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We all have habits and behaviors we’ve developed over time to protect us from the many stresses of life. Most of these are benign or even healthy (like exercising to relieve stress), but some behaviors can become harmful to your physical or mental health.
Behavioral therapy is one way to change behaviors that might be causing negative consequences in your life. Doing this can help you increase your overall well-being.
Here’s what you need to know about behavioral therapy, some common variations, and who these approaches can help.
What is behavioral therapy?
Behavioral therapy is also called talk therapy, psychotherapy, or just therapy. It involves meeting with a trained mental health professional (or “therapist”). You and your therapist will work together to identify and change thoughts, feelings, or behaviors that negatively affect your life (U.S. Department of Health and Human Services, 2016).
There are many different types of behavioral therapy techniques. Quite a few of them have been studied extensively and found to be effective for specific mental health conditions. Your therapist can help you choose which type of therapy will work best for your situation (Cook, 2017).
Behavioral therapy is an umbrella term for a range of therapies based on behavior modification principles (also called behaviorism or classical conditioning). In behavior modification, reinforcement and consequences are used to reduce or eliminate unhelpful behaviors in children or adults. However, there’s little consideration given to the thoughts or feelings driving the behavior (Scott, 2021).
Many behavioral therapies address this gap by combining behavioral modification techniques with other treatments that deal with thoughts and feelings to fully address the bothersome situation (Scott, 2021).
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What types of behavioral therapy are there?
The form of therapy that a mental health clinician uses depends on their training, experience, and the symptoms that you are having. Often, a behavioral therapist will combine interventions from different types of therapy to create a customized treatment plan (U.S. Department of Health and Human Services, 2016).
Here are a few of the most common types of behavioral therapy you might encounter.
Cognitive-behavioral therapy (CBT)
CBT is a short-term, structured type of behavioral therapy first developed by Aaron Beck. The therapist and client work together to identify and modify cognitions (patterns of thinking) and behavior. Over time, this can lead to positive changes in the client’s mood and improved quality of life (Chand, 2021).
Initially developed in the 1960s, CBT has become the most extensively studied of all mental health therapies. Evidence-based research shows CBT is effective at treating (Chand, 2021):
- Anxiety disorders
- Eating disorders
- Substance abuse
- Personality disorders
- Attention deficit hyperactivity disorder (ADHD) in children
Cognitive-behavioral therapy has also been shown to be effective in combination with medication for serious mental disorders such as bipolar disorder and schizophrenia (Chand, 2021).
Dialectical-behavioral therapy (DBT)
DBT was developed as a spin-off of cognitive-behavioral therapy designed to treat borderline personality disorder, a condition previously considered difficult to treat (Chapman, 2006).
Similar to CBT, dialectical behavioral therapy involves uncovering the negative thoughts and feelings that underlie the behaviors that are causing problems for the client. DBT, however, involves a more comprehensive treatment program that includes both individual and group therapy to encourage acceptance, mindfulness, and increased coping skills development (Chapman, 2006).
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In addition to borderline personality disorder, DBT has also been studied as an effective treatment for (Chapman, 2006):
- Eating disorders
- Depression in elderly patients
- Substance use disorders
Eye movement desensitization and reprocessing (EMDR)
EMDR is a novel form of behavioral treatment that involves moving the eyes back and forth (or sometimes using hand tapping or auditory tones) while thinking about a distressing memory. Over 300 studies prove it to be a highly effective treatment for post-traumatic stress disorder (PTSD). There’s some indication it might even be more effective for PTSD than medication or other psychological interventions (Landin-Romero, 2018).
It’s not clear how this treatment works, but we know that it does.
EMDR can also use components of CBT and mindfulness-based therapies. Your therapist may include techniques like body scanning, imagining healthy ways to confront your fears, and replacing negative thoughts with positive beliefs. There is conflicting evidence regarding how much impact the eye movements have versus the other components of EMDR therapy. Nonetheless, participants have reported that the memories become less painful over time, and anxiety levels are reduced (Landin-Romero, 2018).
While primarily used for those with PTSD, EMDR has also been studied in individuals with (Landin-Romero, 2018):
- Bipolar disorder
- Dental phobia
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Alcohol dependency
- Chronic pain
EMDR therapy for anxiety, grief, and PTSD
Exposure therapy is a type of psychological treatment that involves repeated encounters with fear-provoking situations. The goal is to reduce the amount of anxiety these situations create (Craske, 2014).
The exact strategies used for exposure can vary depending on the person. They can include gradual exposure, intense exposure (called flooding therapy), imaginary exposure (thinking about the fear), or in vivo exposure (encountering the fear-provoking situation in real life). The goal is that, over multiple therapy sessions, the person will become desensitized to the anxiety, and the fear will go away (Craske, 2014).
Exposure therapy has been studied in a number of anxiety-related disorders such as (Craske, 2014):
- Panic disorder
- Social anxiety disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Specific phobias
Applied behavioral analysis (ABA) therapy
ABA therapy is a type of behavioral therapy used for treating the symptoms associated with autism spectrum disorder (DeFilippis, 2016).
Applied behavioral analysis uses repetition and positive reinforcement with praise, tokens, or snacks to increase desired behaviors. However, there are some limitations to this type of therapy due to the time and cost involved. It is also dependent on the motivation of the participant (DeFilippis, 2016).
Still, a meta-analysis looking at the effectiveness of ABA therapy with young children with autism found it can have positive effects on (DeFilippis, 2016):
- Intellectual functioning
- Language development
- Daily living skills acquisition
- Social functioning
What other conditions could behavioral therapy help treat?
While the scientific literature usually looks at how different types of behavioral therapy can be used to treat specific mental illnesses, you don’t need to have a mental health diagnosis to benefit (U.S. Department of Health and Human Services, 2016).
Behavioral therapy can help you manage the thoughts and emotions associated with many life situations that could be causing you stress. These might include (U.S. Department of Health and Human Services, 2016):
- Job or family stress
- The death of a loved one
- Coping with physical health problems
- Relationship issues
- Self-defeating behaviors
- Interpersonal conflicts
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How do I find a behavioral therapist?
If you or a loved one are struggling with mental health symptoms, it may help to talk to a behavioral therapist. One way to connect with a therapist is to ask your healthcare provider for a referral or contact your insurance company to find out who’s in your network.
You can also contact the Substance Abuse and Mental Health Services Administration’s national helpline. The helpline is free, confidential, and staffed 24/7 in both English and Spanish. They can help provide referrals for local treatment providers.
- Chand SP, Kuckel DP, Huecker MR. (2021). Cognitive behavior therapy. [Updated 2021 Apr 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470241/
- Chapman A. L. (2006). Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont (Pa.: Township)), 3(9), 62–68. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/
- Cook, S. C., Schwartz, A. C., & Kaslow, N. J. (2017). Evidence-based psychotherapy: advantages and challenges. Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics, 14(3), 537–545. doi: 10.1007/s13311-017-0549-4. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509639/
- Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: an inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23. doi: 10.1016/j.brat.2014.04.006. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114726/
- DeFilippis, M., & Wagner, K. D. (2016). Treatment of autism spectrum disorder in children and adolescents. Psychopharmacology Bulletin, 46(2), 18–41. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044466/
- Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action. Frontiers in Psychology, 9, 1395. doi: 10.3389/fpsyg.2018.01395. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6106867/
- Scott HK, Jain A, Cogburn M. (2021). Behavior Modification. [Updated 2021 Feb 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK459285/
- U.S. Department of Health and Human Services. (2016). Psychotherapies. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/psychotherapies
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.