Although avoidance is a natural mechanism for coping with many kinds of pain or trauma it also serves to maintain a wide range of psychological problems. In the short term avoidance can lead to the (reinforcing) reward of a reduction in real or imagined anxiety – this is the motivator for its use as a coping strategy. In the long term, though, avoidance can act to prevent the disconfirmation of unhelpful beliefs. Further, the use of avoidance as a coping strategy can lead to further unintended negative consequences.
Exposure is the most common therapeutic strategy used to overcome avoidance. There are many varieties of exposure including: in-vivo, imaginal, graded, and interoceptive. Exposure often involves asking a client to face their worst fears, and clear case formulation / coneptualization is critically important in presenting a rationale for exposure.