I feel so grateful to Dr. Craske for giving us her time to help us learn more about inhibitory learning! I find it difficult to inhibit my original learning (habituation, change in beliefs) about mechanisms of change during exposure, and so reading this article, talking with Dr. Craske, and talking with people here will all help me learn this new model. 

I am still working to understand how the inhibitory learning model is related to the intervention of doing behavioral experiments to test beliefs that underpin anxiety and avoidance. Two ideas I am working with are:

A behavioral experiment format for doing exposures is a good way to promote inhibitory learning because the format requires the patient and therapist to beforehand get a very clear idea of what beliefs the patient has that drive his/her fear and avoidance (this is the case conceptualization) and this information helps the patient and therapist identify what new learning the patient needs to get to overcome his/her anxiety. The intervention also emphasizes working actively with the person during and after the exposure to help him/her identify what new learning s/he got from the experience. 

One key point I got from Dr. Craske and from her article is that the goal of inhibitory learning is not to change old beliefs. It is to help the patient have new experiences that will create new beliefs. I have always viewed the behavioral experiment as a way to test and disconfirm problematic beliefs. The inhibitory learning model suggests the goal of treatment is not to change old beliefs but to create new beliefs and increase their strength and likelihood of retrieval.

I am aware now (after hearing the interview, rather than just having read the article) that the prediction testing that has been a part of the CBT exposure protocol that I have always followed really is more focused on changing the patient's beliefs than on focusing on the new (inhibitory) learning (that will lead to new beliefs). It's a fine line, but an important one, I think.

Thanks so much for making this research so much more accessible to us (struggling) clinicians!!

Thank you Jackie for making inhibitory learning model much easier to understand and clinically applicable.  Especially relevant to me is the idea that new learning is very fragile, and the threat laden beliefs and their corresponding behaviors are quite strong, or potent as Craske states.  These new memory structures that are being built through exposures, appear to be more general beliefs, then specific disconfirmation of specific thoughts.  For example the idea that the socially anxious client learns rejection does equate never having meaningful relationship.

The language used, in terms of "violating expectancy" makes sense when taken in the context of the surprise element that helps new learning take place. Loved listening to this, and the second time was even better than the first!