An Inhibitory Learning Approach to Cognitive-Behavioral Therapy for Children and Adolescents
Open accessAbstract
Although exposure-based cognitive-behavioral therapy (CBT) is efficacious for childhood anxiety and obsessive-compulsive disorder (OCD), many youth do not adequately respond to treatment. Extinction learning is an important process in exposure-based CBT. However, youth with anxiety disorders and OCD exhibit impairments in extinction processes that are best characterized by deficits in inhibitory learning. Therefore, the utilization of strategies to optimize inhibitory learning during exposures may compensate for these deficits, thereby maximizing extinction processes and producing more robust treatment outcomes for exposure-based CBT. This paper reviews several strategies to optimize inhibitory learning in youth with anxiety disorders and OCD, and presents practical examples for each strategy. This paper also highlights the difference between inhibitory learning-based exposures and prior conceptual approaches to exposure therapy in clinical practice. It concludes with a discussion of future directions for clinical research on inhibitory learning and exposure-based CBT in youth.
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Building distress tolerance/acceptance skills is a pivotal augmentation for better exposures.
“McGuire and Storch (2019) explained that varying contexts in which exposure occurs, maximizing expectation-outcome discrepancies, eliminating safety behaviors, and building distress tolerance/acceptance skills are pivotal augmentations for better exposures.”
From A Toolbox for Use During the Post-Pandemic Era: Preparing Youth for Re-entry (2024) · cites this paper as McGuire and Storch (2019)
In “Appropriate Initial Psychoeducation” (page not provided), the paper says distress-tolerance strategies may be clinically useful supplements to exposure as indicated and may help patients complete challenging exposures. Calling these skills “pivotal” augmentations overstates that conditional recommendation. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEliminating safety behaviors is a pivotal augmentation for better exposures.
“McGuire and Storch (2019) explained that varying contexts in which exposure occurs, maximizing expectation-outcome discrepancies, eliminating safety behaviors, and building distress tolerance/acceptance skills are pivotal augmentations for better exposures.”
From A Toolbox for Use During the Post-Pandemic Era: Preparing Youth for Re-entry (2024) · cites this paper as McGuire and Storch (2019)
Maximizing expectation-outcome discrepancies is a pivotal augmentation for better exposures.
“McGuire and Storch (2019) explained that varying contexts in which exposure occurs, maximizing expectation-outcome discrepancies, eliminating safety behaviors, and building distress tolerance/acceptance skills are pivotal augmentations for better exposures.”
From A Toolbox for Use During the Post-Pandemic Era: Preparing Youth for Re-entry (2024) · cites this paper as McGuire and Storch (2019)
Varying contexts in which exposure occurs is a pivotal augmentation for better exposures.
“McGuire and Storch (2019) explained that varying contexts in which exposure occurs, maximizing expectation-outcome discrepancies, eliminating safety behaviors, and building distress tolerance/acceptance skills are pivotal augmentations for better exposures.”
From A Toolbox for Use During the Post-Pandemic Era: Preparing Youth for Re-entry (2024) · cites this paper as McGuire and Storch (2019)
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“McGuire and Storch (2019) explained that varying contexts in which exposure occurs, maximizing expectation-outcome discrepancies, eliminating safety behaviors, and building distress tolerance/acceptance skills are pivotal augmentations for better exposures.”
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- Authors
- McGuire, J. F., & Storch, E. A.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- McGuire, Joseph F.
- Venue
- Cognitive and Behavioral Practice
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 26
- Issue
- 1
- Pages
- 214-224
- ISSN
- 1077-7229 (ISSN-L)
- PMC
- PMC6570488
- OpenAlex
- W2790734906
- Cited by
- 82
- References
- 64
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 14 · 2023: 15 · 2022: 8 · 2021: 11 · 2020: 12 · 2019: 5 · 2018: 4
- FWCI
- 10.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cognitive and Behavioral Practice (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health
- National Institutes of Health (T32 MH073517)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Keywords
- inhibitory learning, extinction learning, exposure-based cognitive behavioral therapy, childhood anxiety, obsessive-compulsive disorder, youth, treatment-resistant anxiety
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