Behavioral Therapy: Everything You Need To Know

Behavioral therapy  is a broad word that refers to a variety of strategies for changing non-adaptive behaviours and learning positive behaviour. The main objective of behaviour therapy is to enhance an individual’s quality of life by reducing problematic behaviours and increasing desired behaviours.

In this blog, let’s explore in detail

• What is behaviour therapy?
• Benefits and types of behaviour therapy
• How to get started with behaviour therapy?

What Is Behavioral Therapy?

Behaviour therapy is based on Behaviourism, a school of philosophy that emphasises the notion that we learn from the environment. We need to understand the cause of the behaviour to bring a change in the behaviour. Behaviour therapists use functional analysis to know more about the problem behaviour. The functional analysis has mainly three specific areas – antecedents, response and consequences.

For example, a child who struggles to finish his meal can be rewarded with chocolate every time he finishes his meal. It enhances his desired behaviour (i.e. finishing the meal). Here, the reward should be something the child likes; and the reward should be given only when he shows the desirable behaviour. At first, he will work for the reward, but later on, as the task gets easier, the reward can be removed gradually.

What Are the Signs of Behaviour Disorder?

Outbursts, tantrums, and hostility are a few negative behaviours that are quite common among children. When these factors are affecting their daily life, as a parent, you need to seek professional help.

There are many behavioural disorders in which signs vary from one to another. The most common signs observed in children diagnosed with behaviour disorders include

• Destructive behaviour
• Hostility towards others
• Frequent outbursts or tantrums
• Getting angry easily
• Hitting others
• Difficulty in managing anger or tantrums
• Harming themselves or threatening
• Lying
• Stealing

Who Can Benefit From Behavioural Therapy?

Behaviour therapy strategies vary from one disorder to another. A range of psychological disorders and conditions that can benefit from behaviour therapy include,

• Bipolar disorder
• Alcohol and substance use disorders
• Anxiety
• Attention-deficit hyperactivity disorder (ADHD)
• Autism spectrum disorders
• Borderline personality disorder (BPD)
• Depression
• Eating disorders
• Panic disorder
• Phobias
• Obsessive-compulsive disorder

Behavioural therapy provides a problem-focused and action-oriented approach which helps in more specific psychological issues like stress management and anger control.

Behavioural therapy has also been found to help people with the following:

• Communication with family as well as peers
• Coping strategies
• Healthier thought patterns
• Self-esteem

Different Types Of Behaviour Therapy

Different types of behaviour therapy include,

Cognitive Behaviour Therapy

In cognitive behaviour therapy (CBT), the therapist examines how thoughts influence our feelings and behaviour.

It combines behavioural therapy (which emphasises action patterns) and cognitive therapy (which emphasises thought patterns). A CBT therapist helps deal with negative thinking by logically restating inaccurate and irrational thoughts. It is the most widely used behaviour therapy that is considered the “gold standard” in successfully treating many disorders, including anger, stress, anxiety, and depression.

Cognitive Behaviour Play Therapy

CBPT is a play therapy combining cognitive and behavioural theories.

In cognitive behaviour play therapy, the therapist acquires insight into what a child is uncomfortable expressing or unable to express by watching a child play. Play therapy is most effective in treating children struggling with anger, bullying, academic problems, family problems, generalised anxiety issues, loss of loved ones, attention issues, etc. In CBDT, the therapist builds rapport and trust with the help of play. Gradually the therapist guides the child to new ways of thinking and helps the child to acquire new skills.

Acceptance and Commitment Therapy

We have heard a lot about fixing a negative human emotion, but no one has emphasised how to accept our emotions. Acceptance and commitment therapy helps the clients to accept their inner feelings and emotions and makes them aware that those feelings and emotions are appropriate responses to certain situations. By accepting one’s feelings and emotions, the individual gains commitment to make appropriate changes in the behaviour, thus helping them to lead a positive life.

Dialectical Behaviour Therapy

Dialectical behavioural therapy (DBT) is based on cognitive behavioural therapy.

In cognitive therapy, the therapist helps an individual to reach the goal by altering their negative thoughts and behaviours, whereas, in dialectical behaviour therapy, the therapist uses a more structured way and helps the client to acquire skills by focusing on mindfulness, acceptance, interpersonal effectiveness, and emotion regulation.

DBT also focuses on identifying life-threatening behaviours and the behaviours that act as barriers to progress. It helps to reduce harmful behaviours while increasing positive behaviours. The ultimate goal of dialectical behaviour therapy is to help the client build a meaningful life.

Applied Behavioural Analysis

Applied behaviour analysis (ABA) is a teaching method that employs learning principles to teach socially meaningful actions in real-world contexts. For example, behaviour is more likely to be repeated if a reward or reinforcement follows it. This idea also applies to less desirable actions that are unintentionally encouraged.

For example, in the example mentioned at the beginning of this blog, one common mistake that can negatively affect the child is rewarding or reinforcing the wrong behaviour unintentionally. For instance, when the child wants the chocolate but hasn’t finished his meal, the child may show tantrums like anger or irritable behaviour towards others or his parents. To stop the tantrums, parents allow the child to eat chocolate. Without knowing, the parents are encouraging the child’s problematic or oppositional behaviour. Ignoring is one of the best methods to handle such situations while reinforcing the positive or wanted behaviour as much as possible.

Exposure Therapy

Exposure therapy employs behavioural techniques to help people overcome their fears of situations or objects. Here, the therapist helps the client to overcome their fear by exposing them to their specific fear-evoking environment and situations. It helps treat specific phobias, panic disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder and generalised anxiety disorder.

If we have an extreme fear of something or when our fear affects us functionally, exposure therapy is the most effective technique to reduce fear and cope with the situation.

Exposure therapy includes in-vivo exposure, imaginal exposure, virtual reality exposure, interoceptive exposure, graded exposure, flooding, and systematic desensitisation.

Rational Emotional Behaviour Therapy (REBT) 

One of the main problems we face today is dealing with irrational thoughts and beliefs. These negative thoughts influence the way we respond to a specific situation. Rational emotional behaviour therapy focuses on identifying harmful or destructive thoughts; it guides the patient to actively question those thoughts and replace them with more rational and realistic ones.

REBT uses many techniques such as

• Problem-solving techniques (which include problem-solving skills, social skills, decision-making skills, conflict resolution skills, assertiveness, etc.)
• Cognitive restructuring techniques (such as rationalising techniques, guided imagery, disputing irrational thoughts, exposure to the feared situation, etc.) and
• Coping techniques (which include relaxation, hypnosis, and meditation)

Social Learning Theory

The main focus of social learning theory is that people learn by observing others. Children especially observe and learn from the environment like a sponge absorbing water. Children are exposed to various models and influencers in the environment. They store the information they observe and imitate it subsequently. Observing how others are rewarded or punished for their actions can lead to learning and behaviour modification.

Some Techniques Used In Behaviour Therapy

To understand how behaviour therapy works, it is necessary to learn more about the fundamental principles that contribute to behavioural therapy. The techniques used in this type of treatment are based on classical conditioning and operant conditioning theories.

Classical Conditioning

Classical conditioning is a type of learning that is automatic or unconscious. Classical conditioning states that when a naturally occurring stimulus is repeatedly paired or associated with an environmental stimulus, the environmental stimulus will gradually evoke the same response to the natural stimulus. In simple, it is the association between two stimuli to create new learning. This learning process helps to develop a conditioned response by associating the two different stimuli.

For example, one of the famous experiments associated with classical conditioning is Pavlov’s experiment with dogs. When Pavlov presented the dogs with the sound of a bell, the dogs didn’t salivate. This was the neutral stimulus. Later, when he presented food to the dog, they salivated in response. Here the food is an unconditioned stimulus and saliva is an unconditioned response. Pavlov repeatedly presented the sound of a bell and then the food to the dogs. After a few repetitions, the dogs began to salivate in response to the sound of the bell. Here the bell has become the conditioned stimulus, and salivation has become the conditioned response.

Aversion Therapy 

Aversion therapy is based on classical conditioning. Aversion therapy reduces unwanted or undesirable behaviour such as alcohol addiction, gambling addiction, etc. In aversion therapy, a stimulus, for example, alcohol or cigarette, is continuously paired with an aversive stimulus, such as an electric shock or nausea-inducing drug. After repeated pairing of these two stimuli, the person develops an aversion towards the stimulus, which initially brought deviant behaviour.

Electrical, chemical, or imagined aversive situations are the main stimuli used in aversion therapy.

Example: In aversion therapy, the clients are given an aversive drug that causes vomiting whenever they are exposed to the strong smell or taste of the alcohol (by repeatedly pairing the drug with the alcohol).

Flooding

Through classical conditioning, people are taught to associate fear with stimulus. But in flooding, the same principle of classical conditioning can be used to eliminate fear by replacing them with relaxation techniques and exercises. Flooding is a behaviour therapy technique used to treat phobias and fears by first teaching self-relaxation techniques and exposing them directly to the fear-evoking environment.

The advantage of flooding therapy is that it gives quick results and is very effective. It is the most commonly used therapy by behaviour therapists to treat phobias.

Systematic Desensitisation

If flooding is exposing the client directly to the fear-evoking stimulus, systematic desensitisation is a type of exposure therapy where a person is gradually exposed to a fear-evoking stimulus along with relaxation techniques.

Systematic desensitisation involves three steps

• Learning relaxation techniques (breathing, muscle relaxation, mindfulness, meditation, etc.)
• Making a list of the hierarchy of fears
• Exposing slowly to the fear

Operant Conditioning

Operant conditioning is a method of learning which focuses on how reinforcement and punishment can be used to bring a change in behaviour. The principle of operant conditioning is that behaviour that is rewarded has a high chance of occurring more while the behaviour or an action that is punished will rarely occur.

For example, whenever a boy does his homework, he is allowed to play. Here, he will be motivated to do his homework again because a positive outcome follows that action.

Components of Operant Conditioning

Reinforcement

Reinforcement is anything that facilitates increased or strengthened behaviour. Reinforcement is of two types – positive reinforcement and negative reinforcement.

Positive reinforcement is a favourable outcome or event presented after the behaviour. Here, the person’s behaviour is increased by adding a positive and favourable reward or praise. For example, if a child scores good marks in exams, he is rewarded with chocolates.

Negative Reinforcement: Here, the strengthening or increasing of the behaviour is done by removing an unfavourable event or outcome after the desirable behaviour. For example, if the child follows instructions well in class, he won’t get any homework for the day.

Punishment

Punishment helps decrease negative or undesirable behaviour when followed by a negative event or outcome.

Positive Punishment helps decrease undesirable behaviour when an adverse event or outcome follows the behaviour. For example, asking the child to do household chores for disobeying parents.

Negative Punishment: In negative punishment, the removal of a reinforcing item is used to decrease undesirable behaviour. For example, taking away TV time after the child misbehaves at home.

Contingency Management

Contingency management therapy is based on principles of operant conditioning. The therapist pairs the reward with the desired behaviour to achieve the targeted behaviour. Gradually, the frequency of the reward given is decreased and stopped. The main challenge of this technique is finding the best pair of rewards and behaviour.

Target behaviour, target person, reward, intensity – frequency – time of the reward, and length of the treatment plan is the main principle of contingency management. These factors should work in harmony to achieve the desired goal.

Extinction

If a learned or conditioned behaviour gradually stops, what could be the reason?

Going back to Pavlov’s dog experiment in classical conditioning, if the bell was repeatedly rung without presenting food, then salivation will eventually stop. In operant conditioning, if the behaviour is no longer reinforced, there is a chance for extinction.

The gradual weakening of a conditioned response that leads to decreasing the behaviour is referred to as extinction. In other words, conditioned behaviour eventually comes to an end.

For example, a child drops a toy to get her mom’s attention. Mom smiles at her child and happily picks it from the floor and hands it back to her kid. The child continues the action to get her mom’s continued attention. However, when the mom consistently ignores the child’s negative behaviour, it is more likely that the child’s behaviour will be reduced as the attention she seeks is no longer available.

Behaviour modelling

This method includes learning by observing and modelling the behaviour of others. Rather than relying solely on reinforcement or punishment, modelling enables individuals to learn new skills or acceptable behaviours by observing another person perform those desired skills.

Token economies

One of the most effective techniques to modify behaviour in behaviour therapy is the token economy. This technique helps teachers and parents to encourage positive behaviour in children. Here, children are given reinforcements in the form of tokens for engaging in positive behaviour and lose tokens when they show negative or undesirable behaviour. These tokens can then be exchanged for rewards such as candy, toys, or additional playtime with a favourite toy.

Is Behavioural Therapy Effective?

The use of behavioural therapy is widespread, and it has been proven to be successful in treating a variety of conditions.

Research has shown that Cognitive behaviour therapy (CBT) is most effective for the treatment of:

• Anger issues
• Anxiety
• Bulimia
• Depression
• Somatic symptom disorder
• Stress
• Substance abuse and relapse prevention

Anxiety disorders, such as post-traumatic stress disorder (PTSD), panic disorder, obsessive-compulsive disorder (OCD), and phobias, generally respond well to behavioural therapy. However, studies have found that the effectiveness of behavioural therapy, especially CBT, in treating substance use disorders varies depending on the substance being misused.

The condition being treated and the type of treatments employed can affect how well behavioural therapy works.

This does not imply that the only form of therapy capable of treating mental illness is cognitive behavioural therapy (CBT) or other behavioural therapy techniques.

Things To Consider Before You Start Therapy

Though behaviour therapy has several advantages, behavioural approaches are not always the best solution. Below are some of the points to consider before you start behaviour therapy.

It’s Not Adequate for Complex Mental Health Conditions

Behavioural therapy is frequently used in conjunction with other medical and therapeutic treatments when treating certain psychiatric disorders, such as severe depression and schizophrenia. Behavioural therapy can help manage or cope with specific aspects of these psychiatric conditions, but it should not be used alone.

It May Not Account for Underlying Problems

Behavioural treatments focus on current functional issues rather than fully appreciating or addressing the underlying factors contributing to a mental health problem.

It May Not Address the Whole Picture

Behavioural approaches are focused on the individual. However, some of these approaches frequently fail to address how situations and interpersonal relationships may be contributing to a person’s problems.

How to Get Started?

If you are considering behavioural therapy, there are a few things you can do to make the most of your treatment.

How to Find a Behavioural Therapist?

Mental health professionals like counsellors, psychologists, psychiatrists, and social workers can provide behavioural therapy. You can find behaviour therapists in,

• Hospitals
• Child development centres
• Private mental health clinics

Ask For Recommendations

If unsure where to begin your search, ask your primary care physician for a referral.

Contact Your Health Insurance

Determine whether your plan covers behavioural therapy and, if so, how many sessions are covered.

Set Goals

Discuss your objectives as you begin treatment. Knowing your goals can help you and your therapist to develop an effective treatment plan.

Be An Active Participant

For behavioural therapy to be effective, you must be willing to participate in the process. Strictly follow the home programs as suggested by the therapist.

Conclusion 

Behaviour therapy aims to replace negative behaviours with more positive and beneficial behaviour patterns. It helps improve the individual’s quality of life. In kids, behaviour therapy helps improve the parent-child relationship. It guides the parents to learn new skills that facilitate a positive, caring, and nurturing environment for their children, making them better parents.

Hope this blog has helped you get an insight into behaviour therapy. If you have any questions, write to us in the comments below, and our team will get back to you at the earliest.