Chapter 7: Behavioral work/ decreasing avoidance

Question 1

2 interventions to target avoidance behaviour

Answer 1

1. exposure treatments

2. behavioural activation

Question 2

exposure treatment

Answer 2

= exposure to feared stimulus, goals of habituation of physiological anxiety, reduction of fears, provisions of opportunities for new learning to occur
- newer research: random and variable exposure produces similar outcomes to traditional gradual systematic exposure

Question 3

ways to maximise the effectiveness of exposure therapy

Answer 3

• use of expectancy violation: if clients feared outcome will not occur, he or she will learn more effectively
• reduction of anxiety during exposure may not have to be reduced and teaching of coping skills may not be required

Question 4

minimizing factors that inhibit successful exposure therapy

Answer 4

• most anxious clients typically have mental, interpersonal or behavioural habits that serve to decrease their anxiety and minimise the effectiveness of exposure, e.g. reassurance seeking, safety behaviours, self-or anxiety-focused attention –> purpose: temporariliy reduce anxiety, making treatment less effective
• safety behaviours have negative consequences, including increased focus on anxiety, prevention of new learning, prevention of true involvement in the exposure practice
• -> anxiety neutralisation or maintenance factors can be defined as factors that minimise the effects of exposure
• helpful to reduce these behaviours systematically in a gradual fashion, building their reduction into the exposure
• make clients aware of them

Question 5

methods to minimise avoidance and maintain gains during exposure therapy

Answer 5

e. g.,
1. identification though functional analysis
2. vigilance and close observation
3. make clients aware of them
4. partners/families assistance for identification
5. gradual and systematic reduction in collaboration with client
6. client: learn how to tolerate and accept anxiety
7. repeat exposure

Question 6

behavioural activation

Answer 6

• idea: avoidance works to maintain depressed mood

- Behavioral activation targets avoidant coping as a primary problem in depression

Question 7

steps in behavioural activation

Answer 7

1. conduct a functional analysis to determine the clients avoidance patterns
   - TRAP (triggers, response avoidance pattern)
   - TRAC ( triggers, response, alternative coping)