Behavioral Therapy: Techniques and Effectiveness

Kristin Hall

Reviewed by Kristin Hall, FNP

Written by Rachel Sacks

Published 08/17/2022

Updated 08/18/2022

Sometimes our daily lives can become overwhelming. Or perhaps we find ourselves feeling anxious or in a low, depressed mood more often than normal.

This is where therapy and working with a mental health professional come in.

With the term “psychotherapy” coined in the 1800s, therapy has been around for a long time. Since then, several types of therapy have developed to address different mental health conditions such as depression, anxiety and other issues.

A few different types of therapy fall under the category of behavioral therapy, an umbrella term for therapies that treat mental health disorders.

So exactly what is behavioral therapy? We cover everything you need to know about this therapy, along with its techniques, effectiveness and who could benefit from it.

Behavioral therapy is a term to describe a broad range of techniques used to change behaviors that interfere with daily living.

Behavioral therapy is based on the principles of behaviorism, the school of thought that we learn from our environments and that our learned behaviors can be changed.

Rather than looking inward at emotions, cognition or mood — which are considered subjective — behavioral psychology believes that behaviors can be modified.

Behavioral therapy is action-based rather than insightful, such as psychoanalytic therapy for example. The “problematic” behavior was learned so therefore a new behavior can be learned to eliminate the previous issue.

Behaviorism first came about in the early 1900s with American psychologist Edward Thorndike being one of the first to refer to the idea of modifying behavior.

The techniques used in behavioral therapy are based on two theories: classical conditioning and operant conditioning.

Classical Conditioning

Classical conditioning — automatic or unconscious learning — involves forming an association with a stimulus or something that triggers a response. Neutral stimuli are paired with a stimulus that naturally and automatically evokes a response. After repeated pairings, an association is formed and the previously neutral stimulus comes to evoke the response on its own.

One classic example: Pavlov’s dog. The neutral signal was the sound of a tone and the naturally occurring reflex was salivating in response to food. By associating the neutral stimulus (sound) with the unconditioned stimulus (food), the sound of the tone alone could make the dog salivate.

Some techniques used in classical conditioning to alter behavior include:

  • Systematic desensitization. Systematic desensitization is a process that helps you to become less sensitive to certain triggers. You’re taught to replace fear responses with relaxation responses from previously taught breathing and relaxation practices.

  • Aversion therapy. Aversion therapy is often used to treat disorders like substance use disorder and alcohol use disorder. It works by teaching people to associate a stimulus that’s pleasant but unhealthy with an extremely unpleasant stimulus.

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Operant Conditioning

Operant conditioning focuses on reinforcement and punishment to either increase or decrease the behavior frequency. Behaviors followed by desirable consequences are more likely to occur again in the future, whereas ones followed by negative consequences are less likely to occur.

Techniques used in operant conditioning are:

  • Contingency management. This approach uses a formal written contract between a client and a therapist that outlines behavior-change goals, reinforcements, rewards and penalties.

  • Extinction. To produce behavior change, stop reinforcing behavior to eliminate the response. During time-outs for example, a person is removed from a situation that provides reinforcement. By taking away what the person found rewarding, unwanted behavior is eventually extinguished.

  • Behavior modeling. This technique involves learning through observation and modeling the behavior of others. Individuals learn new skills or acceptable behaviors by watching someone else perform those desired skills.

  • Token economies. This strategy relies on reinforcement to modify behavior. Parents and teachers let kids earn tokens for engaging in preferred behaviors and lose tokens for undesirable behaviors. Tokens can then be traded for rewards such as candy or a toy.

There are several different types of behavioral therapy. The technique of behavioral therapy used can depend on the condition being treated and the severity of the person's symptoms.

Cognitive Behavioral Therapy

A common therapy, cognitive behavior therapy is a combination of two therapeutic techniques: cognitive therapy and behavioral therapy.

Cognitive therapy focuses on patterns of thought and helps you form a clear idea of your thoughts and expectations.

Behavioral therapy focuses on patterns of action and when combined with cognitive therapy, cognitive-behavioral therapy is how your thoughts and beliefs influence your actions and moods.

Cognitive-behavioral therapy stemmed from what already existed in behavioral therapy but included an emphasis on the role of thought — or cognition — in our behaviors.

The premise of cognitive-behavioral therapy is that harmful or unhelpful ways of thinking can lead to negative behavior — or vice versa — which feeds back into destructive emotions and behaviors.

Cognitive behavior therapy aims to interrupt that cycle by learning to recognize dysfunctional thoughts and behaviors and then by learning to correct them. 

Cognitive behavioral therapy is a widely researched form of therapy and has repeatedly been shown to be a superior form of therapy when compared with other types.

Our guide on cognitive behavioral therapy covers more about this type of behavioral therapy as well as cognitive therapy.

Cognitive-Behavioral Play Therapy

Cognitive behavioral play therapy is commonly used as a treatment for mental health conditions in children. Arts and crafts, dolls and puppets or role-playing are used to help the child address problems and work out solutions while keeping them engaged.

Considered an “offspring” of cognitive therapy, cognitive behavioral play therapy combines the verbal interventions of cognitive therapy and the focus of action and play from play therapy.

In some forms of play therapy, therapists may teach parents how to use play to improve communication with their children as well as teach the child how to cope well and achieve their defined goals.

Some of the potential benefits of play therapy are:

  • Taking responsibility for certain behaviors

  • Developing coping strategies and creative problem-solving skills

  • Self-respect

  • Empathy and respect for others

  • Alleviation of anxiety

  • Learning to fully experience and express feelings

  • Stronger social skills

  • Stronger family relationships

According to Play Therapy International, up to 71 percent of children referred to play therapy may experience positive change.

Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is a type of psychotherapy that comes from behavior therapy and cognitive behavioral therapy with more of an action-oriented approach.

ACT emphasizes acceptance as a way to deal with negative thoughts, emotions or circumstances that are appropriate responses to certain situations. Rather than trying to control painful emotions, clients instead learn mindful behavior, attention to personal values and commitment to changing their behavior.

Acceptance and commitment therapy involves six parts:

  • Being present. ACT encourages you to stay mindful of your surroundings and learn to shift your attention away from internal thoughts and feelings.

  • Self as context. This involves learning to see your thoughts about yourself as separate from your actions.

  • Values. These are the areas of your life that are important enough to you to motivate action. You’ll clarify fundamental hopes, values and goals.

  • Acceptance. This means allowing your inner thoughts and feelings to occur without trying to change them or ignore them.

  • Commitment. This process involves changing your behavior based on principles covered in therapy.

  • Cognitive defusion. Defusion is the process of separating yourself from your inner experiences. This allows you to see thoughts simply as thoughts, stripped of the importance that your mind adds to them.

Your therapist will help you learn how to apply these concepts to your life and make sure they are helping you become more aware of your behaviors and whether they are helpful or detrimental to your life.

Dialectical Behavioral Therapy

Dialectical behavioral therapy is a modified type of cognitive behavioral therapy to teach people how to live in the moment, develop healthy ways to cope with stress, regulate emotions and improve their relationships.

This type of behavioral therapy was created by Dr. Marsha Linehan from evidence-based, cognitive-behavioral therapies to treat suicidal behavior in women.

Dialectical behavioral therapy (DBT) has been proven as a comprehensive treatment for borderline personality disorder, an emotional regulation disorder marked by suicidal behavior, depression, unstable personal relationships, and other symptoms.

DBT is effective at treating other mental health conditions such as eating disorders and substance abuse disorders.

DBT consists of four strategies:

  • Core mindfulness

  • Interpersonal effectiveness (improves relationships with others and yourself)

  • Emotional regulation

  • Distress tolerance

People receiving DBT are taught skills and coping strategies to help them lead healthier, happier lives.

Exposure Therapy

Exposure therapy utilizes behavioral therapy techniques to help people overcome their fears of situations or objects. This type of therapy is useful for those who suffer from panic disorder, social anxiety disorder or phobias.

According to the American Psychological Association, the idea behind exposure therapy is that exposing people to stimuli that cause distress in a safe environment will help them decrease avoidance and overcome their fear.

Exposure therapy may help in four ways:

  • Emotional processing. Exposure therapy helps you create realistic beliefs about a feared stimulus.

  • Extinction. Exposure therapy can help you unlearn negative associations with a feared object or situation.

  • Habituation. Repeated exposure to a feared stimulus over time helps decrease your reaction.

  • Self-efficacy. Exposure therapy helps show you that you’re able to overcome your fear and manage your anxiety.

Behavioral therapy is used for a wide range of mental health conditions and to help people with emotional issues.

Some mental health conditions 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 (OCD)

Although behavioral therapies are effective for different disorders such as anxiety disorders, it doesn’t mean behavior therapy is the right choice for every condition.

Of those who go through psychotherapy, about 75 percent benefit from this particular treatment.

Some studies support the use of play therapy in treating young children.

How effective behavioral therapy is depends on a variety of factors, including the specific type of treatment used and the condition being treated.

For some, medication may be a better alternative treatment option or in combination with behavioral therapy. Some healthcare professionals may prescribe an SSRI like fluoxetine for a patient struggling with panic disorder who is also going through cognitive-behavioral therapy. A combination of psychotherapy and medication can sometimes be the most effective treatment.

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Behavioral therapy encompasses a range of different therapies, all designed to change behaviors that are detrimental to your life and well-being.

If you think you would benefit from a behavioral therapy technique or method, talk to your healthcare professional for recommendations.

You can also access professional help from your home using our online mental health platform, such as online therapy and psychiatry.

17 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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