What Is Behavioral Therapy And What Are Its Benefits?
Behavioral therapy is a psychotherapeutic treatment focused on the mental processes that can manifest as observable behaviors. One of the main goals of behavioral therapy is to allow an individual to put labels on cognitive distortions and learn healthy coping skills based on research.
Treating various mental health disorders, such as anxiety disorders, phobias, depression, post-traumatic stress disorder, eating disorders, and personality disorders, is among the benefits of behavioral therapy. However, this type of therapy can be useful even if you do not have a mental health diagnosis for which you’re seeking treatment.
What is behavioral therapy?
This type of therapy targets symptoms by breaking thoughts into digestible concepts. It focuses on the relationships between what you think, feel, and do. Research on this method suggests that behavior can be learned and unlearned and is not part of someone's core self. The objective is to assist a person in discovering new behaviors to suppress or reduce unwanted ones.
It can be important to note that behavior therapy generally differs from cognitive behavioral therapy, or CBT. Behavioral therapy combines with cognitive therapy to form CBT. In CBT, an emphasis is usually put on identifying unhelpful or unhealthy thought patterns, such as those that can lead to anxiety or exacerbate post-traumatic stress disorder. With CBT, people are normally taught about the ways in which their thoughts can impact their emotions and behaviors.
How does this therapy help patients recover?
Behavioral therapy addresses mental illness by focusing on the interconnections between thoughts, feelings, and behaviors. Using principles from science and cognitive therapies, therapists can identify and replace maladaptive behaviors with healthier alternatives.
Applied behavior analysis (ABA) is a common part of mental health treatment in behavior therapy programs. Programs can help teach coping skills and encourage positive behavior for those struggling with substance use or mental health conditions like depression, bipolar disorder, or post-traumatic stress disorder.
Contextual science emphasizes the role of context in shaping behavior, cognition, and emotion. By understanding these factors, therapists help individuals make lasting changes and overcome challenges, ultimately fostering healthier behaviors.
Behavior therapy vs psychoanalysis
How is behavior therapy different from psychoanalysis? Therapeutic techniques like psychoanalysis and cognitive therapy focus primarily on insight, while behavioral therapies focus on actions. Several therapies are available, including, but not limited to, the following:
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy, or CBT is an integrative therapy that combines parts of behavioral treatment with cognitive therapy. While the behavior change aspect can be essential, cognitive therapy can help people identify unwanted thoughts or distorted beliefs. With CBT, mental health professionals can apply certain principles to maladaptive behaviors, mental health conditions, and relationship conflicts. CBT has proven effective in treating many conditions, as well as prolonged exposure to stress. For instance, it can be a form of treatment for eating disorders, post-traumatic stress disorder, and obsessive-compulsive disorder.
Cognitive-behavioral play therapy (CBPT)
Therapists may use various methods of play to assess and treat mental health problems in children and improve behaviors through awareness of thought. Children might do roleplay, guided play, art therapy, or narrative therapy with a therapist to understand their feelings or what they're experiencing at home.
Dialectical behavioral therapy (DBT)
DBT teaches people to develop healthy coping skills, improve relationships, and manage emotions. It provides a profound focus on mindfulness and distress tolerance techniques.
According to Harvard Health Publishing, DBT therapists often emphasize mindfulness, compassion, acceptance, and a non-judgmental attitude when teaching these skills. This approach validates a person’s challenging thoughts and emotions so the individual can accept, process, and cope with them.
What’s the difference between DBT and CBT?
DBT and CBT are similar forms of behavioral therapy, but they take distinct approaches to thoughts and emotions. In DBT, most thoughts and emotions are approached as valid so the individual can accept and approach them to find the best ways to cope with them. This differs from CBT, which often challenges unwanted thoughts and emotions as “distortions” to replace them with different ones.
Rational emotive behavior therapy (REBT)
Rational emotive behavior therapy (REBT) focuses on replacing irrational thoughts with rational ones based on facts and understanding. It also helps people learn to use rational thoughts to calm their emotions, creating a connection between logical thinking and what an individual feels.
Similar to CBT, REBT focuses on how thoughts can affect behavior and may emphasize challenging and coping with unhelpful thoughts with the assistance of a therapist.
Example of REBT
Suppose an individual talks to their therapist and begins to explore their emotions during a REBT session. As they have this discussion with their therapist, the individual might identify that they’ve been stressed about the possibility that the company they work for will go under.
In this case, an REBT therapist might then guide the individual to explore where this fear comes from and form reassuring and rational thoughts about the likelihood of this scenario.
Then, when they find themselves worrying about whether their job is secure, the individual can try to use REBT methods to replace these worries with reassuring ones to calm their emotions.
Exposure therapy or exposure and response prevention (ERP)
Exposure and response prevention, also known as ERP or exposure therapy, is often used to treat patients with phobias, OCD, and post-traumatic stress disorder (PTSD), among other conditions.
ERP uses systematically controlled techniques that expose people to the source of their phobias or fears (or triggers, in the case of post-traumatic stress disorder) while simultaneously incorporating relaxation techniques. This approach can help patients overcome their fears and triggers gradually while remaining in a safe, controlled environment during exposure.
Foundations of behavior therapies: Classical conditioning
Classical conditioning is one of the main principles of modern behavioral therapy. Behavioral treatment based on classical conditioning focuses on forming associations between neutral stimuli and stimuli that provoke a response.
There are numerous methods of changing behavior through classical conditioning, many of which are detailed below.
Flooding
Flooding is a procedure used by behavior therapists that involves exposing an individual to objects or situations they may be afraid of. An example of this could include exposing an individual who fears cats to pictures of cats, conversations about cats, and a real cat. Through flooding, an individual may learn that their fear response is not congruent with the actual danger of the situation.
During the procedure, the individual cannot avoid the situation or object, which forces them to embrace their fear. However, the approach can be disconcerting for some, so an experienced therapist is usually needed to facilitate the process.
Systematic desensitization
Systematic desensitization is similar to flooding but occurs more gradually. The behavioral therapist may begin by requesting that the person create a list of their fears. Afterward, the therapist typically teaches relaxation tactics for the person to utilize while contemplating those fears.
Next, they might work their way up from the minor fear-inducing stimuli to the most fear-triggering. The therapist will assist the person in embracing their fears in an undisturbed state. Exposure therapy (ERP) is a form of systematic desensitization. ERP is sometimes used to treat post-traumatic stress disorder and phobias.
Aversion
Aversion therapy often aims to pair unwanted or unhealthy behaviors with aversive stimuli to reduce undesirable behavior effectively. For example, this therapy might be used when an individual who wants to stop chewing on their nails uses bitter-tasting nail polish to cause disgust if they start nail biting. Due to the negative consequences of biting their nails, they might start to avoid the habit altogether.
Foundations of behavior therapies: Operant conditioning
Operant conditioning is another primary principle upon which modern behavioral therapies are based. It’s a practice that uses positive reinforcement, punishment, and modeling to change unwanted behavior.
Below, you’ll find information on some of the many strategies used in operant conditioning.
Token economics
Token economics is based on positive reinforcement, giving people tokens to exchange for desired privileges when positive behaviors are shown. Teachers and parents commonly use the strategy to enhance and manage a child's behavior and mark progress toward a long-term goal.
Contingency management
Contingency management may involve a formal written agreement between a therapist and the client that outlines the objectives, rewards, and penalties associated with the conditions of a treatment plan. For many, having a written contract could play a role in altering behavior and ensuring accountability. For others, this process may feel limiting.
Modeling
Modeling involves learning via observing and imitating others. A role model plays a crucial role in showing another person healthier behaviors. For example, a parent might be a role model to a child, or a therapist may be a role model to a client.
Extinction
Extinction often works by eliminating all forms of reinforcement to a specific behavior in order to eliminate that unwanted behavior. For example, each time you procrastinate studying, you might decide not to leave your home for the day except for errands. Doing so removes any rewards you might receive from going out with friends, eating out, or shopping.
Is behavioral therapy effective?
These methods are considered effective for many, with a success rate upwards of 75%. CBT may be the most popular form of behavioral therapy and can treat conditions like:
Anxiety disorders
Depression
Borderline personality disorder
Autism spectrum disorder
Somatoform disorders
Attention deficit hyperactivity disorder (ADHD)
Chronic psychological stress
Anger management difficulties
Eating disorders
Substance use disorders
Peer-reviewed research shows that CBT is more effective than medication and other forms of talk therapy when treating panic attacks, generalized anxiety disorder, phobias, OCD, and PTSD. However, it may not be effective for everyone, and some individuals may prefer a different approach.
Some individuals might also try medication for their symptoms. Consult with a mental health or medical professional to find the most suitable option for you. You may start to see results quickly, or it may take some time.
Therapy and counseling options
Finding a therapist can be challenging. You may search for a provider through your insurance company or obtain a referral through your doctor. An online search might also yield results for therapists in your area. Regardless of where you look, ensure that the therapist you hire is licensed and experienced in treating your concerns.
If you struggle to find a behavioral therapist in your area or face barriers to treatment, such as cost, you can also consider online therapy, like internet-based CBT. Online therapy has been proven as effective as in-person therapy in treating symptoms of depression, anxiety, and PTSD. If you’re looking for qualified mental health counselors, consider signing up for an online platform like BetterHelp, which offers over 30,000 therapists specializing in various treatment types, including CBT.
Online therapy can allow you control over your treatment, as you can choose between phone, video, or live chat sessions.
Takeaway
Behavioral therapy targets the way emotions and thoughts can impact behaviors and decisions. If you're interested in trying this therapy or researching its methods further, consider discussing the topics above with a mental health professional for guidance and resources.
What happens during behavioral therapy?
During behavioral therapy, the therapist works with the client to identify and modify maladaptive, problematic behaviors or responses in certain situations. The psychologist uses various behavioral therapy techniques to help the client understand the thoughts and feelings that contribute to unwanted behaviors and teach them strategies to change their thoughts to change their behavior.
What are the techniques used in behavior therapy?
The type of techniques used in behavioral therapy might vary depending on the specific needs of the patient and the psychologist’s preferred treatment method. For example, therapists working with children might focus on positive reinforcement and behavioral activation. At the same time, people in therapy for post-traumatic stress disorder (PTSD) might benefit most from systematic desensitization and relaxation techniques. Here are a few methods commonly used in behavior therapy:
- Cognitive behavioral therapy (CBT): This approach focuses on identifying and changing negative thought patterns and beliefs that contribute to problematic behaviors. CBT helps people develop more productive, adaptive ways of thinking.
- Exposure therapy: This technique gradually exposes individuals to the stimuli or environments that trigger anxiety and fear with the aim of reducing avoidant behaviors. Through repeated exposure paired with relaxation techniques, people can learn to manage their anxiety and modify their behaviors.
- Behavioral activation: This type of therapy focuses on increasing participation in positive, rewarding activities to improve mood, cultivate self-esteem, and strengthen motivation.
- Dialectical behavioral therapy: This is a form of cognitive behavioral therapy that focuses on teaching individuals the skills they need to manage emotions, improve relationships, cope with stress healthily, and modify behaviors. It combines change-based and acceptance strategies to strike a balance between the need to change problematic behaviors and acceptance of oneself.
- Relaxation techniques: Techniques like deep breathing, mindfulness meditation, and progressive muscle relaxation can help people reduce stress and anxiety, which contribute to problem behaviors.
- Behavioral rehearsal: This technique involves role-playing and practicing new behaviors in a safe, supportive environment. It helps individuals develop and reinforce new skills and coping strategies.
- Social skills training: This type of behavior therapy helps individuals improve their interpersonal and communication skills. It involves teaching individuals how to resolve conflicts, interact effectively with others, and establish healthy relationships.
What should I expect from a behavioral therapist?
When working with a behavioral therapist, you can expect a structured, goal-oriented approach to therapy involving close collaboration and practical activities. The treatment process and approach typically vary between individuals according to their needs and might change with the individual’s progress over time. Here are some things you can expect from a behavioral therapist while you’re in treatment:
Assessment
Behavioral therapy typically begins with an initial assessment to learn more about your background, past experiences, goals, and concerns. During this phase, the therapist will likely administer surveys and other types of tests to learn more about your symptoms and behaviors.
Collaborative strategies
You and your therapist will work collaboratively to develop a plan addressing your specific needs and goals during treatment. This might involve setting measurable goals and constructing strategies to achieve them.
Skill-building exercises
Behavioral therapists often use sessions to teach practical skills and techniques designed to help you change problematic behaviors, manage emotions, and improve coping strategies. They may include communication skills training, relaxation techniques, and conflict resolution training.
Homework assignments
Your therapist might assign “homework” between sessions to help reinforce the skills you’re learning in therapy and learn to apply them in real-life situations.
Treatment adjustment
Like most types of therapy, your psychologist will regularly monitor your progress throughout the treatment process. They might use outcome measures or self-assessment tools to track changes in your symptoms or behaviors over time and adjust the plan accordingly when needed.
Does behavioral therapy work?
A comprehensive body of medically reviewed research shows that behavioral therapy, particularly cognitive behavioral therapy, is highly effective in helping individuals with a wide range of mental health conditions.
What is the success rate of behavioral therapy?
Success rates of behavioral therapy fluctuate depending on treatment plans and mental conditions, but overall, research suggests it is highly successful. For example, studies indicate that 75% of individuals with obsessive-compulsive disorder (OCD) experience significant improvement in symptoms with CBT. Research also suggests that roughly half of individuals treated for PTSD with CBT experience long-term remission.
How long does behavioral therapy last?
The length of behavioral therapy treatment will depend on an individual’s progress and the severity of their condition, but it’s typically considered to be a short-term treatment. In CBT, individuals attend weekly or bi-weekly sessions of 30-60 minutes each. Length of treatment can range from 12 to 20 weeks but may last longer if necessary. The length of therapy might be different based on age, as well, with sessions that might last between one and two hours for children with ADHD and their parents.
Is behavioral therapy expensive?
Rates for therapy vary depending on the length of your treatment plan, the area in which you live, the type of therapist you see, the modality you use, and whether your insurance will cover treatment. According to BetterHelp, on average, in-person individual sessions with a psychologist run about $100 per hour, and sessions with a psychiatrist are between $100 and $200 per hour. Some people find online therapy a more affordable option, with prices ranging from $65-$100 per week or $260-$400 per month.
Who benefits from behavioral therapy?
Because it can be tailored to meet the unique needs of the individual, behavioral therapy benefits a wide range of people of all ages with different types of mental illness or behavioral challenges. Some of the populations that might benefit from behavioral therapy include:
- substance use disorders: Behavioral therapy techniques like CBT can help individuals address underlying issues related to substance use and learn coping strategies to avoid relapse.
- obsessive-compulsive disorder (OCD): Behavioral therapy is a common treatment approach for individuals with OCD to help them manage intrusive thoughts and resulting compulsive behaviors.
- mood disorders like depression and bipolar disorder: CBT is often used to help individuals with depression and bipolar develop coping skills and encourage positive thought patterns and behaviors. CBT can also help individuals with bipolar disorder learn to regulate behaviors during manic episodes.
- personality disorders: Methods like dialectical behavioral therapy and CBT can help people manage and reduce behavioral inhibitions that often appear as a symptom of certain personality disorders.
- anxiety disorders: Behavioral therapy like is often used to help individuals manage symptoms of anxiety disorders such as generalized anxiety disorder, social anxiety disorder, and phobias.
- trauma-related disorders: Exposure therapy and CBT can be effective in treating individuals with post-traumatic stress disorder (PTSD) and other trauma-related disorders.
- eating disorders: CBT and dialectical behavioral therapy can help individuals with eating disorders develop healthier relationships with food and body image and help them regulate emotional responses to behavioral “triggers.”
- Behavioral issues in children and adolescents: Behavioral therapy can be effective for helping children and adolescents with behavioral problems related to conditions like ADHD, conduct disorder, and oppositional defiant disorder (ODD).
Is behavioral therapy better than medication?
In most cases, research suggests that behavioral therapies like CBT are equally as effective as medication for treating many conditions like anxiety, OCD, and depression. Each has its benefits and drawbacks. For example, medications may work faster, but CBT may have longer-lasting benefits and higher remission rates.
Some people prefer behavioral therapy to medication because there are no side effects or physiological reactions. It might also be safer and more appropriate for certain populations, such as young children or people with certain physical conditions. Severe mental conditions like schizophrenia and other psychotic disorders do require pharmaceutical intervention in combination with psychotherapies.
What disorders do behavioral therapies work best for?
Behavioral therapies can be helpful in treating most conditions in which symptoms include emotional and behavioral dysregulation. Behavioral therapies are most commonly used in treating mood and anxiety disorders, panic disorders, PTSD, and OCD. They might also be effective in treating eating disorders, ADHD, phobias, and substance use disorders.
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