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Behavioral Therapy: When And Why Is It Needed?

Behavior therapy is a popular choice for people who are struggling with issues such as phobias and anxiety. It is also a go-to for parents who are coping with Autism and related disorders in children because it delivers effective behavioral changes. 

Here’s how behavioral therapy works, and why it is still a very much needed approach in psychotherapy.

What is behavioral therapy?

Behavioral therapy encompasses a broad range of techniques that work to change unwanted and/or harmful behaviors. The main goal is to reinforce preferred behaviors and eliminate undesirable ones. 

Behaviorism is a school of thought based on the idea that people learn from their environment. It is suggested that it was old learning that led to the development of the issue and thus, new learning can bring change. The first person to bring up the idea of behavior modification was Edward Thorndike. 

Compared to humanistic therapies and psychoanalytic therapy, behavioral therapy is highly focused and action-based. As such, the behavior itself is seen as the problem and the therapist’s aim is to teach new ways of conduct in order to overcome or eliminate the issue. 

What can behavioral therapy treat? 

This therapy is aimed to treat a variety of psychological disorders, such as:

  • Alcohol & Substance use disorders
  • Anxiety
  • Autism spectrum disorders
  • Attention deficit hyperactivity disorder (ADHD)
  • Depression
  • Bipolar disorder
  • Eating disorders
  • Phobias
  • Panic disorder
  • Obsessive-compulsive disorder (OCD)
  • Borderline personality disorder (BPD)
  • Anger management
  • Stress management
therapy
Photo by Priscilla Du Preez on Unsplash

Types of behavioral therapy

There are quite a number of behavioral therapies. While each of these therapies aims for behavioral changes, they each have their unique strategies. The type of therapy used often depends on factors such as the mental health issue and the severity of it. 

Cognitive-behavioural therapy (CBT)

CBT is a popular therapy that combines principles and techniques from both cognitive and behavioral therapies. Treatment focuses on how thoughts and beliefs can influence a person’s conduct and actions. The long term goal of CBT is to affect change in an individual’s negative thoughts and thus, behavioral patterns. 

Cognitive-behavioural play therapy

This approach is usually used with children. Therapists observe and gain insight into the child’s world by watching them play. In cognitive-behavioural play therapy, children are given permission to choose what they want to play with and engage in free play. 

The therapist may also ask the child to draw pictures or create scenes during play. 

Therapists using this approach use play to help kids learn new behavior via play, and may also show parents how to use play to improve communication with their kids. 

Exposure therapy

Exposure therapy is usually used to treat anxiety and phobias. This behavioral approach aims to help individuals overcome their fears of objects and situations by exposing them to the source of fear. Therapists teach relaxation strategies and coping skills to empower patients to face their fears. 

Dialectical behavioral therapy (DBT) 

In dialectical behavioral therapy, both behavioral and cognitive techniques are used to help patients. DBT works by getting people to understand and accept difficult feelings, learn how to cope and manage these feelings and make positive changes in life. 

DBT is often used with people who experience intense and overwhelming emotions. 

For more information, read our article on “Dialectical behavioral therapy.

Rational emotive behavioral therapy (REBT)

Rational emotive behavioral therapy is based on the premise that our thoughts, emotions and behaviors are connected. Thus, psychological issues and mental distress are overcome by challenging irrational beliefs and negative thinking patterns. 

REBT is also sometimes referred to as the ABC theory of personality. 

For more information, read our article on “Rational emotive behavioral therapy.” 

Applied behavior analysis (ABA)

In applied behavior analysis, problematic behaviors are modified via operant conditioning. ABA can be used to improve communication and social skills, academics, living skills and job competence. 

It is an effective approach for both children and adults with psychological issues in schools, homes, and workplaces. 

Social learning theory

Social learning theory suggests that people learn behavior through observation and imitation. Behavioral changes can occur when we observe how others are rewarded or punished for their actions. 

Behavioral therapy principles and techniques

Behavioral therapy techniques are based on classical conditioning and operant conditioning. 

Classical conditioning

Classical conditioning uses the formation of associations between stimuli. A neutral stimulus is paired with another stimulus that automatically produces a response. Repeated pairings of both these stimuli result in an association, with the previously neutral stimuli now producing the same response. 

Techniques based on the principle of classical conditioning include:

Systematic desensitization

Systematic desensitization is a technique often used to treat anxiety disorders and phobias. 

In this technique, people start by confronting the least fear-inducing item until they are able to face the most fear inducing item. 

For example, to help a person who has a phobia of dogs, the therapist may first have the person just look at pictures of dogs. Once the person is comfortable, the therapist can introduce the person to a real dog. This step is then followed by the person being near the dog, touching the dog, and so on.  

Aversion therapy

In aversion therapy, undesirable behavior is paired with an aversive stimulus. It is hoped that the unwanted behavior will lessen due to the negative consequences it brings. 

Flooding

Flooding is a technique that can be used to treat phobias. In this technique, people are rapidly exposed to the feared object or situation. Escaping or avoiding the situation is not allowed and thus, the individual is forced to face their fears.  

Operant Conditioning

Operant conditioning utilizes reinforcement and punishment to increase or decrease the frequency of certain behavior. It is expected that desirable consequences following a particular behavior will encourage it to occur again in the future and vice versa. 

Operant conditioning can bring about fast and effective behavioral changes. 

Techniques based on the principle of operant conditioning include:

Contingency management

In contingency management, a ‘contract’ between the therapist and client is made. In this contact, goals of behavioral changes, reinforcements, rewards as well as penalties are outlined clearly. This approach to behavioral change is effective as rules are very clear for both parties. 

Token economies

This reinforcement technique is often used by parents and teachers to encourage wanted behaviors. Children earn tokens when they engage in the preferred behaviors and lose tokens when they partake in unwanted behaviors. They can then exchange the tokens they earn for a reward. 

Extinction

In extinction, a behavior or situation that is providing reinforcement is stopped or eliminated to produce behavioral changes. For example, a child who is snatching toys is put in a time-out to remove him from the situation. 

The unwanted behavior will soon be extinguished because the rewarding situation is taken away. 

Behavior modeling

Behavior modeling allows the individual to learn via observation and modelling behavior of other people. Instead of the basic reinforcement and punishment, behavior modeling enables individuals to learn acceptable behaviors by observing other people engaging (and getting rewarded) in the preferred skills and behaviors. 

Behavioral therapy effectiveness

While success rates of behavioral therapies depend on the specific type of treatment applied and the condition being treated, behavioral therapies are considered to be highly effective. In fact, research shows that about 75% of those who try psychotherapy see a positive improvement

CBT, in particular, has shown to be an effective treatment for post-traumatic stress disorder, panic disorder, obsessive-compulsive compulsive disorder. Additionally, CBT also has benefits for those who are suffering from schizophrenia

Behavioral therapy for ADHD

Behavioral therapy can help people with attention deficit hyperactivity disorder (ADHD) manage behaviors that they are struggling with. Symptoms of ADHD can make daily life very challenging. 

However, new and positive behaviors can be developed to effectively manage these symptoms. ADHD treatment plans often utilize behavioral therapy together with medication. 

Read more in our article on “Behavioral therapy for ADHD: How can it help?

Behavioral therapy for depression

Behavioral therapy for depression often focuses on behavioral activation, in which patients engage in activities that promote positive feelings. CBT and DBT are also often used to help those who are struggling with depression. 

Behavioral therapy autism

While there is no cure for autism, behavior therapy such as applied behavior analysis and cognitive behavioral therapy can be a great help for those who are struggling with autism. 

Behavioral therapies can help those with autism reduce unwanted and even harmful behaviors that are interfering with learning and everyday life. It can also help in the development of social skills.

Behavioral therapy for children

Applied behavior therapy and play therapy are often used to teach children how to respond more positively to situations. These therapies reward good behaviors and punish unwanted behaviors. Parents help to reinforce the positive behaviors daily in order to affect the behavioral changes. 

children therapy
Photo by Robert Collins on Unsplash

Things to consider

While behavioral therapy can be very effective, there are some limitations that should be considered:

  • It may not be sufficient for complex mental health issues. There are times when behavioral therapy needs to be used together with other medical and therapeutic interventions. For example, patients with schizophrenia most likely need medication in addition to therapy. 
  • It may not be able to deal with the root issue. Behavioral interventions usually focus on current problems patients face and may not give enough weight to underlying factors contributing to the issue. 
  • It may not address situational factors and interpersonal relationships that might have contributed to the issue. 

Conclusion

Behavioral therapy is one of the most effective ways to affect long term behavioral changes. If you’re looking for a behaviorist, your local mental health practitioner will be able to make recommendations according to the condition needing treatment. 

If you’re a behavioral therapist, A Space Between is a professional co-working space that offers numerous rooms suitable for therapy practices.

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A Space Between provides flexible co-working office spaces for rent to therapists and other professionals in Singapore.
A Space Between is a destination for mental health therapy activities. Counsellors utilise our many conducive therapy rooms for consultations. Located conveniently downtown and offering your independent therapists rent by the hour, we house many professional mental health practitioners, including LGBTQ+ friendly ones. To find out more about the therapists practising in A Space Between, write to us at [email protected].
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