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Research concerning the effects of distracted versus focused exposure has produced mixed findings. A recent meta-analysis found that overall there was no difference between distracted versus focused exposure in terms of treatment outcome (Podin? et al., 2013). However, the results were in favor of distracted exposure �C greater approach of and reduced distress concerning previously feared stimuli following treatment �C relative to focused exposure when there were multiple exposure sessions (Oliver and Page, 2008) and when distraction involved client-therapist interaction concerning something irrelevant to the exposure (e.g., Johnstone and Page, 2004). Parrish et al. (2008) suggested that the beneficial effects of distraction may be due to increases in self-efficacy and the belief that threat and the accompanying anxiety could be controlled, however, multiple sessions may be required in order to see this benefit. Interpreting these data in line with attention biases, we might expect that a tendency to attend away from threat would not necessarily be associated with worse treatment outcome if such avoidance during exposure were accompanied by a belief that threat and/or the fear response can be managed. However, if the immediate post-treatment benefit of attending away from threat is provided by improvements in self-efficacy, rather than enhanced inhibitory learning, there is a possibility that fear might return later if people no longer feel as though they are competent enough to manage threat (Craske et al., 2008). That is not to say that attending toward threat would not be beneficial for the treatment of fear. Waters and Kershaw (2015) recently showed that children with an attention bias toward threat, measured using a Dot Probe task, showed enhanced extinction of fear to a CS, relative to children with an avoidant attention bias. As models of extinction learning and exposure suggest, the reduction of fear selleck products requires at least some engagement with the potential sources of threat and subsequent learning about the non-occurrence of anticipated danger. Attention and Context Dependency The inhibitory model of extinction and exposure was developed following research concerning the fragility of extinction learning and the factors that can lead to a return of fear after extinction. One of the main findings concerned the context dependency of extinction learning and the renewal effect. During extinction and exposure, when a feared stimulus is presented and the expected aversive US does not occur, the anxious or fearful person seeks to resolve the conflict between their expectation and reality (Bouton, 2004).