Treatment of avoidance behavior as an adjunct to exposure therapy: Insights from modern learning theory

•Avoidance behavior can persist following extinction or exposure.•The availability of avoidance behavior can renew fear.•Modern learning theory provides suggestions for novel behavioral and pharmacological interventions for avoidance behavior.

Pathological avoidance of benign stimuli is a hallmark of anxiety and related disorders, and exposure-based treatments have often encouraged the removal of avoidance, or safety behaviors, due to their negative effects on extinction learning. Unfortunately, empirical evidence suggests that avoidance behaviors can persist following treatment, and the mere availability of avoidance behavior can be sufficient to renew fear following successful extinction learning. The present paper critically examines the function of avoidance behavior through the lens of modern learning theory, and speculates on novel behavioral and pharmacological strategies for targeting avoidance as an adjunct to current evidence-based treatments.