(False) safety behaviors are behaviors (including types of reassuring thoughts) used in an attempt to prevent fears from coming true and often help an individual to feel somewhat more comfortable in situations where they are anxious. These strategies often work in the short-term to reduce anxiety but often play a significant role in maintaining anxiety in the long-term. Moreover, they often do not actually confer much safety as the feared outcomes often would not have come true, even without the safety behavior. Thus, these strategies are sometimes referred to as "false safety behaviors." Some clinicians have found the term "false safety behaviors" or "safety behaviors" a confusing term to use, particularly with children, as it can be difficult for some to understand the difference between unhelpful and false safety behaviors and true "safe behavior." As such, the term "fix-it behaviors" has emerged as a useful substitution as it describes the desire for these behaviors to "fix" the anxiety/distress.

Below are tools for explaining the role of false safety or fix-it behaviors including demonstrations videos and clinical guides to help clinicians introduce the concept with their patients/clients as well as resources that are intended for use with patients/clients.

Demonstration Videos

These videos provide examples of how a clinician might introduce the concept of false safety behaviors to a patient/client in session.

• Explaining Safety Behaviours and Why We Drop Them - In this video, the clinician explains to a patient/client how safety behaviors can keep their anxiety going and provide a rationale for why it is important to drop these safety behaviors in order to break the cycle of anxiety. The video comes from the Center for Clinical Interventions (CCI) CBT Clinical Demonstration video series.

Clinician Guides

These chapters and articles review the literature on safety behaviors and provide some guidance for clinicians based on the extant evidence.

• Telch, M. J., & Zaizar, E. D. (2020). Safety behaviors. In J. S. Abramowitz & S. M. Blakey (Eds.), Clinical handbook of fear and anxiety: Maintenance processes and treatment mechanisms (pp. 27–44). American Psychological Association. - This chapter describes the role safety behaviors play in the emergence, maintenance, and escalation of anxiety-related pathology and how different common safety behaviors tend to map onto specific perceived threats. It also provides a brief overview of the theories attempting to explain the anxiogenic effects of safety behaviors and identifies threat disconfirmation attenuation as a common element across theories.
• Telch, M. J., & Lancaster, C. L. (2012). Is there room for safety behaviors in exposure therapy for anxiety disorders? In P. Neudeck & H.-U. Wittchen (Eds.), Exposure therapy: Rethinking the model - refining the method (pp. 313–334). Springer Science + Business Media. - This chapter discusses whether to make safety behaviors available during exposure treatment and provides clinicians with specific recommendations for clinical assessment of safety behaviors, strategies for helping patients/clients fade anxiogenic safety behaviors, and strategies for utilizing safety behaviors to enhance exposure treatments.

Video Explainers

These videos provide psychoeducation on false safety behaviors that are suitable to send or show directly to patients/clients.

• These animated videos provide psychoeducation on false safety behaviors or "fix-it" behaviors. These videos were created for an Internet-based CBT program for the treatment of anxiety in children with autism (referred to as LUNA in the video) by researchers at Baylor College of Medicine (Guzick, A.G., Garcia Perozo, A., Kook, M., McNeel, M., Riddle, D.B., Schneider, S.C., & Storch, E.A. (unpublished website). Learning to Understand and Navigate Anxiety (LUNA) for Autistic Youth Program.). While the video refers to a few elements specific to LUNA (e.g., rewards) the videos are widely applicable.
  • For pre- and early adolescents
  • For younger kids (7-9 years old)

Handout Explainers

These handouts provide psychoeducation on false safety behaviors that are suitable to send or show directly to patients/clients.

• What Are Safety Behaviours? - A one-page handout from the CCI briefly explaining what safety behaviors are and their negative long-term effects.