Avoidance Learning in Clinical Psychology

Within clinical psychology, avoidance learning is pertinent in both understanding the causes of maladaptive behaviors and formulating methods to intervene therapeutically. Relative to etiology, psychologists have long posited that experiential avoidance is at the heart of many clinical disorders. Thus, a person who struggles to cope effectively may abuse alcohol or use illicit drugs to avoid confronting sources of stress and discomfort.

When implemented for therapeutic purposes, avoidance learning is promoted according to a five-step process: (1) identifying a problem behavior to be reduced or eliminated, (2) selecting a response to serve as replacement for the problem behavior, (3) choosing a negative consequence, (4) pairing the negative consequence with the problem behavior, and (5) allowing the person receiving treatment to avoid the negative consequence. Although this step-wise progression looks like a straightforward process, it is not without complications. First, there are ethical concerns when proposing or using negative and distressing events with individuals who already have adjustment difficulties. Second, even if an avoidance learning approach to treatment seems appropriate, it can be an arduous task arranging contiguous behavior and unpleasant conditions. And third, negative reinforcement generally would not be considered the sole basis of treatment, but instead it would be combined with other therapeutic procedures to prompt and maintain compensatory skills.

Avoidance learning for therapeutic purposes is employed typically by professionals from the disciplines of behavior therapy and behavior modification. Beginning in the early 1960s, several research reports by behavioral psychologists described examples of avoidance conditioning that incorporated extremely aversive stimulation. In one demonstration, children who had autism and were unresponsive to social interaction learned to avoid electric shock by approaching a therapist who called to them, "Come here." Faradic and other noxious stimuli such as foul odors and tastes also were programmed with individuals to condition avoidance of cues and situations associated with alcohol ingestion, drug use, and "deviant" sexual orientation. By contemporary standards these approaches would be unacceptable and viewed by some as dehumanizing. In fact, the majority of behavioral practitioners have essentially abandoned aversive treatment procedures in favor of positively oriented and skill-building strategies.

Although avoidance learning is still included in many current therapies, the types of negative experiences are more benign than those found in the historical record. As a whole, and when contrasted to other behavior-change procedures, avoidance learning and training is used less frequently in clinical practice. Again, because avoidance must be produced by exposure (real or threatened) to unpleasant conditions, it should be considered cautiously and applied with great care on those occasions when it can be justified clinically.

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