Mary hasn’t been feeling well for the past few months, she’s been feeling tired, uninterested, and gloomy. She finds that she sleeps far too much during the day and has been missing school resulting poor grades. She knows something isn’t right as she was fine just before the start of first year university. After a visit with the university counsellor she decides to seek therapy at her advice. They discuss the various options, and they decide upon Behavioral Therapy that is based on the belief system in which thinking and behavior can be changed. Behavior therapy focuses on the current problem and works on finding new ways to process the situation and teach productive methods of interpreting negative issues.
Behavioral therapy offers a wide range of treatment in everything from depression, anxiety and anger issues to disorders such as OCD, eating disorders, phobias, PTSD, self-harm and addiction. This therapy technique is derived from the traditional teachings of Ivan Pavlov’s Classical Conditioning and B.F. Skinner’s Operant Conditioning.
- Classical Conditioning is the process by which a neutral stimulus is conditioned to provoke a response via the continual presence of another stimulus. Behavioral therapy is based on this process after a famous study on salivating dogs conducted by Ivan Pavlov. He was able to train the dogs to salivate from the ringing of a bell alone by the process of classical conditioning and the pairing of the bell with food.
- Operant Conditioning is the process by which behavior can either be reinforced or decreased dependent on consequences of actions. Behavioral therapy is also based on this process through various studies conducted by B.F. Skinner on positive and negative reinforcement and positive and negative punishment.
There are several components of behavioral therapy to help with various circumstances. These techniques can be implemented either in combination or individually and with or without prescription medication.
This approach is based on counterconditioning; re-training or (conditioning) the brain to respond in an alternate way to phobias such as height, snakes and spiders for example. This is done through systematic desensitization which is a gradual process of steps to desensitize the client to their specific phobias. Relaxation techniques are used during exposure to the feared stimulus. This exposure will start off with a story and a picture to the slow inclination towards the actual presence of the stimulus itself. Each progression must graduate to the next step only once the client is comfortable and relaxed. Hopefully these steps will result in the elimination of the phobia completely. This process takes time, but has proven to be successful. Videos, stories, pictures can all be utilized in this form of therapy.
Just as the name suggests, the phobia or anxiety provoking stimulus is exposed to the client immediately until the fear is gone. This is a harsh form of behavioral therapy but has been met with success. An example would be a person with the fear of leaving their homes (agoraphobia) will be taken for a walk to a café, for example, with their therapist. Another instance could be an individual with arachnophobia (fear of spiders) would be exposed to a spider by touching it or having it crawl on them, or someone with a fear of darkness would be left in a dark room until the fear ceases.
Also known as Conversion Therapy is the method of pairing a maladaptive behavior or unwanted behavior which tends to be learned with an unpleasant stimulus. This process will ultimately condition the client to ‘unlearn’ the behavior by eventually and subconsciously linking the unpleasant stimulus with the unwanted behavior. Addiction to cigarettes can be overcome using this therapy by taking a certain medication that will promote nausea when paired with smoking. Ideally, the client will ultimately learn to become averse to cigarette smoking. This technique has also been successful in the rehabilitation of sexually inappropriate behavior or sexual predator behavior through exposure of pictures and videos paired with an unpleasant stimulus such as electric shock or ill inducing photos ultimately resulting in the client’s cognitive pairing of the unwanted behavior with the unpleasant stimulus automatically.
Cognitive Behaviour Therapy (CBT)
The most popular form of therapy and possibly the most effective style is cognitive behavioral therapy. This is the reconditioning of negative or irrational thoughts to a more positive interpretation of a situation, or a change to more productive thoughts. This technique will ultimately reduce negative emotions or behavior. Cognitive behavioral therapy is goal oriented and has been an effective form of treatment for anxiety, depression, eating disorders, addiction, and PTSD as well as many other emotional disorders. CBT teaches the client to look at their problems from a more productive and less harmful view which can in turn be a life-long skill in problem-solving. Based on two techniques; cognitive restructuring - implements a change in thinking patterns, and behavioral activation which teaches clients the skills needed to overcome negative obstacles. Cognitive behavioral therapy with a licensed therapist generally takes 14 to 16 weeks in which during that time the client and therapist decide on and reach short-term and long-term goals. A variety of homework, role-play, imagery and behavioral experiments are tools that are utilized during treatment.
Applied Behavior Analysis (ABA)
Predominantly used in teaching children with autism, this technique is used to improve social, motor, verbal and reasoning skills in social behavior. Applied behavior analysis is the study of autistic children in a setting, monitoring the triggers to unwanted behavior and rewarding the positive behavior. Eventually the analyst will learn the triggers and eliminate them from the child’s environment using the affective positive reinforcements for the teaching of other necessary behavior.
Teaching Family Model (TFM)
This technique of behavioral therapy is used internationally for troubled youth. Found to be quite successful in keeping youth out of trouble, this model teaches youth necessary life and interpersonal skills that may be lacking. This therapeutic setting is not only for youth with behavioral problems, but also for victims of abuse or those that are emotionally challenged. The youth or children are placed in a home with ‘teaching-parents’ that have been selected, trained and certified to optimally change negative behaviors with hands on care and role-modeling to offer the youth the best chance at overcoming their difficulties, and to improve the quality of their lives and future. The teaching-family model also offers necessary skills to parents and care-givers.
Positive Behavior Support (PBS)
This form of therapy is utilized in a succession of steps; each step must be completed prior to the next. PBS is successful in treating problem behavior in children with the use of a team consisting of essential mentors and care-givers in the child’s life.
Positive Behavior Support Steps:
- Building a Behavior Support Team – building a team of family members, teachers and therapists to work together to reach the goal of the desirable behavior
- Person-Centered Planning - the planning stage; visions of the best possible outcome for the child.
- Functional Behavioral Assessment – the scientific strategy of determining the triggers of problem behavior
- Hypothesis Development – developing a hypothesis for the reason of the problem behavior
- Behavior Support Plan Development – utilizing the data collected during the functional behavioral assessment and the hypothesis, the plan is put into action consisting of prevention strategies, CBT for new ways of dealing with emotions and lifestyle goals
- Monitoring Outcomes – this final step monitors the behavior and determines what is working and / or not working
Behavioral therapy as we can see is quite varied yet simultaneously precise. Each method or technique of treatment is at the discretion of the therapist who will decide which treatment plan will work best with for the client, and will then prepare to implement the techniques. Behavioral therapy works very well when combined with medication such as anti-depressants or anti-anxiety required drugs if required.
The techniques discussed have been widely successful in many cases of addiction, depression, anxiety and various disorders. Behavioral therapy is highly recommended by therapists world-wide.
- Wade, Tavris, Saucier, Elias Second Canadian Edition Psychology, (2007) Pearson Prentice Hall