Prolonged exposure — session tracking form

Complete before and after each exposure exercise  ·  All entries are private and clinician-use only

Session information

Triggers
SUDS rating
Coping
PCL-5 scoring
Session log

Trigger identification

Select all that apply for this session

SUDS — subjective units of distress scale

Rate distress from 0 (none) to 100 (worst imaginable)

50
0 none25 mild50 moderate75 severe100 extreme
70
0 none25 mild50 moderate75 severe100 extreme
40
0 none25 mild50 moderate75 severe100 extreme

Coping strategies used

Select all strategies utilized during or after this session

PCL-5 — PTSD checklist for DSM-5

In the past month, how much were you bothered by the following problems?

0 = not at all  ·  1 = a little bit  ·  2 = moderately  ·  3 = quite a bit  ·  4 = extremely

—
Total PCL-5 score (max 80)
Scoring thresholds:
0–20 minimal  ·  21–32 mild  ·  33–49 moderate  ·  50–80 severe
Provisional PTSD: score ≥ 33 and ≥1 B item, ≥1 C item, ≥2 D items, ≥2 E items all rated ≥ 2

Session-to-session score history

Log scores each session — clinically meaningful change = 10–15 point reduction

SessionDateTotalSeverityChangeNotes

Session exposure log

# Exposure target Before Peak After Coping used Notes / observations
1

Overall session notes