Purpose of Review <p>Despite the efficacy of exposure therapy for pediatric obsessive-compulsive disorder, a significant portion of patients fail to achieve remission, clinically significant change, or low levels of symptomatology. Thus, there is a need to more directly target treatment mechanisms in order to improve outcome. Although extinction learning and habituation are often touted as principal mechanisms of exposure therapy, numerous clinical, theoretical, and empirical errors act as barriers to effective research and implementation. The aim of the current paper is to discuss the extant basic science on extinction learning and habituation in order to elucidate common deviations that impede research and clinical practice, with the hope of stimulating more targeted psychotherapy research.</p> Recent Findings <p>Empirical studies and theoretical papers demonstrate numerous errors when attempting to target extinction learning including failing to identify unconditional stimuli, attempting extinction when there is no unconditional stimulus, and exposing patients to stimuli that are not conditional stimuli. Clinical scientists and practitioners routinely misuse the term habituation and employ methodology that has precluded our ability to understand habituation as a mechanism of exposure therapy.&#xa0;</p> Summary <p> There are numerous theoretical errors plaguing the literature on Pavlovian extinction learning and habituation within exposure therapy.&#xa0;</p>