms or physical tension after being triggered. You can ask your client to sit in a comfortable position so you can guide them as they tense and release muscles from their head to their toes. You will ask them to be mindful of the changes they experience as they tense and relax their muscles. You can process their experience and explore the benefits of using this practice before a feared event or situation.
- Creating a fear timeline can be used with clients who experience chronic or recurrent fear. This narrative therapy activity will have your client create a timeline that shows significant fear-related experiences that they have had. Once they are complete, you can explore how these events affected their thoughts and behaviors and how they moved past these experiences. This can help them gain self-awareness by recognizing turning points and patterns that contribute to their current difficulties.
- ACT techniques can also be used for overcoming fear activities. Clients who struggle with OCD symptoms and intrusive thoughts may benefit from learning to externalize their thoughts. You can begin by helping them identify their unhealthy thoughts and reword them. You may encourage them to say things like “I’m having the thought that…” or use metaphors. This can help them learn to recognize the presence of these thoughts without reacting in fear or judging their thoughts.
- Clients who struggle with fear-based criticism or shame may benefit from incorporating compassion towards themselves during the day. You can help your client identify situations when fear or self-blame comes up and explore various ways that they can respond compassionately. You may encourage them to say something like “This is a challenging moment, and fear is a natural response to it.” This can help normalize the presence of fear that they are accustomed to being ashamed of.
Frequently Asked Clinical Questions
Below are FAQs clinicians are asking:
How does a clinician differentiate between an adaptive survival fear and a pathological, disproportionate anxiety disorder during intake assessment?
Evaluate whether the client’s internal reaction is triggered by an objective, immediate environmental threat or if it stems from a dysregulated neural pathway that activates the amygdala in entirely safe scenarios. Adaptive survival fear serves a protective function rooted in physical preservation, whereas a pathological anxiety disorder involves chronic activation of the sympathetic nervous system, causing somatic symptoms like hypervigilance, catastrophizing, and maladaptive avoidance patterns that disrupt their day-to-day functional capabilities.
What is the recommended clinical protocol if moving up a systematic exposure hierarchy triggers a severe, unmanageable panic attack mid-session?
Pause the active presentation of the feared stimulus immediately and guide the client through structured progressive muscle relaxation and paced grounding techniques. Avoid allowing the client to completely flee the clinical space, as premature escape pathologically reinforces their avoidance behaviors; instead, maintain a supportive environment to help them tolerate the peak sympathetic arousal until their autonomic nervous system naturally stabilizes.
How should a child therapist handle a situation where asking a pediatric client to draw their fear triggers deep emotional flooding or a behavioral meltdown?
De-escalate the emotional intensity immediately by changing the visual scale and properties of the image or utilizing a feelings thermometer to establish containment. Move your clinical focus away from direct exposure and collaboratively help the child alter the drawing by shrinking its physical size, changing its color values, or introducing elements like a monster spray metaphor to help them regain a sense of external control and psychological safeness.
When is it clinically appropriate to prioritize ACT cognitive defusion and externalization over standard CBT thought-challenging logs for intrusive fear-based thoughts?
Deploy cognitive defusion techniques when a client presents with severe obsessive-compulsive traits, rigid perfectionism, or highly repetitive intrusive thoughts that escalate when directly debated. Reframing internal dialogue into objective phrases like “I am having the thought that I am unsafe” allows the client to observe their fear-based criticism from a safe distance without executing compulsive safety behaviors or getting caught in over-analytical evidence-gathering loops.
Can advanced exposure-based overcoming fear activities be safely implemented with clients presenting with acute, unmanaged post-traumatic stress disorder?
No, systematic exposure and high-intensity fear-related activities must be carefully delayed until the client develops reliable affect tolerance and masters foundational stabilization strategies. Attempting to force an acutely traumatized individual to construct a fear timeline or confront traumatic reminders before their nervous system has adequate coping capacity risks severe psychological retraumatization, profound dissociation, and immediate treatment dropout.
Final Thoughts On Choosing The Right Overcoming Fear Activities for your Clients
Because fear is a natural human experience, it is an emotional reaction that our clients will experience. It is important to recognize the importance of fear and normalize it in appropriate contexts. Overcoming fear activities can help our clients find a healthy balance of fear for their lives while maintaining control over how they respond to it. It may take time for clients to notice these changes, during which you can recognize and praise their continual efforts to improve their emotional health.
If you would like to learn more about how to help clients who are struggling with fear, you can look for related continuing education and training experiences. Evidence-based therapies that you could look into include Cognitive Behavioral Therapy (CBT), exposure therapy, Acceptance and Commitment Therapy (ACT), and play therapy for children.
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Resources:
- Menting, A. M. (2025, March 14). The Chill of Fear. Harvard Medicine Magazine. https://magazine.hms.harvard.edu/articles/chill-fear
- Sussex Publishers. (n.d.-b). Fear. Psychology Today. https://www.psychologytoday.com/us/basics/fear/amp