Example of a mission plan with insistence on sameness and wanting to stick to routines

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Neil’s fear of change is an example of a fear that has overlap between anxiety and insistence on sameness/wanting to stick to routines. As you may recall, Neil does not like when his schedule changes and he suddenly needs to go somewhere, or when his mother drives home from school using a different path or another caregiver picks him up.

If there is a change, he will repeatedly ask his parents questions about the new plan and insists on knowing every detail ahead of time. Here is an example of how Neil’s family could work on an aspect of this fear and work towards the goal of Neil tolerating changes in routine when he is notified right before they are happening:

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Step	Anxiety Rating 0-10 or Easy \| Medium \| Hard	Reward / Brace Bucks
Neil’s mom will tell Neil in the morning that they are making a stop on the way home to his favorite ice cream shop and reminds him when she picks him up from school. They drive to the ice cream store on their way home.	3	10 extra minutes of screen time
Neil’s mom will tell Neil when she picks him up from school that they are stopping at his favorite ice cream shop on the way home. She proceeds to drive to the ice cream store and gets Neil a snack.	4	Stay up an extra 30 minutes on the weekend
Neil’s mom will tell Neil in the morning that they are making a fun special stop on the way home and reminds him when she picks him up from school. She will not respond to Neil’s questions about where they are going at any time. Instead, she will say, “it’s a surprise.” They will stop somewhere that Neil likes on the way home.	4	Have breakfast in bed
Neil’s mom will tell Neil when she picks him up from school that they are making a fun special stop on the way home. She will not respond to Neil’s questions about where they are going, and they will stop somewhere that Neil likes, like his favorite comic store or milkshake place.	5	Ride a bike with mom
Neil’s mom will tell Neil in the morning that they will be driving one of two different ways home from school that day. When she picks him up, she reminds him and has him pick a slip of paper out of a bowl. Whatever street is on the slip of paper he picks will be the way they drive home.	7	20 extra minutes of screen time
Neil’s mom will tell Neil when she picks him up from school that they will be driving one of two different ways home. She has him pick a slip of paper out of a bowl. Whatever street is on the slip of paper he picks will be the way they drive home.	8	Go to Neil's favorite restaurant
Neil’s mom will tell Neil when she picks him up from school that they will be driving a new way home.	9	Go to a dance workshop that Neil really wanted to go
Neil’s mom will tell Neil when she picks him up from school that she needs to run an errand on the way home. Neil will then accompany her on her errand on the way home.	10	Buy a new item in a video game that Neil wanted

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Example of a mission plan with insistence on sameness and wanting to stick to routines