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What Is Behavioral Therapy?

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For every person, there exists a deep connection between their thoughts and their actions. Even actions that may seem to be reactionary are thought of previous to being committed but perhaps not in the way we associate thinking. There are actually two different types of thinking, and each of them influences our actions in different ways. 

One is conscious thinking which contains the thoughts, memories, feelings, and wishes of which a person is aware at any given moment. The other is unconscious thinking which is a sort of reservoir of feelings, thoughts, memories, and urges that a person is unaware they are thinking. 

An easier way to put it is that one is based on decision making — I choose to perform this action for these reasons — while the other is more reactionary — I reacted to the situation in this way.

While we cannot easily control these reactionary behaviors, there are a few things that we can do to positively influence them. The importance of maintaining a positive focus, regardless of the situation, is often overlooked by people. Without a positive state of mind then it will be easy to fall into ineffective or even harmful thought patterns in both conscious and unconscious levels of thinking. 

These negative patterns have a tendency to turn into problematic behavior, often unknowingly. After all, no person would willingly choose to become stressed out in a situation and have a panic attack but negative patterns of thinking turn a minor inconvenience into a full-blown anxiety episode. Dealing with these issues on behavior that stem from thinking is the root of behavioral therapy. 

History of Behavior Therapy

Behavior therapy began in the mid-1900s with several pioneers contributing to its creation. 

Edward Thorndike was one of the first to consider the idea of modifying behavior for treatments. Other early pioneers included psychologists Hans Eysenck and Joseph Wolpe. 

John B. Watson used what would become known as conditioning in his experiments that conditioned a young child to fear a white rat. Later on, Mary Cover Jones was able to replicate this experiment but then used counterconditioning techniques in order to desensitize and eliminate the fear response. 

B.F. Skinner was a behaviorist as his work had a major influence on the development of behavior therapy and introduced many concepts and techniques still in use today. 

Psychologists Aaron Beck and Albert Ellis added a cognitive element to behavioral strategies and created cognitive behavior therapy. This model of therapy attempted to alter negative thinking patterns, now called maladaptive cognitions, in order to alleviate emotional trauma and therefore discourage damaging behavior. 

In the early days of behavior therapy, the studies being performed would show that people would have “automatic thoughts” that would seem to arise spontaneously and almost always be negative. The patients would experience negative thoughts that would fall into one of three categories: ideas of themselves, the world, or the future. 

The treatment began to take the form of helping patients to identify and evaluate their automatic thoughts. By doing this, patients were able to start to think more realistically and felt better emotionally, therefore, allowing them to behave more functionally. Once the patients began to change their underlying beliefs about themselves, their world, and other people around them, they experienced long-lasting positive changes. 

What Is Behavior Therapy?

The National Alliance on Mental Illness defines psychotherapy as when a person speaks with a trained therapist in a safe and confidential environment in order to explore and understand their feelings and behaviors in order to gain coping skills for their mental health.

Behavior therapy is an offshoot of psychotherapy and focuses specifically on exploring relationships among a person’s thoughts, feelings, and unhealthy behaviors. The goal is to replace the problematic thoughts and patterns with positive ones in order to eliminate or improve negative behaviors in specific situations or average day-to-day life well-being.

Behavior therapy is not one exact treatment style. Indeed, there are several different types of therapy that can depend on several factors, such as the mental health disorder being treated and the severity of symptoms. These are some of the more prevalent types of behavior therapy in use today:

  • Applied behavior analysis: Most effective as a learning tool for children with autism. Applied behavior analysis uses operant conditioning in order to improve, shape, and modify problematic behaviors. The therapist will help to create an association in their patient that rewards will come for positive behaviors and punishments will come for negative behaviors
  • Aversion therapy: Often used to treat problems such as alcoholism and substance abuse. Aversion therapy works by teaching people to associate something desirable but unhealthy (such as drugs or alcohol) with something extremely unpleasant that causes discomfort. For example, relating alcohol to an unpleasant memory will make the alcohol less desirable and easier to avoid.
  • Cognitive-behavioral therapy: By utilizing behavioral techniques and adding a cognitive element, this therapy focuses on the problematic thoughts that lie behind behaviors. By identifying and improving these negative patterns of thinking, the problematic and troublesome behavior will cease.
  • Dialectical behavioral therapy: A form of cognitive behavior therapy that utilizes behavioral and cognitive techniques in order to help people learn how to better manage their emotions, cope with stress and improve relationships with others. 
  • Exposure therapy: Also known as system desensitization, exposure therapy uses behavioral techniques to help people overcome their fears of objects or situations. The approach is to incorporate techniques that slowly expose people to their fears while they learn and practice relaxation strategies. 
  • Play therapy: Most commonly used to treat children but can be effective with adults in certain situations. A therapist will watch a child play in order to gain insight into what the child is uncomfortable or unable to express. Sometimes the therapist will join in and dictate the rules of play, and others will sit back and watch as the child plays freely. The goal is to improve communication with the child in order to gain insight into the thoughts that influence their behavior. 
  • Rational emotive behavior therapy: The focus of this therapy is to identify negative or destructive thoughts and feelings and then actively challenge these thoughts and replace them with rational and realistic ones.
  • Social learning theory: Based around the inherent ability of people to learn through observation. Observing others being rewarded or punished for their actions can lead directly to learning and behavior change in the observer even though they experience neither.

The Techniques of Behavior Therapy 

While there is a lot to know in order to understand behavior therapy, there are really only two basic principles used, and understanding them can help to better explain behavior therapy or what a behavioral therapist does in general. These principles fall under classical conditioning and operant conditioning

Classical Conditioning

Classical conditioning involves the formation of associations between stimuli. Previous neutral stimuli will be paired with a stimulus that naturally and automatically invokes a response. After repeated pairing, an association will be formed, and the previously neutral stimulus will begin to invoke a response on its own. Some of the techniques that use classical conditioning are:

  • Aversion: This process involves pairing an undesirable behavior with an aversive stimulus in order to reduce the behavior. This treatment is used often with issues stemming from substance abuse. For example, a person with alcoholism may take disulfiram (a drug causing severe headaches, nausea, anxiety, and vomiting) with alcohol in order to create a negative stimulus and experience around alcohol in order to reduce the desire to drink.
  • Flooding: This process will involve exposing people to fear invoking objects and situations intensely and rapidly in order to treat phobias. During the flooding, the individual is prevented from escaping or avoiding the situation. 
  • System desensitization: This process will have a person make a list of their fears and learn to relax while concentrating or confronting those fears. Starting with the least intense fear and working upward, a therapist will guide the patient through systematically confronting their fears while teaching relaxation techniques. 

Operant Conditioning 

This principle focuses on how reinforcement and punishment can be used in order to increase or decrease the frequency of any given behavior. Behaviors resulting in desirable outcomes are more likely to be pursued in the future, while those with negative consequences are likely to be avoided. 

Contingency management: Using a formal written contract between a client and therapist that outlines goals, reinforcements, rewards, and penalties. The rules will be spelled out clearly and will result in neither party being able to back down from their promises.

Extinction: One way to produce a change in behavior is to eliminate the response. A timeout is an example of extinction. During the timeout, a person will be removed from a situation they found rewarding, and by losing this positive reinforcement, the unwanted behavior will eventually stop. 

Modeling: This process relies on learning through observation and by modeling the behavior of others. Instead of relying on reinforcement and punishment, modeling allows for someone to learn new skills and acceptable behavior based on the other people performing these skills and behaviors. 

Token economies: This technique allows for tokens to be exchanged for special privileges or desired items. Parents and teachers most often use token economies and allow kids to earn tokens for preferred behavior while losing tokens for undesirable behavior. Tokens are then traded in for candy, toys, or extra privileges. 

What Does Behavior Therapy Treat? 

With so many different types and techniques falling under the category of behavior therapy, there are many different psychological conditions that can be treated. Some of the most common disorders that can be treated by a behavior therapist include:

  • Alcoholism
  • Anger management
  • Anorexia
  • Antisocial disorder or poor social skills
  • Anxiety Disorder
  • Attention deficit hyperactivity disorders (ADHD)
  • Autism spectrum disorder
  • Bipolar disorder
  • Binge eating disorder
  • Borderline personality disorder
  • Bulimia
  • Depression
  • Fatigue
  • Insomnia
  • Obsessive-compulsive disorder (OCD)
  • Panic disorders
  • Phobias
  • Post-Traumatic Stress Disorder
  • Stress management
  • Substance abuse

The Takeaway

The relationship between thoughts and behavior is the core focus of behavior therapy, and the goal is to improve thinking by using several different methods and techniques in order to positively influence behavior for short-term and long-term behaviors.

A person’s thoughts and feelings have a tremendous effect on their behaviors, both consciously and unconsciously. Anyone engaging in behavior therapy will learn ways to improve their thinking patterns in order to positively influence their behavior. If anyone you know or a family member suffers from any of the disorders listed in this article, it might be a good idea to see about getting a therapy session through your healthcare provider. While the techniques may vary from confronting fears directly to talking comfortably with a therapist, the goal is the same: improve thoughts and ways of thinking in order to improve behavior. 

Sources

  1. What Is Behavioral Therapy? (verywellmind.com)
  2. What Is Behavior Therapy, and Why Is It Important? (online.regiscollege.edu)
  3. History of Cognitive Behavior TherapyCBT (beckinstitute.org)
  4. Pavlov’s Dogs Study and Pavlovian Conditioning Explained (simplypsychology.org)

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