In-vivo indication and safety planning

In-vivo work may be indicated when avoidance of objectively safe reminders limits daily functioning; it is not required for every child. This form is not an independent exposure assignment for families. Decisions require assessment of actual danger and collaboration with the child and caregiver.

Decide whether this component fits

Describe the avoided situation in general terms and the effect on daily life. Distinguish a trauma reminder from ongoing danger. How was safety verified, by whom, and what information is missing? Do not plan exposure to abuse, unsafe people, or other genuine threats. If safety is uncertain, address protection and clarify conditions first.

Design a collaborative plan

If indicated, agree on a meaningful functional goal. Identify manageable steps, support arrangements, and a way to review distress and learning. Adapt communication and expectations to development and access needs. The therapist determines the plan; this reference does not prescribe a sequence, duration, or distress cutoff.

Define roles and revision points

• What will the therapist teach and review before any practice?
• How will the caregiver support rather than pressure or surprise the child?
• What signs require stopping to reassess safety, support, or the plan?
• How will changes in real-world circumstances be checked?

Review functioning, the child’s experience, and caregiver feedback rather than completion alone. Revise collaboratively if practice is overwhelming or circumstances change. Seek consultation when indication, safety, or adaptation remains unclear.