Rediscovering the Role of Avoidance in Psychotherapy Progress and Outcome

Avoidance has been proposed as an important variable in the development of psychological problems. Relatively little empirical work has been conducted, however, that examines the relationship of avoidance to progress in therapy. This report first describes the theoretical contribution of avoidance-related constructs in the development of psychological problems and in obstructing therapeutic progress. Next, the report reviews research indicating that (a) avoidance may interfere with emotional and cognitive processes necessary for therapeutic progress and (b) substantial differences in therapeutic progress exist between clients who do and do not evidence avoidance of negative affect (NA). Finally, new exploratory analyses are reported that indicate (a) considerable variability in the frequency with which therapists identified client avoidance and (b) how avoidance and progress monitoring data can be combined to estimate the likelihood of short-term client progress. Overall, findings suggest that clinicians should pay particular attention to avoidance in clients who are failing to improve.