When you think of therapy, you might picture a patient lying on a couch, talking about their childhood, delving into their past regrets and self-esteem issues, and spilling out unconscious desires and fears. This is what psychoanalysis, the original “talk therapy,” often looks like.
Behavioral therapy is different. Behavioral therapy is an evidence-based type of therapy focused more on changing specific behavior and thought patterns. It’s solution-focused, and works on current issues rather than how your past may have affected your present struggles. Compared with traditional psychotherapy, behavior therapy is usually a short-term treatment. The most common type of behavioral therapy is cognitive behavioral therapy (CBT).
What is Behavioral Therapy Used for?
Behavioral therapy treats various mental health conditions, says Melissa Galica, LPC, a licensed professional counselor with Grow Therapy. “Behavioral therapy is used to help people suffering from a variety of mental health or behavior issues, including addictions, eating disorders, anxiety disorders, depression, and difficulty managing anger or stress disorder.”
What is Behavioral Therapy Best for?
According to the National Library of Medicine, cognitive behavioral therapy (CBT), the most common behavioral therapy, can address numerous conditions. It includes both mental health conditions and physical conditions.
Some of the primary mental health conditions CBT treats are:
- Depression
- Obsessive-compulsive disorder (OCD)
- Anxiety, including panic disorder, phobias, and post-traumatic stress disorder
- Addictions, including substance use disorder
CBT can’t cure medical conditions, but it can relieve the symptoms of several conditions, including:
- Tinnitus (ringing or other unusual sounds in the ear)
- Chronic pain disorders
- Rheumatism (conditions characterized by inflammation)
In some cases, cognitive behavioral therapy may be used on its own to treat mental health conditions; however, people sometimes have the best outcomes when combining medications with therapeutic treatment. Most medical conditions also require medication, even if behavioral therapy is a supplement. Your healthcare provider and mental health team will work together to help find the best treatment plan for you.
What are the Goals of Behavioral Therapy?
In a nutshell, the goal of behavioral therapy is to change the negative behaviors that we’ve been exposed to in life or that we learned over the course of our lives, explains Cynthia Mobley, CSW, a clinical social worker and therapist at Grow Therapy. Behavioral therapy is used to “change a maladaptive behavior that is causing distress in someone’s life, such as substance use or another impulsive action/behavior,” she describes.
Galica says that the overarching goal of behavioral therapy is to “unlearn problematic automatic behaviors and thought processes and acquire healthier responses that improve daily functioning and mental health.” Evidence-based behavioral approaches “equip people with tangible lifestyle skills and awareness that empower positive trajectories in relationships, self-image, productivity, and more,” Galica emphasizes.
What are the Different Kinds of Behavioral Therapy?
According to Mobley, the most common types of behavioral therapy include the following:
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is by far the most common form of therapy for behavioral modification. CBT is based on the idea that our thinking patterns and beliefs strongly impact our behaviors. The goal of CBT is to help people become more aware of how their negative thoughts and attitudes shape their behavior and to come up with coping skills to help reduce these unwanted behaviors.
Dialectical Behavior Therapy (DBT)
Dialectical behavior therapy (DBT) was first conceived of by American psychologist Dr. Marsha Linehan. It’s based on principles of CBT, and is used primarily to treat borderline personality disorder. DBT is also thought to help treat other mental illnesses, including post-traumatic stress disorder, substance abuse disorder, eating disorders, and various mood disorders.
Acceptance and Commitment Therapy (ACT)
Acceptance and commitment therapy (ACT) is a form of therapy based on the idea that life challenges and mental health conditions like anxiety, grief, and illness are an inevitable part of life and that our goals as humans should be to learn to accept these realities and adapt to the challenges that life presents. ACT encourages patients to confront their struggles and mental health challenges, rather than trying to avoid them.
Exposure Therapy
The goal of exposure therapy is to help people face their fears instead of running away from them. Often, when you have an anxiety disorder or a phobia, you retreat from the things that scare you in your daily life. Over time, your fear grows even more. Exposure therapy allows patients to face their fears within the safe and controlled space of the therapy relationship and therapist’s office.
Applied Behavior Analysis (ABA)
Applied behavior analysis (ABA) is a type of behavioral therapy that’s primarily used to address the needs of autistic individuals. However, it has also been used for people with developmental disabilities, children in special education, and in the elderly.
Emotional Behavior Therapy (REBT)
Some scholars believe that rational emotional behavior therapy (REBT) was the first form of CBT. Developed in the 1950s by Dr. Albert Ellis, REBT’s main tenant is that it’s not the events of our lives that cause challenging emotions or behaviors. Instead, it’s our thought patterns and beliefs that influence our feelings and behaviors. The key philosophy behind REBT is known as the ABC framework. “A” stands for activating event/adversity, “B” stands for beliefs, and “C” stands for consequences.
What are Some Examples of Behavioral Therapy?
So, how might behavioral therapy look in practice? And what are some behavioral therapy treatment options?
According to the National Library of Medicine, some examples of CBT (the most common type of behavioral therapy) in practice might look like:
- CBT for generalized anxiety disorder might include working on replacing negative thoughts with more helpful thoughts, and possibly combining this treatment with selective serotonin reuptake inhibitors (SSRIs)
- CBT for panic disorder might look like using systematic desensitization therapy or combining CBT with exposure therapy
- CBT for depression might look like combining CBT with antidepressants
- CBT for attention deficit hyperactivity disorder (ADHD) might look like combining therapy with stimulant medication (only in kids aged 6 and older)
How Does Behavioral Therapy Work?
The way that behavioral therapy works depends on your mental health needs, the type of behavioral therapy you are in, and your behavioral therapist’s philosophy and relationship with you. Here’s how CBT usually works, as outlined by the National Library of Medicine:
- You will start by getting to know your behavioral therapist and forming a trusting relationship with them; therapy won’t work well unless this is established
- Once therapy is underway, you will generally begin by sharing your current struggles and describing what you hope to accomplish in therapy
- After this, you and your therapist will make a treatment plan, understanding that the plan may be tweaked as the sessions progress
- As you move through the therapy, your therapist will regularly check in with you to make sure things are progressing as you expect and will adjust techniques as needed
There are various methods employed during CBT or other types of behavioral therapy, according to Galica. These include:
- Journaling to monitor your mood and identify your triggers
- Role-playing
- Practicing new social skills
- Relaxation and other techniques to manage emotional reactions
How Long Does it Take Behavioral Therapy to Work?
Behavioral therapy is an evidence-based, effective way to modify negative behaviors. “With an experienced therapist providing support, encouragement, and accountability, meaningful change is absolutely within reach,” Galica says. However, she notes, achieving this goal and experiencing lasting change in our life doesn’t happen overnight. Behavioral changes take time and require consistency.
“On average, most clients make significant progress after 10-15 weekly therapy sessions, though growth continues well beyond,” Galica says. “Sticking with the process is crucial.” However, this is only an average. Some people need more or less time to meet their goals in behavioral therapy. It depends on how severe your symptoms are and how your respond to therapy.”