What is central to exposure therapy for anxiety disorders?

• A. Relaxation training
• B. Exposure to feared object combined with prevention of avoidance
• C. Cognitive restructuring
• D. Medication management

Answer: (B)

Exposure therapy centers on facing the feared stimulus or situation and not giving in to avoidance. By repeatedly approaching the trigger in a controlled way, the fear response tends to lessen as the person learns that the anticipated catastrophe is unlikely or manageable. This relies on extinction learning and expectancy violation—the brain updates its predictions about danger when disconfirming evidence accumulates. The approach can involve in vivo exposure, imaginal exposure, or interoceptive exposure. The key is preventing avoidance and safety behaviors, because those actions keep fear alive by letting the person test the belief under false safety. While relaxation skills, cognitive restructuring, or medications can help support treatment, they’re not the central mechanism of exposure itself.