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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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Avoidance and Escape
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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

ABC Model

ABC is an acronym for Antecedents, Behavior, Consequences. It is used as a tool for the assessment and formulation of problem behaviors and is useful ... https://www.psychologytools.com/resource/abc-model

Activity Diary (Hourly Time Intervals)

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-hourly-time-intervals

Activity Diary (No Time Intervals)

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-time-intervals

Activity Menu

Helping clients to choose which activities to target during behavioral activation (BA) can be accomplished in a variety of ways: activity monitoring c ... https://www.psychologytools.com/resource/activity-menu

Activity Planning

Research suggests that an activity is more likely to be completed if it is planned and scheduled in advance. The Activity Planning worksheet can be us ... https://www.psychologytools.com/resource/activity-planning

Activity Selection

Activity selection is a technique for rating the difficulty of different activities. It is a helpful tool when clients have difficulty choosing betwee ... https://www.psychologytools.com/resource/activity-selection

Am I Experiencing Death Anxiety?

Am I Experiencing Death Anxiety? is an indicative screening tool, designed to help clients self-assess whether their experiences might warrant further ... https://www.psychologytools.com/resource/am-i-experiencing-death-anxiety

Am I Experiencing Depression?

Depression is a condition characterized by an extended period of low mood, anhedonia, and reduction in activity. Am I Experiencing Depression? is an i ... https://www.psychologytools.com/resource/am-i-experiencing-depression

Am I Experiencing Generalized Anxiety Disorder (GAD)?

Generalized anxiety disorder (GAD) is a condition characterized by problematic worry. Am I Experiencing Generalized Anxiety Disorder? is an indicative ... https://www.psychologytools.com/resource/am-i-experiencing-generalized-anxiety-disorder-gad

Am I Experiencing Health Anxiety?

Health anxiety (also referred to as illness anxiety disorder and hypochondriasis) is a condition characterized by a preoccupation with, or fear about, ... https://www.psychologytools.com/resource/am-i-experiencing-health-anxiety

Am I Experiencing Panic Attacks?

Panic attacks are discrete episodes of intense fear or apprehension. They are accompanied by the rapid and concurrent onset of characteristic symptoms ... https://www.psychologytools.com/resource/am-i-experiencing-panic-attacks

Am I Experiencing Panic Disorder?

Panic attacks are discrete episodes of intense fear or apprehension, accompanied by the rapid and concurrent onset of several physiological and psycho ... https://www.psychologytools.com/resource/am-i-experiencing-panic-disorder

Am I Experiencing Post-Traumatic Stress Disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a condition characterized by unwanted memories of trauma, high levels of arousal, and avoidance. Am I Experie ... https://www.psychologytools.com/resource/am-i-experiencing-post-traumatic-stress-disorder-ptsd

Am I Experiencing Social Anxiety?

Social anxiety disorder is characterized by persistent fear or anxiety concerning social or performance situations that is out of proportion to the ac ... https://www.psychologytools.com/resource/am-i-experiencing-social-anxiety

Approach Instead Of Avoiding (Psychology Tools For Overcoming Panic)

When we start to avoid things it can shrink the number of places that it feels ‘safe’ to go. It can cut us off from rewarding experiences, and avo ... https://www.psychologytools.com/resource/approach-instead-of-avoiding-psychology-tools-for-overcoming-panic

Assertive Communication

Communicating and acting assertively is an interpersonal skill that helps people to maintain healthy relationships, resolve interpersonal conflict, an ... https://www.psychologytools.com/resource/assertive-communication

Audio Collection: Psychology Tools For Overcoming PTSD

The Psychology Tools for Overcoming PTSD Audio Collection is designed for anyone with post-traumatic stress disorder (PTSD). This skills development p ... https://www.psychologytools.com/resource/psychology-tools-for-overcoming-ptsd-audio-collection

Autonomic Nervous System

The autonomic nervous system (ANS) automatically regulates the function of body systems outside of voluntary control. The Autonomic Nervous System han ... https://www.psychologytools.com/resource/autonomic-nervous-system

Avoidance Hierarchy (Archived)

NOTE: An improved version of this resource is available here: Fear Ladder. Older versions of a resource may be archived in the event that they are ava ... https://www.psychologytools.com/resource/avoidance-hierarchy

Balance

Our sense of balance is the result of a complex system which receives visual, vestibular, and proprioceptive inputs. This Balance client information h ... https://www.psychologytools.com/resource/balance

Behavioral Activation Activity Diary

Behavioral activation (BA) is an effective treatment for depression. Different behavioral activation protocols include a variety of treatment componen ... https://www.psychologytools.com/resource/behavioral-activation-activity-diary

Behavioral Activation Activity Planning Diary

Behavioral activation (BA) is an effective treatment for depression. Different behavioral activation protocols include a variety of treatment componen ... https://www.psychologytools.com/resource/behavioral-activation-activity-planning-diary

Behavioral Experiment

Behavioral experiments are planned experiential activities to test the validity of a belief. They are one of the most powerful techniques available to ... https://www.psychologytools.com/resource/behavioral-experiment

Behavioral Experiment (Portrait Format)

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-portrait-format

Being With Difficulty (Audio)

Being With Difficulty is a mindfulness exercise which gently brings present-moment awareness to bear upon thoughts and feelings that are more difficul ... https://www.psychologytools.com/resource/being-with-difficulty-audio

CBT Appraisal Model

The CBT Appraisal Model worksheet is a transdiagnostic formulation tool. The centrality of appraisals underpins all of the disorder-specific cognitive ... https://www.psychologytools.com/resource/cbt-appraisal-model

Changing Avoidance (Behavioral Activation)

Behavioral activation (BA) is a structured psychotherapeutic approach effective for a range of disorders, including depression (Ekers et al., 2014), a ... https://www.psychologytools.com/resource/changing-avoidance-behavioral-activation

Cognitive Behavioral Model Of Anorexia Nervosa (Fairburn, Cooper, Shafran, 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-fairburn-cooper-shafran-2003

Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)

Depersonalization is an experience where an individual feels a sense of detachment from themselves, or estrangement from their perceptions, actions, a ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-depersonalization-hunter-phillips-chalder-sierra-david-2003

Cognitive Behavioral Model Of Fear Of Body Sensations

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-body-sensations

Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with h ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-health-anxiety-salkovskis-warwick-deale-2003

Cognitive Behavioral Model Of Low Self-Esteem (Fennell, 1997)

Low self-esteem is characterized as a negative sense of the self and co-occurs with many other mental health problems. Although not formally represent ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-low-self-esteem-fennell-1997

Cognitive Behavioral Model Of Obsessive Compulsive Disorder (OCD: Salkovskis, Forrester, Richards, 1998)

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

Cognitive Behavioral Model Of Panic (Clark, 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-clark-1986

Cognitive Behavioral Model Of Persistent Postural-Perceptual Dizziness (PPPD: Whalley, Cane, 2017)

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

Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)

Anke Ehlers' & David Clark's Cognitive Behavioral Model Of Post-Traumatic Stress Disorder (PTSD) is an influential account of the condition. The ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-post-traumatic-stress-disorder-ptsd-ehlers-clark-2000

Cognitive Behavioral Model Of Social Phobia (Clark, Wells, 1995)

People suffering from social anxiety disorder (previously known as social phobia) experience persistent fear or anxiety concerning social or performan ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-social-phobia-clark-wells-1995

Cognitive Behavioral Model Of Tinnitus (McKenna, Handscombe, Hoare, Hall, 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-mckenna-handscombe-hoare-hall-2014

Cognitive Behavioral Treatment Of Childhood OCD: It's Only A False Alarm: Therapist Guide

Cognitive Behavioral Treatment Of Childhood OCD: It’s Only A False Alarm comes in two volumes. This page is for the Therapist Guide. Click on the fo ... https://www.psychologytools.com/resource/cognitive-behavioral-treatment-of-childhood-ocd-its-only-a-false-alarm-therapist-guide

Cognitive Behavioral Treatment of Childhood OCD: It's Only a False Alarm: Workbook

Cognitive Behavioral Treatment Of Childhood OCD: It’s Only A False Alarm comes in two volumes. This page is for the Workbook. Click on the following ... https://www.psychologytools.com/resource/cognitive-behavioral-treatment-of-childhood-ocd-its-only-a-false-alarm-workbook

Critical Care And PTSD

The Critical Care And PTSD information handout is designed to help clients to learn about the properties of critical care that can increase the likeli ... https://www.psychologytools.com/resource/critical-care-and-ptsd

Critical Illness Intensive Care And Post-Traumatic Stress Disorder (PTSD)

This is a free guide designed for people who have spent time in an intensive care unit and are experiencing symptoms of post-traumatic stress disorder ... https://www.psychologytools.com/resource/critical-illness-intensive-care-and-post-traumatic-stress-disorder-ptsd

Embracing Uncertainty

Intolerance of uncertainty (IU) was first described in individuals suffering from Generalized Anxiety Disorder (GAD). Many behaviors associated with G ... https://www.psychologytools.com/resource/embracing-uncertainty

Exposure And Response (Ritual) Prevention For Obsessive Compulsive Disorder (Second Edition): Therapist Guide

Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder comes in two volumes. This page is for the Therapist Guide. Click on the f ... https://www.psychologytools.com/resource/exposure-and-response-ritual-prevention-for-obsessive-compulsive-disorder-therapist-guide

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

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

Exposure Session Record

The Exposure Session Record is a tool for recording clients’ use of exposure. The worksheet guides clients to identify a specific fear they are will ... https://www.psychologytools.com/resource/exposure-session-record

Facing Your Fears (CYP)

Graded or graduated exposure is a traditional way of overcoming fears and phobias. The therapist helps the client to draw up a list of feared situatio ... https://www.psychologytools.com/resource/facing-your-fears-cyp

Facing Your Fears And Phobias

The Facing Your Fears And Phobias guide is written for clients who struggle with fears or phobias. It provides comprehensive information about what fe ... https://www.psychologytools.com/resource/facing-your-fears-and-phobias

Fear Ladder

The Fear Ladder is a tool for exploring and ranking the contexts or situations in which a client experiences fear. It is designed to help the client a ... https://www.psychologytools.com/resource/fear-ladder

Fight or Flight (CYP)

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

Fight Or Flight Response

The fight or flight response is an automatic physiological reaction to an event that is perceived as stressful or frightening. The perception of threa ... https://www.psychologytools.com/resource/fight-or-flight-response

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

Health Anxiety Formulation

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with h ... https://www.psychologytools.com/resource/health-anxiety-formulation

Interoceptive Exposure

Misappraisals of body sensations trigger emotional and physiological reactions of fear and heightened arousal. These feelings motivate behavioral resp ... https://www.psychologytools.com/resource/interoceptive-exposure

Intolerance Of Uncertainty

Uncertainty is a normal part of life – we can never be 100% sure about what will happen next. Many people feel good about uncertainty and live lives ... https://www.psychologytools.com/resource/intolerance-of-uncertainty

Managing Social Anxiety (Third Edition): Therapist Guide

Managing Social Anxiety – A Cognitive-Behavioral Therapy Approach comes in two volumes. This page is for the Therapist Guide. Click on the following ... https://www.psychologytools.com/resource/managing-social-anxiety-therapist-guide

Managing Social Anxiety (Third Edition): Workbook

Managing Social Anxiety – A Cognitive-Behavioral Therapy Approach comes in two volumes. This page is for the Workbook. Click on the following link t ... https://www.psychologytools.com/resource/managing-social-anxiety-workbook

Mastery And Pleasure 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/mastery-and-pleasure-activity-diary

Mastery Of Your Anxiety And Panic (Fifth Edition): Therapist Guide

Mastery Of Your Anxiety And Panic comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying C ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-panic-therapist-guide

Mastery Of Your Anxiety And Panic (Fifth Edition): Workbook

Mastery Of Your Anxiety And Panic comes in two volumes. This page is for the Workbook. Click on the following link to access the accompanying Therapis ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-panic-workbook

Mastery Of Your Anxiety And Worry (Second Edition): Therapist Guide

Mastery Of Your Anxiety And Worry comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying W ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-worry-therapist-guide

Mastery Of Your Anxiety And Worry (Second Edition): Workbook

Mastery Of Your Anxiety And Worry comes in two volumes. This page is for the Workbook. Click on the following link to access the accompanying Therapis ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-worry-workbook

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

Obsessive Compulsive Disorder (OCD) Formulation

An important treatment implication of the cognitive behavioral model of OCD is that clinicians can work at the level of the meaning of the intrusion. ... https://www.psychologytools.com/resource/obsessive-compulsive-disorder-ocd-formulation

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

Overcoming Eating Disorders (Second Edition): Therapist Guide

Overcoming Eating Disorders comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the Client Workbook.&nbs ... https://www.psychologytools.com/resource/overcoming-eating-disorders-therapist-guide

Overcoming Your Eating Disorder: Workbook

Overcoming Eating Disorders comes in two volumes. This page is for the Client Workbook. Click on the following link to access the accompanying Therapi ... https://www.psychologytools.com/resource/overcoming-your-eating-disorder-workbook

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 'boom and ... https://www.psychologytools.com/resource/pacing-for-pain-and-fatigue

Panic - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/panic-self-monitoring-record

Panic Attack Record

Self-monitoring of thoughts, feelings, and symptoms is an essential skill for clients engaged in cognitive behavioral therapy (CBT). The Panic Attack ... https://www.psychologytools.com/resource/panic-attack-record

Panic Formulation

The aim of a formulation is to help the client and therapist to come to a shared understanding of what a client is experiencing. The Panic Formulation ... https://www.psychologytools.com/resource/panic-formulation

Problem Solving

Problem Solving is a structured worksheet which encourages solution-focused thinking. Clients are encouraged to identify a problem, identify multiple ... https://www.psychologytools.com/resource/problem-solving

Problem Solving (CYP)

Effective problem solving is an essential life skill and this Problem Solving worksheet is designed to guide children and adolescents through steps wh ... https://www.psychologytools.com/resource/problem-solving-cyp

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

Prolonged Exposure Therapy For PTSD (Second Edition): Therapist Guide

Prolonged Exposure Therapy For PTSD comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying ... https://www.psychologytools.com/resource/prolonged-exposure-therapy-for-ptsd-therapist-guide

PTSD Formulation

This PTSD Formulation is designed for use in trauma-focused cognitive therapy for PTSD (CT-PTSD): an empirically supported treatment for post-traumati ... https://www.psychologytools.com/resource/ptsd-formulation

Reclaiming Your Life From A Traumatic Experience (Second Edition): Workbook

Prolonged Exposure Therapy For PTSD comes in two volumes. This page is for the Client Workbook. Click on the following link to access the accompanying ... https://www.psychologytools.com/resource/reclaiming-your-life-from-a-traumatic-experience-workbook

Safety Behaviors

Safety behaviors are actions carried out with the intention of preventing a feared catastrophe. In the short-term they often give a sense of relief, b ... https://www.psychologytools.com/resource/safety-behaviors

Self-Monitoring Record (Universal)

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/self-monitoring-record-universal

Social Anxiety Formulation

People suffering from social anxiety disorder (previously known as social phobia) experience persistent fear or anxiety concerning social or performan ... https://www.psychologytools.com/resource/social-anxiety-formulation

Stages Of Social Anxiety

The Stages Of Social Anxiety worksheet is a tool to record unhelpful socially anxious responses to social situations, and to map alternative ways of t ... https://www.psychologytools.com/resource/stages-of-social-anxiety

Starvation Syndrome – The Effects of Semi-Starvation

The Starvation Syndrome – Effects of Semi-Starvation handout provides an overview of the Minnesota Starvation Experiment and common symptoms of semi ... https://www.psychologytools.com/resource/starvation-syndrome-the-effects-of-semi-starvation

Stimulus Discrimination (Audio)

The Stimulus Discrimination audio exercise is taken from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to help people with ... https://www.psychologytools.com/resource/stimulus-discrimination-audio

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

Transdiagnostic Processes

A ‘transdiagnostic process’ is the label given to a mechanism which is present across disorders and which is either a risk or maintaining factor f ... https://www.psychologytools.com/resource/transdiagnostic-processes

Treating Your OCD With Exposure And Response (Ritual) Prevention (Second Edition): Workbook

Exposure and Response (Ritual) Prevention for Obessssive-Compulsive Disorder comes in two volumes. This page is for the Client Workbook. Click on the ... https://www.psychologytools.com/resource/treating-your-ocd-with-exposure-and-response-ritual-prevention-workbook

Uncertainty Beliefs – Experiment Record

Situations which are uncertain, novel, or ambiguous trigger a state of uncertainty. Evidence indicates that individuals who are dispositionally high i ... https://www.psychologytools.com/resource/uncertainty-beliefs-experiment-record

Understanding Death Anxiety

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-death-anxiety

Understanding Depression

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-depression

Understanding Fears And Phobias

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-fears-and-phobias

Understanding Health Anxiety

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-health-anxiety

Understanding Obsessive Compulsive Disorder (OCD)

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are ... https://www.psychologytools.com/resource/understanding-obsessive-compulsive-disorder-ocd

Understanding Panic

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-panic

Understanding Post-Traumatic Stress Disorder (PTSD)

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-post-traumatic-stress-disorder-ptsd

Understanding Social Anxiety

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-social-anxiety

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Client Workbook

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition) comes in two volumes. This page is for the Client Workbook. ... https://www.psychologytools.com/resource/unified-protocol-for-transdiagnostic-treatment-of-emotional-disorders-second-edition-client-workbook

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Therapist Guide

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition) comes in two volumes. This page is for the Therapist Guide. ... https://www.psychologytools.com/resource/unified-protocol-for-transdiagnostic-treatment-of-emotional-disorders-second-edition-therapist-guide

Values: Connecting To What Matters

Values: Connecting To What Matters is a practical self-help guide which introduces the reader to a cornerstone of acceptance and commitment therapy (A ... https://www.psychologytools.com/resource/values-connecting-to-what-matters

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

  • Oxford - Agoraphobic Avoidance Scale (O-AS) | Lambe, S., Bird, J. C., Loe, B. S., Rosebrock, L., Kabir, T., Petit, A., ... & Freeman, D. | 2023
    • Scale
    • Reference Lambe, S., Bird, J. C., Loe, B. S., Rosebrock, L., Kabir, T., Petit, A., ... & Freeman, D. (2023). The Oxford agoraphobic avoidance scale. Psychological Medicine, 53(4), 1233-1243.

Exercises

What Are Avoidance And Escape?

Disorders That May Be Maintained by Avoidance and Escape

Avoidance and escape are often maintenance factors in:

Helpful Questions for Assessing Avoidance and Escape

Some helpful questions for assessing avoidance and escape include:

  • How do you respond when you feel threatened?
  • What activities/​people/​places/​situations/​objects do you avoid?
  • What does the avoidance get in the way of you doing?
  • What would happen if you stopped avoiding?

Treatment Approaches That Target Avoidance and Escape

Exposure is often considered the method of choice to reduce avoidance across the anxiety disorders. Varieties of exposure techniques include in-vivo exposure, graded exposure, and interoceptive exposure. Mowrer’s two-stage model of fear and avoidance is cited as the origin of the behavioral practice of reducing avoidance (Mowrer, 1939, 1960). According to this theory, avoidance behavior is reinforced when it is followed by a reduction in anxiety.

Cognitive techniques have also been found to be highly effective treatments for anxiety, with successful treatment leading to reductions in avoidance (Kaczkurkin & Foa, 2015).

References

  • Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28(10), 857–870.
  • Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behaviouralprocesses across psychological disorders: A transdiagnostic approach to research and treatment. New York: Oxford University Press.
  • Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in Clinical Neuroscience, 17(3), 337–346.
  • Lewisohn, P. M. (1975). Engagement in pleasant activities and depression level. Journal of Abnormal Psychology84(6), 729–731.
  • Mowrer, O. H. (1939). Anxiety and learning. Psychological Bulletin, 36, 517–518.
  • Mowrer, O. H. (1960). Learning theory and behavior. New York: Wiley.
  • Salkovskis, P. M. (1991). The importance of behaviourin the maintenance of anxiety and panic: A cognitive account. Behavioural and Cognitive Psychotherapy, 19(1), 6–19.
  • Wilson, G. T. and O’Leary, D. (1980). Principles of behavior therapy. Englewood Cliffs, NJ: Prentice-Hall.