Evidence-based practice inherently involves critical thinking and flexibility to deliver these treatments in an efficacious yet tailored manner. Experiences during the COVID-19 pandemic presented us with a new question: When is avoidance an adaptive response to a shifting and uncertain environment, and when is it a symptom? We discuss ways in which avoidance emerged following the start of the pandemic. Clinical and ethical considerations are also presented, with a focus on discerning when avoidance is problematic versus a reasonable response to a novel stressor, as well as how to responsibly proceed when the context of treatment dramatically changes.
Keywords: COVID-19, anxiety related disorders, exposure, treatment modification, OCD, PTSD