BIP Goals for a Kid With Anxiety: A Step Ladder That Works

If you are writing a Behavior Intervention Plan (BIP, the document a Board Certified Behavior Analyst, or BCBA, uses to spell out a treatment plan for a hard behavior) for a kid with anxiety, a token board is the wrong tool. The right tool has two rails. Rail one is non-contingent assent withdrawal, which means the kid can tap out at any time, no matter what, and nobody pushes back. Rail two is contingent escape, which means the kid only earns a break by taking one small step forward into the thing that scares them. Then you write a ladder of steps, and you put both rails next to every step. The case study in this CEU is a teen named M who started at step zero, which was full refusal to get out of the car at a brand new high school, and ended at step nine, which was sitting in class for the day. Nine steps. Two rails. That is the BIP. Here it is, written the way it would land on a real plan.

Why a token board is the wrong BIP for an anxious kid#

A token board treats the problem like a motivation problem. Sit in class, get a point. Stack the points, get the prize. That works when the kid wants to be in class and just needs a reason to push through a boring task. It does not work when the kid's body is reading the classroom as a threat. Now the points are pulling the kid toward the thing that is firing their fear response, and the kid still cannot get there. The board does not move the wave of anxiety. It just dangles a reward on top of it.

If we're thinking of anxiety as just, oh, they just don't want to do it. And we implement, you know, a token board, for example, that's an oversimplification of the nature of the avoidance that's occurring. We're not tapping into the broad base of evidence around anxiety and treatment of anxiety. From the talk — Dr. Clelia Sigaud

So the BIP has to do something different. It has to give the kid a way to step toward the scary thing in small enough doses that the wave does not crash. It has to honor the kid's no. And it has to deliver the break the moment the kid takes the step. That is what the two-rail design does.

The two rails: non-contingent assent withdrawal and contingent escape#

The first rail is non-contingent. That word matters. Non-contingent means the kid does not have to earn it. At any moment, with no warning, the kid can say no and go all the way home. The team does not negotiate. The team does not prompt one more time. The kid is in the driver's seat, and the team's job is to make that real.

The second rail is contingent. Escape from the scary thing is only delivered after the kid takes one small step into the scary thing. The break is the reward, but the kid only gets it by moving forward. That is how the BIP teaches the body that forward motion ends the discomfort. The token board teaches the opposite, which is that you sit in the discomfort until the timer runs out.

We came on this non-contingent assent withdrawal and contingent escape. At any time, no matter what, assent withdrawal was respected. If he said no, no, he didn't have to move forward. From the talk — Dr. Clelia Sigaud

Run together, the two rails feel almost counterintuitive. The kid can always quit. The kid still moves forward most days. The reason it works is that the kid learns the team will not trap them. Once that lesson lands, the kid stops fighting the team and starts fighting the fear.

What a real step looks like written into the BIP#

Every step in the plan needs three things on the page. A clear action the kid takes. A clear duration or completion mark. And both rails, listed under the step, so the team in the room knows what to do when the kid moves and what to do when the kid says no. No vague phrasing. No "tolerate school." A step is a thing you can watch happen.

Here is the literal text from the first two steps of M's plan.

Step number one, the goal there was to drive by and stop for 30 seconds without problem behavior. If they were at step number two, it was step out of the car without problem behavior. From the talk — Dr. Clelia Sigaud

Notice what is in there. The action is concrete. The duration is concrete. The success criterion is concrete: without problem behavior. The two rails are not written into the step itself because they apply to every step. They sit at the top of the plan as standing rules. You can read more about how to build that step list one rung at a time in the fear hierarchy guide.

M's nine-step ladder, end to end#

Here is the full ladder, as M's team ran it. Step zero is the baseline they walked into.

• Step zero. Pull up to the school, attempt drop-off, full refusal. Severe behavior. Assent withdrawal honored. Drive home.
• Step one. Drive by the school and stop for 30 seconds without problem behavior.
• Step two. Step out of the car without problem behavior.
• Step three. Walk through the cafeteria. No fear response triggered. The team focused on teaching the body that the cafeteria itself was safe.
• Step four. Sit outside the hallway.
• Step five. Sit down outside the classroom, sometimes for up to an hour. This is the step where the team practiced contingent escape in its clearest form.
• Step six. Step inside the classroom, even for a moment.
• Step seven. Stay inside the classroom for a short stretch of class time.
• Step eight. Stay inside the classroom for most of a class period.
• Step nine. Participate in class. Actually go to school and be there.

The team ran steps one and two once or twice a day because the logistics of driving up to school could not be repeated more than that. Once M was actually on campus, the team could run "push and reinforce escape" several times in a single day, which is how the data started climbing fast. The graph the team kept did not record every attempt. It recorded the highest step M hit that day. That single rule made the data easy for everyone, including teachers, to read.

The step that mattered most was step five. That is where the team got to practice both rails in full.

When he was on step five and he was spending an hour sitting outside the classroom, at any time, he could withdraw his assent and go all the way back home. Or I might encourage him, hey, you seem like you're in a good place. Why don't we try to step inside? From the talk — Dr. Clelia Sigaud

That single passage is the whole design. The kid can quit, the team can encourage, and the moment the kid steps in, the team walks the kid right back out for a chill break. The classroom becomes a place you can leave, not a place you get stuck in.

How to know a step is too big#

A step is too big when the kid's body says no before the kid's mouth does. Severe behavior, refusal in the car, full shutdown at the door, those are not motivation problems. Those are the wave breaking. The fix is not to push harder. The fix is to insert a smaller step between the current step and the next one. If the kid was at step three and step four fell apart twice in a row, add a "step three and a half." Walk to the door of the hallway and turn around. Then try step four again the next session.

The other tell is the data plateau. If the kid hits the same step for three or four sessions in a row and nothing moves up or down, the step is sized right but the contingent escape is not landing. Check that the break is actually a break. Sometimes the team keeps the demand running in the background and the kid notices.

Data: what to score and what to ignore#

Score one number a day: the highest step the kid hit. That is the line on the graph. Ignore total attempts. Ignore total minutes in the classroom. Those numbers feel like progress and they hide what is actually moving. If M ran step six six times and stayed on step five all day, the graph reads step six. That is the rung you can build on tomorrow.

Ignore problem behavior counts during exposure. The BIP is not a behavior reduction plan in the usual sense. The behavior will drop as the steps climb. If you score behavior, you tempt the team to chase the behavior down and ignore the step. Score the step. Trust the design.

What you do track on a side column is assent withdrawal. Mark every time the kid taps out. Not as a failure. As a sign that rail one is real. A BIP for anxiety that never sees a single assent withdrawal in the first two weeks is suspicious. The kid either is not at threat yet, or worse, the team is not actually letting them tap out.

When to slow down even after a good day#

The biggest mistake the team almost made with M was treating a great day as proof the kid was done. M jumped from step six to step nine in a single session because the teacher had laid out coloring pages he liked. That was a real win. It was not a signal to remove the ladder. The next morning, the wave was still there. The team kept the rails. They kept the option to come home. They kept the contingent escape. The win bought them faster pacing, not the end of the plan.

The same rule applies when the schedule changes. New semester, new teacher, sub day, a fire drill. Slide the kid down a step on purpose. Run that step clean. Then climb back up. The ladder is a tool, not a trophy.

Frequently asked questions#

How many steps should an anxiety BIP have?

As many as the kid needs. M's plan had ten rungs, counting step zero. Most plans land between six and twelve. Fewer than six and the steps are usually too big. More than twelve and you are sometimes writing the same step twice in slightly different words. The right test is the data. If the kid is climbing rung by rung without skipping, the ladder is sized right. If the kid plateaus, add a half step. If the kid jumps two rungs in one session, you can drop a rung from the plan.

Can a BIP for anxiety include a prompt?

Yes. The prompt has to come from a place of equal, not pressure. The team's words sound like, "Hey, come on, buddy. You want to try it." Not, "You need to go in now." A prompt that does not respect rail one is not a prompt. It is a demand. If the kid says no after the prompt, the team backs all the way off and the next attempt waits.

What do I write in the BIP when the kid taps out?

Two lines. Line one: the team will honor assent withdrawal at any time, with no negotiation. Line two: the session ends or pauses at the kid's stated stopping point, and the team returns the kid to their preferred location, including home if that is what the kid asks for. Both lines sit at the top of the plan as standing rules, not inside any individual step. They are the floor everything else is built on.

Watch the full case#

The CEU walks through M's full graph, the school placement fight, and the moment the team realized step five was the rung that held the whole ladder together. You can see the data climb in real time and hear how the school team came around once the design started working.