Which behavior therapy technique is commonly used to treat anxieties or fears?

Exposure therapy is a psychological treatment that was developed to help people confront their fears. When people are fearful of something, they tend to avoid the feared objects, activities or situations. Although this avoidance might help reduce feelings of fear in the short term, over the long term it can make the fear become even worse. In such situations, a psychologist might recommend a program of exposure therapy in order to help break the pattern of avoidance and fear. In this form of therapy, psychologists create a safe environment in which to “expose” individuals to the things they fear and avoid. The exposure to the feared objects, activities or situations in a safe environment helps reduce fear and decrease avoidance.

Exposure therapy has been scientifically demonstrated to be a helpful treatment or treatment component for a range of problems, including:

• Phobias
• Panic Disorder
• Social Anxiety Disorder
• Obsessive-Compulsive Disorder
• Posttraumatic Stress Disorder
• Generalized Anxiety Disorder

There are several variations of exposure therapy. Your psychologist can help you determine which strategy is best for you. These include:

• In vivo exposure: Directly facing a feared object, situation or activity in real life. For example, someone with a fear of snakes might be instructed to handle a snake, or someone with social anxiety might be instructed to give a speech in front of an audience.
• Imaginal exposure: Vividly imagining the feared object, situation or activity. For example, someone with Posttraumatic Stress Disorder might be asked to recall and describe his or her traumatic experience in order to reduce feelings of fear.
• Virtual reality exposure: In some cases, virtual reality technology can be used when in vivo exposure is not practical. For example, someone with a fear of flying might take a virtual flight in the psychologist's office, using equipment that provides the sights, sounds and smells of an airplane.
• Interoceptive exposure: Deliberately bringing on physical sensations that are harmless, yet feared. For example, someone with Panic Disorder might be instructed to run in place in order to make his or her heart speed up, and therefore learn that this sensation is not dangerous.

Exposure therapy can also be paced in different ways. These include:

• Graded exposure: The psychologist helps the client construct an exposure fear hierarchy, in which feared objects, activities or situations are ranked according to difficulty. They begin with mildly or moderately difficult exposures, then progress to harder ones.
• Flooding: Using the exposure fear hierarchy to begin exposure with the most difficult tasks.
• Systematic desensitization: In some cases, exposure can be combined with relaxation exercises to make them feel more manageable and to associate the feared objects, activities or situations with relaxation.

Exposure therapy is thought to help in several ways, including:

• Habituation: Over time, people find that their reactions to feared objects or situations decrease.
• Extinction: Exposure can help weaken previously learned associations between feared objects, activities or situations and bad outcomes.
• Self-efficacy: Exposure can help show the client that he/she is capable of confronting his/her fears and can manage the feelings of anxiety.
• Emotional processing: During exposure, the client can learn to attach new, more realistic beliefs about feared objects, activities or situations, and can become more comfortable with the experience of fear.

Source: APA Div. 12 (Society of Clinical Psychology)

Date created: July 2017

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• What is behavioral therapy?
  • What can behavioral therapy treat? 
• Types of behavioral therapy
  • Cognitive-behavioural therapy (CBT)
  • Cognitive-behavioural play therapy
  • Exposure therapy
  • Dialectical behavioral therapy (DBT) 
  • Rational emotive behavioral therapy (REBT)
  • Applied behavior analysis (ABA)
  • Social learning theory
• Behavioral therapy principles and techniques
  • Classical conditioning
    • Systematic desensitization
    • Aversion therapy
    • Flooding
  • Operant Conditioning
    • Contingency management
    • Token economies
    • Extinction
    • Behavior modeling
• Behavioral therapy effectiveness
  • Behavioral therapy for ADHD
  • Behavioral therapy for depression
  • Behavioral therapy autism
  • Behavioral therapy for children
• Things to consider
• Conclusion

Behavior therapy is a popular choice for people who are struggling with issues such as phobias and anxiety. It is also a go-to for parents who are coping with Autism and related disorders in children because it delivers effective behavioral changes. 

Here’s how behavioral therapy works, and why it is still a very much needed approach in psychotherapy.

What is behavioral therapy?

Behavioral therapy encompasses a broad range of techniques that work to change unwanted and/or harmful behaviors. The main goal is to reinforce preferred behaviors and eliminate undesirable ones. 

Behaviorism is a school of thought based on the idea that people learn from their environment. It is suggested that it was old learning that led to the development of the issue and thus, new learning can bring change. The first person to bring up the idea of behavior modification was Edward Thorndike. 

Compared to humanistic therapies and psychoanalytic therapy, behavioral therapy is highly focused and action-based. As such, the behavior itself is seen as the problem and the therapist’s aim is to teach new ways of conduct in order to overcome or eliminate the issue. 

What can behavioral therapy treat? 

This therapy is aimed to treat a variety of psychological disorders, such as:

• Alcohol & Substance use disorders
• Anxiety
• Autism spectrum disorders
• Attention deficit hyperactivity disorder (ADHD)
• Depression
• Bipolar disorder
• Eating disorders
• Phobias
• Panic disorder
• Obsessive-compulsive disorder (OCD)
• Borderline personality disorder (BPD)
• Anger management
• Stress management

Types of behavioral therapy

There are quite a number of behavioral therapies. While each of these therapies aims for behavioral changes, they each have their unique strategies. The type of therapy used often depends on factors such as the mental health issue and the severity of it. 

Cognitive-behavioural therapy (CBT)

CBT is a popular therapy that combines principles and techniques from both cognitive and behavioral therapies. Treatment focuses on how thoughts and beliefs can influence a person’s conduct and actions. The long term goal of CBT is to affect change in an individual’s negative thoughts and thus, behavioral patterns. 

Cognitive-behavioural play therapy

This approach is usually used with children. Therapists observe and gain insight into the child’s world by watching them play. In cognitive-behavioural play therapy, children are given permission to choose what they want to play with and engage in free play. 

The therapist may also ask the child to draw pictures or create scenes during play. 

Therapists using this approach use play to help kids learn new behavior via play, and may also show parents how to use play to improve communication with their kids. 

Exposure therapy

Exposure therapy is usually used to treat anxiety and phobias. This behavioral approach aims to help individuals overcome their fears of objects and situations by exposing them to the source of fear. Therapists teach relaxation strategies and coping skills to empower patients to face their fears. 

Dialectical behavioral therapy (DBT) 

In dialectical behavioral therapy, both behavioral and cognitive techniques are used to help patients. DBT works by getting people to understand and accept difficult feelings, learn how to cope and manage these feelings and make positive changes in life. 

DBT is often used with people who experience intense and overwhelming emotions. 

For more information, read our article on “Dialectical behavioral therapy.”

Rational emotive behavioral therapy (REBT)

Rational emotive behavioral therapy is based on the premise that our thoughts, emotions and behaviors are connected. Thus, psychological issues and mental distress are overcome by challenging irrational beliefs and negative thinking patterns. 

REBT is also sometimes referred to as the ABC theory of personality. 

For more information, read our article on “Rational emotive behavioral therapy.” 

Applied behavior analysis (ABA)

In applied behavior analysis, problematic behaviors are modified via operant conditioning. ABA can be used to improve communication and social skills, academics, living skills and job competence. 

It is an effective approach for both children and adults with psychological issues in schools, homes, and workplaces. 

Social learning theory

Social learning theory suggests that people learn behavior through observation and imitation. Behavioral changes can occur when we observe how others are rewarded or punished for their actions. 

Behavioral therapy principles and techniques

Behavioral therapy techniques are based on classical conditioning and operant conditioning. 

Classical conditioning

Classical conditioning uses the formation of associations between stimuli. A neutral stimulus is paired with another stimulus that automatically produces a response. Repeated pairings of both these stimuli result in an association, with the previously neutral stimuli now producing the same response. 

Techniques based on the principle of classical conditioning include:

Systematic desensitization

Systematic desensitization is a technique often used to treat anxiety disorders and phobias. 

In this technique, people start by confronting the least fear-inducing item until they are able to face the most fear inducing item. 

For example, to help a person who has a phobia of dogs, the therapist may first have the person just look at pictures of dogs. Once the person is comfortable, the therapist can introduce the person to a real dog. This step is then followed by the person being near the dog, touching the dog, and so on.  

Aversion therapy

In aversion therapy, undesirable behavior is paired with an aversive stimulus. It is hoped that the unwanted behavior will lessen due to the negative consequences it brings. 

Flooding

Flooding is a technique that can be used to treat phobias. In this technique, people are rapidly exposed to the feared object or situation. Escaping or avoiding the situation is not allowed and thus, the individual is forced to face their fears.  

Operant Conditioning

Operant conditioning utilizes reinforcement and punishment to increase or decrease the frequency of certain behavior. It is expected that desirable consequences following a particular behavior will encourage it to occur again in the future and vice versa. 

Operant conditioning can bring about fast and effective behavioral changes. 

Techniques based on the principle of operant conditioning include:

Contingency management

In contingency management, a ‘contract’ between the therapist and client is made. In this contact, goals of behavioral changes, reinforcements, rewards as well as penalties are outlined clearly. This approach to behavioral change is effective as rules are very clear for both parties. 

Token economies

This reinforcement technique is often used by parents and teachers to encourage wanted behaviors. Children earn tokens when they engage in the preferred behaviors and lose tokens when they partake in unwanted behaviors. They can then exchange the tokens they earn for a reward. 

Extinction

In extinction, a behavior or situation that is providing reinforcement is stopped or eliminated to produce behavioral changes. For example, a child who is snatching toys is put in a time-out to remove him from the situation. 

The unwanted behavior will soon be extinguished because the rewarding situation is taken away. 

Behavior modeling

Behavior modeling allows the individual to learn via observation and modelling behavior of other people. Instead of the basic reinforcement and punishment, behavior modeling enables individuals to learn acceptable behaviors by observing other people engaging (and getting rewarded) in the preferred skills and behaviors. 

Behavioral therapy effectiveness

While success rates of behavioral therapies depend on the specific type of treatment applied and the condition being treated, behavioral therapies are considered to be highly effective. In fact, research shows that about 75% of those who try psychotherapy see a positive improvement. 

CBT, in particular, has shown to be an effective treatment for post-traumatic stress disorder, panic disorder, obsessive-compulsive compulsive disorder. Additionally, CBT also has benefits for those who are suffering from schizophrenia. 

Behavioral therapy for ADHD

Behavioral therapy can help people with attention deficit hyperactivity disorder (ADHD) manage behaviors that they are struggling with. Symptoms of ADHD can make daily life very challenging. 

However, new and positive behaviors can be developed to effectively manage these symptoms. ADHD treatment plans often utilize behavioral therapy together with medication. 

Read more in our article on “Behavioral therapy for ADHD: How can it help?“

Behavioral therapy for depression

Behavioral therapy for depression often focuses on behavioral activation, in which patients engage in activities that promote positive feelings. CBT and DBT are also often used to help those who are struggling with depression. 

Behavioral therapy autism

While there is no cure for autism, behavior therapy such as applied behavior analysis and cognitive behavioral therapy can be a great help for those who are struggling with autism. 

Behavioral therapies can help those with autism reduce unwanted and even harmful behaviors that are interfering with learning and everyday life. It can also help in the development of social skills.

Behavioral therapy for children

Applied behavior therapy and play therapy are often used to teach children how to respond more positively to situations. These therapies reward good behaviors and punish unwanted behaviors. Parents help to reinforce the positive behaviors daily in order to affect the behavioral changes. 

Things to consider

While behavioral therapy can be very effective, there are some limitations that should be considered:

• It may not be sufficient for complex mental health issues. There are times when behavioral therapy needs to be used together with other medical and therapeutic interventions. For example, patients with schizophrenia most likely need medication in addition to therapy. 
• It may not be able to deal with the root issue. Behavioral interventions usually focus on current problems patients face and may not give enough weight to underlying factors contributing to the issue. 
• It may not address situational factors and interpersonal relationships that might have contributed to the issue. 

Conclusion

Behavioral therapy is one of the most effective ways to affect long term behavioral changes. If you’re looking for a behaviorist, your local mental health practitioner will be able to make recommendations according to the condition needing treatment. 

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No matter what you’re facing, perhaps our website can offer up some solace or comfort. Know that you’re not alone, and that there is help available. This can be hard to keep in mind if you haven’t quite found the right support system. While it’s definitely not easy to find the right fit—whether you’re looking for a support group or a mental health provider—with diligence, it’s totally possible.

If you are a therapist, life coach or counsellor looking to join our growing community, head over to book a tour once you have learnt about the plans we offer. At A Space Between, there is a ready league of providers you can network with. With professionals from various backgrounds and therapy practices, there are bound to be the ones you can connect with. Private practice does not have to be lonely.

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