Behavioral Therapy: Techniques and Effectiveness

Maybe you’ve felt extra stressed and overwhelmed lately or noticed a persistent low mood. The good news is that working with a mental health professional might help you start to feel better.

The term “psychotherapy” was coined in the 1800s. Since then, several types of therapies — including behavioral therapy — have been developed to address different mental health conditions, such as depression, anxiety, and other issues.

Behavioral therapy is an umbrella term for a few different types of therapies that treat mental health disorders by helping people modify maladaptive behaviors. But what is behavior therapy, exactly?

Ahead, we’ll cover everything you need to know about behavioral therapy, including its various types, techniques, and effectiveness, and who could benefit from it.

Behavioral therapy encompasses various techniques therapists use to change behavioral patterns that interfere with daily life.

It’s based on the principles of behaviorism, a school of thought that suggests we learn from our environments and can change those learned behaviors. Behaviorism first emerged in the early 1900s, led by American psychologist Edward Thorndike, who was among the first to develop the concept of behavior modification.

Unlike approaches that focus on emotions and mood — which are considered subjective — behavioral psychology believes that problematic behaviors are learned and can be replaced with new and improved behaviors. In other words, behavioral therapy is action-based rather than insightful, unlike psychoanalytic therapy. The idea is that behavior and emotions are closely linked. If you transform negative behaviors into positive ones, your mood will subsequently improve. It’s an indirect approach that works well for many people.

What Conditions Does Behavioral Therapy Treat?

Behavioral therapy is used to treat a wide range of mental health conditions and to help those who face emotional challenges.

Some of these mental health conditions can include:

• Bipolar disorder

• Alcohol and substance use disorders

• Anxiety disorders

• Attention-deficit hyperactivity disorder (ADHD)

• Autism spectrum disorders

• Borderline personality disorder (BPD)

• Depression

• Post-traumatic stress disorder (PTSD)

• Eating disorders

• Panic disorder

• Phobias

• Obsessive-compulsive disorder (OCD)

There are several different types of behavioral therapy. Let’s unpack the details of some of the most popular types ahead.

Cognitive Behavioral Therapy

Cognitive behavior therapy (CBT) combines cognitive and behavioral techniques to address various issues.

Cognitive therapy helps you identify your thought patterns and expectations, while behavioral therapy addresses patterns of action. Combining the two, CBT examines how thoughts and beliefs influence actions and moods.

CBT evolved from behavioral therapy but emphasizes the role of thought — or cognition — in our behaviors and moods. It posits that negative thoughts or unhelpful ways of thinking can lead to harmful behaviors and vice versa, perpetuating destructive emotions and actions.CBT aims to break this cycle by helping people recognize and correct dysfunctional thoughts and behaviors.

There are also tailored versions of CBT catered to specific issues and conditions, like CBT-I for insomnia and sleep anxiety.

Research has consistently found that CBT is a very effective form of therapy. Our guide on cognitive behavioral therapy delves deeper into these principles.

Cognitive-Behavioral Play Therapy

Cognitive behavioral play therapy (CBPT) is a common method for treating mental health issues in children. It uses arts and crafts, dolls, puppets, and role-playing to engage children in addressing problems and finding solutions.

Considered an extension of cognitive therapy, CBPT blends the verbal interventions from cognitive therapy with the interactive and playful aspects of traditional play therapy. It can be easier for children to engage with difficult thoughts and experiences in the context of play.

Some forms of play therapy include teaching parents how to use play to enhance communication with their children and helping children develop effective coping strategies to achieve their 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 experience and express feelings fully 

• 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 integrates principles from behavior therapy and cognitive behavioral therapy with an action-oriented approach.

ACT emphasizes accepting negative thoughts, emotions, or circumstances — when they’re appropriate responses to certain situations. Instead of trying to control painful emotions, clients learn mindfulness techniques, focus on personal values, and commit to changing their behavior.

This type of 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 refers to understanding oneself as the stable, observing presence that experiences thoughts and emotions, rather than being defined by them.

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

• Acceptance. This means allowing your inner thinking patterns and feelings to occur without trying to change or suppress them.

• Commitment. This process involves making a commitment or forming an intention to change your behavior so that it aligns with your values.

• Cognitive defusion. Defusion (to “un-fuse” or take apart) is the process of separating yourself from your inner experiences. This allows you to see thoughts simply as natural occurrences, stripped of the desires, fears, and possibly shame that your mind adds to them.

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

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) is a modified form of cognitive behavioral therapy designed to help people live in the moment, develop healthy coping strategies for stress, regulate emotions, and improve relationships.

This type of behavioral therapy was developed from evidence-based cognitive-behavioral approaches to address suicidal behavior in women.

DBT has proven highly effective as a comprehensive treatment for borderline personality disorder, which is characterized by emotional instability, unstable relationships, and more. It’s also effective at treating other mental health conditions, such as eating disorders and substance abuse disorders.

DBT consists of four strategies:

• Core mindfulness

• Interpersonal effectiveness (improving 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.

Applied Behavior Analysis (ABA)

This type of behavior therapy emphasizes using behavioral analysis techniques in real-world scenarios. It emphasizes external actions and behaviors more than it does cognition.

It’s often used to treat children and adults who have intellectual or developmental disorders, like autism spectrum disorder.

One of the primary techniques in ABA is modeling. In other words, therapists will help patients learn new skills or acceptable behaviors by showing them how to perform said desired skills.

More research is needed to determine how effective ABA is.

Exposure Therapy

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

The idea behind exposure therapy is that exposing people to distressing stimuli in a safe environment will help them overcome their fear and stop avoiding these stimuli.

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.

The techniques used in each type of behavioral therapy can vary, but they’re all based on two theories: classical conditioning and operant conditioning. The specific behavioral therapeutic approach a therapist uses will depend on the condition you’re treating and the severity of your symptoms.

Let’s break down the basic techniques.

Classical Conditioning

Classical conditioning is a type of automatic or unconscious learning where you create a connection between a neutral stimulus and something that naturally triggers a response. 

Through repeated pairings, the previously neutral stimulus eventually causes the response on its own.

One classic example is Pavlov’s dog experiment. In the experiment, a bell sound (the neutral stimulus) was paired with food, which made the dog naturally salivate (the natural reflex trigger). The dog learned to associate the sound with the food, so the tone alone could eventually make the dog salivate.

Some techniques used to alter behavior through classical conditioning include:

• Systematic desensitization. This technique helps you become less sensitive to specific triggers. You’ll learn breathing and relaxation practices that you can then use to replace fear responses with relaxation responses.

• Aversion therapy. This type of therapy is often used to treat conditions like nail biting. Applying a bitter-tasting substance to the nails has shown consistent success in reducing nail biting, particularly in children. 

Operant Conditioning

Operant conditioning focuses on reinforcement and punishment to either increase or decrease a behavior’s frequency. Behaviors followed by desirable outcomes are more likely to occur again, whereas ones followed by negative outcomes 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. This is when one changes a behavior by stopping reinforcing it. For example, if a child received attention and treats in response to temper tantrums, training the parents to withhold this rewarding response would reduce the frequency of the tantrums. 

• Behavior modeling. This technique involves learning through observation and modeling the behavior of others.

• Token economies. This strategy relies on reinforcement to modify behavior. For example, kids can earn tokens for engaging in preferred behaviors and lose tokens for undesirable behaviors. They can then trade tokens for rewards such as candy or a toy.

About 75 percent of people who participate in any kind of psychotherapy find it beneficial. However, while behavioral therapies are effective for different disorders, such as anxiety disorders, behavior therapy isn’t necessarily the right choice for every condition. 

Behavioral therapy's effectiveness depends on various factors, including the specific type of treatment used, the skill of the therapist, and the condition being treated.

Research supports the effectiveness of CBT for many types of conditions and issues. Meanwhile, exposure therapy is highly effective for phobias, and many studies support the use of play therapy in treating young children.

Other Forms of Talk Therapy

• Psychodynamic therapy. Here, the goal is to help people uncover the underlying issues and memories driving their present-day behavior and emotions.

• Humanistic therapy. Based on the principles of humanism, humanistic therapy centers around connecting with the individual, working to enhance their strengths, and striving for growth.

• Interpersonal therapy. Interpersonal therapy is designed to treat mood disorders and improve relationships. It can be a great tool, especially for those living with depression.

Mental Health Medications

For some, medication may be an effective alternative treatment option — and it often works best when you use it in combination with therapy. Some healthcare professionals may prescribe an antidepressant in conjunction with talk therapy, for example.

Some common mental health medications include:

• Selective serotonin reuptake inhibitors (SSRIs). SSRIs are a class of antidepressants that increase the amount of serotonin available in the brain. Some examples include Celexa^® (citalopram), Lexapro^® (escitalopram), Prozac^® (fluoxetine), and Zoloft^® (sertraline).

• Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs are another class of antidepressants and act on both serotonin and norepinephrine levels in the brain. Examples include Effexor^® (venlafaxine), Cymbalta^® (duloxetine), and Pristiq^® (desvenlafaxine).

• Atypical antidepressants. Wellbutrin^® (bupropion) is referred to as an atypical antidepressant because it doesn’t fall under the other classes of antidepressants. It works by increasing levels of dopamine and norepinephrine in the brain.

• Beta-blockers. Some beta-blockers, like propranolol, can be effective in certain anxiety-inducing situations. They work by preventing stress hormones from going haywire.

There are a few steps you can take to find a behavior therapist. Here are some tips:

• Get a referral from your primary care doctor.

• Ask for a recommendation from family and friends.

• Contact your insurance company to see if they can point you to an in-network provider.

Whatever brought you here, learning about behavioral therapy might get you one step closer to feeling better. Here’s what to keep in mind about behavior therapy:

• Behavioral therapy encompasses a range of different therapies designed to change behaviors detrimental to your life and well-being. Some behavioral therapy examples include cognitive behavioral therapy, dialectical behavior therapy, exposure therapy, and more.

• Behavioral therapy techniques vary, but they’re all based on the theories of classical conditioning and operant conditioning.

• Behavioral therapies can be an effective way to manage symptoms of a range of mental health disorders and emotional challenges, including depression, anxiety, and more. That said, it may not be the best treatment plan for everyone. And in some cases, a combination of psychotherapy and medication is best.

Ready to take the next step in your mental health journey?

You can also access professional help from your home using our online mental health platform, which includes access to psychiatry resources.