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.

Psychology Tools cognitive behavioral therapy (CBT) worksheets for avoidance


The Centre for Clinical Interventions (CCI) is an Australian mental health organisation that conducts research, provides training and supervision, and offers a clinical service. They have made some distress tolerance resources which can be helpful in overcoming avoidance.

Distress Intolerance

Self-help Programme

  1. Understanding distress intolerance
  2. Accepting distress
  3. Improving distress
  4. Tolerating distress