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Avoidance and Escape

Avoidance and escape refer to behaviors where people either do not enter a situation (avoidance) or leave situations after they have entered (escape). Distraction is considered to be a subtle form of avoidance behavior. Avoidance and escape are natural mechanisms for coping with many kinds of pain and trauma. When used as part of a repertoire of other coping mechanisms, escape and avoidance can considered adaptive. However, they are considered problematic when used too frequently or when they are used to the exclusion of other strategies, and they are included as diagnostic features of a range of disorders. Clinically, avoidance and escape are considered to be problematic because:
  • avoidance and escape behaviors remove the opportunity to disconfirm negative beliefs (Salkovskis, 1991);
  • they reduce an individual’s opportunities to obtain positive reinforcement and thus contribute to the maintenance of low mood (Ferster, 1973; Lewinsohn, 1975);
  • they reduce the number of external stimuli present in an individual’s environment (‘shrinks their world’) which may exacerbate self-focused attention and repetitive thinking (Harvey, Watkins, Mansell, & Shafran, 2004);
  • according to a habituation model of anxiety the relatively brief exposure periods occasioned by escape and avoidance may server to ‘sensitize’ patients to their feared stimuli (Wilson & O’Leary, 1980).
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Problem

Therapy tool

Language

A Guide To Emotions (Psychology Tools For Living Well)

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/a-guide-to-emotions-psychology-tools-for-living-well/

Chapter

Activity Diary

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/activity-diary/

Worksheet

Activity Diary (No Time Slots)

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/activity-diary-no-times/

Worksheet

Approach Instead Of Avoiding (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter discusses avoi ... https://www.psychologytools.com/resource/approach-instead-of-avoiding-psychology-tools-for-overcoming-panic/

Chapter

Assertive Communication

Communicating assertively is an essential skill for maintaining healthy self-esteem and strong relationships. This information handout describes the k ... https://www.psychologytools.com/resource/assertive-communication/

Information Handout

Avoidance Hierarchy

Avoidance and safety-seeking behavior serves to maintain anxiety, and exposure to the fear stimuli/situation is an effective treatment for anxiety. Th ... https://www.psychologytools.com/resource/avoidance-hierarchy/

Exercise

Behavioral Experiment

Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ... https://www.psychologytools.com/resource/behavioral-experiment/

Worksheet

Cognitive Behavioral Model Of Anorexia Nervosa (2003)

Anorexia nervosa is an eating disorder characterized by restriction of energy intake and intense fear of gaining weight. For women, the lifetime preva ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-anorexia-nervosa-2003/

Information Handout

Cognitive Behavioral Model Of Fear Of Bodily Sensations (2018)

Fear of bodily sensations is present in a number of conditions, most notably panic disorder. The Cognitive Behavioral Model Of Fear Of Bodily Sensatio ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-fear-of-bodily-sensations-2018/

Information Handout

Cognitive Behavioral Model Of Health Anxiety (2018)

The Cognitive Behavioral Model Of Health Anxiety describes maintaining factors which prolong distress in health-anxious clients. The formulation is pr ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-health-anxiety-2018/

Information Handout

Cognitive Behavioral Model Of Obsessive Compulsive Disorder (1998)

The essential insight of the cognitive behavioural model of obsessive compulsive disorder (OCD) is that it is the client’s interpretation of the int ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-obsessive-compulsive-disorder-1998/

Worksheet

Cognitive Behavioral Model Of Panic (1986)

The Cognitive Behavioral Model Of Panic identifies catastrophic misinterpretation of body sensations as a criticial maintenance factor which serves to ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-panic-1986/

Information Handout

Cognitive Behavioral Model Of Persistent Postural-Perceptual Dizziness (PPPD) (2017)

Persistent postural-perceptual dizziness (PPPD) is a form of dizziness which is thought to be maintained by psychological factors. ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-persistent-postural-perceptual-dizziness-pppd-2017/

Information Handout

Cognitive Behavioral Model Of Tinnitus (2014)

The Cognitive Behavioral Model Of Tinnitus identifies cognitive, behavioral, and perceptual changes which operate to maintain tinnitus perception and ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-tinnitus-2014/

Information Handout

Emotions Motivate Actions

Many clients find it helpful to recognize the range of actions that are motivated by different emotional states. This worksheet encourages clients to ... https://www.psychologytools.com/resource/emotions-motivate-actions/

Information Handout

Exposure And Response Prevention

Exposure And Response Prevention (ERP, EX/RP) is an effective treatment for obsessive compulsive disorder (OCD). This CBT worksheet guides therapists ... https://www.psychologytools.com/resource/exposure-and-response-prevention/

Exercise

Exposure Practice Form

Exposure is an effective treatment for many forms of anxiety. The Exposure Practice Form is a CBT worksheet which guides therapists and clients throug ... https://www.psychologytools.com/resource/exposure-practice-form/

Exercise

Fight or Flight (CYP)

The Fight Or Flight (CYP) information handout has been specifically designed for younger children and includes carefully simplified language. The full ... https://www.psychologytools.com/resource/fight-or-flight-cyp/

Information Handout

Habituation

The Habituation information sheets are designed to help clinicians to explain the concept of habituation and its role in exposure therapy. The handout ... https://www.psychologytools.com/resource/habituation/

Information Handout

Interoceptive Exposure

Interoceptive exposure (exposure to bodily sensations) is a critical part of CBT treatment for panic disorder. This information sheet and worksheet de ... https://www.psychologytools.com/resource/interoceptive-exposure/

Exercise

Maximizing The Effectiveness Of Exposure Therapy

Despite its position as the leading treatment technique for anxiety disorders, not all clients respond to exposure therapy and some individuals relaps ... https://www.psychologytools.com/resource/maximizing-the-effectiveness-of-exposure-therapy/

Information Handout

OCD Hierarchy

Part of traditional CBT treatment for OCD is exposure to situations which trigger obsessions (classically accompanied by the prevention of the associa ... https://www.psychologytools.com/resource/ocd-hierarchy/

Exercise

Pacing For Pain And Fatigue

Pacing is an evidence-based approach to increasing activity and fitness, and in reducing overall pain and fatigue. It is designed to prevent ‘bo ... https://www.psychologytools.com/resource/pacing-for-pain-and-fatigue/

Exercise

Process Focused Case Formulation

The Process-Focused Case Formulation encourages clinicians to make hypotheses regarding mechanisms or processes which they believe may be maintainin ... https://www.psychologytools.com/resource/process-focused-case-formulation/

Worksheet

Stages Of Social Anxiety

Stages of Social Anxiety is a CBT worksheet to explore maintaining factors with a client and then to explore possible treatment strategies. ... https://www.psychologytools.com/resource/stages-of-social-anxiety/

Worksheet

Thought Suppression And Intrusive Thoughts

Suppression is a common approach to unwanted thoughts, worriers, doubts, or urges. Unfortunately, there are good reasons why this strategy fails. This ... https://www.psychologytools.com/resource/thought-suppression-and-intrusive-thoughts/

Information Handout

Intervention

Self-Help Programmes

Overcoming distress intolerance