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8 DISCUSSION 199 In the context of stimuli that give rise to disgust, safety behaviors that preclude the occurrence of threat, but allow confrontation with the disgust-eliciting stimulus (e.g., using a hygienic wipe or hand sanitizer after touching a contaminant) may be allowed during the early stages of exposure therapy. Cleaning safety behavior did not hamper the beneficial effects of exposure to a contaminant in chapter 3 (van Uijen, van den Hout, Klein Schiphorst, et al., 2017), and previous studies (Goetz & Lee, 2015; Rachman et al., 2011; van den Hout et al., 2011, 2012). However, these positive effects may be specific to the early stages of treatment, and to the novelty of the cleaning behavior (Levy & Radomsky, 2016a). Recent findings suggest that incorporating cleaning safety behavior in the early stages of exposure therapy, and letting patients determine when safety behavior is faded in the course of treatment increases treatment effectivity and acceptability in the context of contamination fear (Levy & Radomsky, 2016b). Furthermore, the findings presented in chapter 2 suggest that safety behavior that does not preclude the occurrence of threat may be allowed during exposure therapy for certain individuals, but should be eliminated for others (van Uijen, Dalmaijer, et al., 2017). It remains unclear for whom safety behavior that allows the occurrence of threat has detrimental effects on exposure outcomes. Therefore, if safety behavior that allows threat occurrences is incorporated in exposure exercises, it is advised to make an individual assessment of whether this hampers extinction learning for a patient. Safety behaviors that motivate approach may increase access to disconfirmatory evidence, and thereby have positive effects on exposure outcomes (e.g., Milosevic & Radomsky, 2008, 2013). Additionally, anxious individuals may infer safety from approach behavior (chapter 6, van Uijen, van den Hout, & Engelhard, 2017), although it remains unclear if this adds to the beneficial effects of exposure (chapter 7, van Uijen et al., 2015). Approach-supportive behaviors may not be considered safety behaviors, but adaptive coping strategies (Thwaites & Freeston, 2005).