Short case example
A patient stops attending appointments after panic symptoms in the waiting room; relief after cancelling strengthens the belief that attending is unsafe.
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Formulation mechanism
A pattern of keeping away from internal experiences, situations, people, or tasks that trigger distress or perceived threat.
What matters now
Fit, function, and alternatives
Use sequence, function, patient language, and disconfirming evidence to decide whether this hypothesis adds explanatory value.
Across the formulation
Short case example
A patient stops attending appointments after panic symptoms in the waiting room; relief after cancelling strengthens the belief that attending is unsafe.
Formulation language
Avoidance appears to reduce distress briefly, but it also prevents corrective experience and maintains the threat appraisal.
Treatment implications
Plan graded appointment attendance with reduced safety behaviours and a brief post-session review of what was learned.