Behavioral therapy

Behavioral therapy is a term that describes a broad range of techniques used to change maladaptive behaviors. The goal is
to reinforce desirable behaviors and eliminate unwanted ones.
Behavioral therapy is rooted in the principles of behaviorism, a school of thought focused on the idea that we learn from
our environment. This approach emerged during the early part of the 20th-century and became a dominant force in the field
for many years. Edward Thorndike was one of the first to refer to the idea of modifying behavior.
Unlike the types of therapy that are rooted in insight (such as psychoanalytic therapy and humanistic therapies), behavioral
therapy is action-based. Because of this, behavioral therapy tends to be highly focused. The behavior itself is the problem
and the goal is to teach people new behaviors to minimize or eliminate the issue. 1
Behavioral therapy suggests that since old learning led to the development of a problem, then new learning can fix it.
Types of Behavioral Therapy

 There are a number of different types of behavioral therapy. The type of therapy used can depend on a
variety of factors, including the condition being treated and the severity of the person's symptoms.
 Applied behavior analysis uses operant conditioning to shape and modify problematic behaviors.
 Cognitive behavioral therapy (CBT) relies on behavioral techniques, but adds a cognitive element,
focusing on the problematic thoughts behind behaviors.
 Cognitive behavioral play therapy utilizes play to assess, prevent, or treat psychosocial challenges. The
therapist may use play to help a child learn how to think and behave differently.
 Dialectical behavioral therapy (DBT) is a form of CBT that utilizes both behavioral and cognitive
techniques to help people learn to manage their emotions, cope with distress, and improve interpersonal
relationships.
Types of Behavioral Therapy
 Exposure therapy utilizes behavioral techniques to help people overcome their fears of situations or
objects. This approach incorporates techniques that expose people to the source of their fears while
practicing relaxation strategies. It is useful for treating specific phobias and other forms of anxiety.
 Rational emotive behavior therapy (REBT) focuses on identifying negative or destructive thoughts and
feelings. People then actively challenge those thoughts and replace them with more rational, realistic
ones.
 Social learning theory centers on how people learn through observation. Observing others being
rewarded or punished for their actions can lead to learning and behavior change. 2
Techniques

 In order to understand how behavioral therapy works, it is important to know more about the basic principles that
contribute to behavioral therapy. The techniques used in this type of treatment are based on the theories of classical
conditioning and operant conditioning.
 Classical Conditioning
 Classical conditioning involves forming associations between stimuli. Previously 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 will come to evoke the response on its own.
 Classical conditioning is one way to alter behavior. Several different techniques and strategies are used in this
approach to therapy.
Techniques
 Aversion therapy: This process involves pairing an undesirable behavior with an aversive stimulus in the hope
that the unwanted behavior will eventually be reduced. For example, someone with an alcohol use disorder might
take Antabuse (disulfiram), a drug that causes severe symptoms (such as headaches, nausea, anxiety, and vomiting)
when combined with alcohol.

 Flooding: This process involves exposing people to fear-invoking objects or situations intensely and rapidly. It is
often used to treat phobias. During the process, the individual is prevented from escaping or avoiding the situation.
 Techniques
 Systematic desensitization: In this technique, people make a list of fears and then learn to relax while
concentrating on these fears. Starting with the least fear-inducing item and working their way to the most fear-
inducing item, people systematically confront these fears under the guidance of a therapist. Systematic
desensitization is often used to treat phobias and other anxiety disorders. 2
 Operant Conditioning
 Operant conditioning focuses on how reinforcement and punishment can be utilized to either increase or
decrease the frequency of a behavior. Behaviors followed by desirable consequences are more likely to occur
again in the future, while those followed by negative consequences become less likely to occur.
 Behavioral therapy techniques use reinforcement, punishment, shaping, modeling, and related techniques to alter
behavior. These methods have the benefit of being highly focused, which means they can produce fast and
effective results.
Positive and Negative Reinforcement in Operant Conditioning
Understanding Reinforcement

 In operant conditioning, "reinforcement" refers to anything that increases the likelihood that a response will occur.
Psychologist B.F. Skinner coined the term in 1937,2

 For example, reinforcement might involve presenting praise (a reinforcer) immediately after a child puts away their
toys (the response). By reinforcing the desired behavior with praise, the child will be more likely to perform the same
action again in the future.

 Reinforcement can include anything that strengthens or increases a behavior.3 In a classroom setting, for example,
types of reinforcement might include giving praise, letting students out of unwanted work, or providing token rewards,
candy, extra playtime, or fun activities.
Positive and Negative Reinforcement

 Positive and Negative Reinforcement

 In operant conditioning, there are two different types of reinforcement (beyond primary and secondary
reinforcements). Both influence behavior but in different ways. The two types are: 6
 Positive reinforcement: This involves adding something to increase response, such as giving a piece of candy to a
child after they clean their room.
 Negative reinforcement: This involves removing something to increase response, such as canceling a quiz if
students turn in all of their homework for the week. By removing the aversive stimulus (the quiz), the teacher hopes
to increase the desired behavior (completing all homework).
 While these terms involve the words positive and negative, it's important to note that Skinner did not utilize these
to mean "good" or "bad."6 Instead, think of what these terms would mean when used mathematically.
Positive and Negative Reinforcement
 Positive is the equivalent of a plus sign, meaning something is added to or applied to the situation. Negative is the
equivalent of a minus sign, meaning something is removed or subtracted from the situation.
 Real-World Examples of Reinforcement
 Here are a few real-world examples of how reinforcement can be used to change behavior.
 Positive Reinforcement
 EXAMPLE
 During practice for your office softball team, the coach yells, "Great job!" after you throw a pitch. Because of this,
you're more likely to pitch the ball the same way again. This is an example of positive reinforcement.
 Another example is while at work, you exceed your manager's sales quota for the month, so you receive a bonus as part
of your paycheck. This makes it more likely that you will try to exceed the minimum sales quota again next month.

Negative Reinforcement
 You go to your doctor and get your yearly flu shot to avoid coming down with the flu. In this case, you are engaging in
a behavior (getting a shot) to avoid an aversive stimulus (getting sick). This is an example of negative reinforcement.
 Another example is if you slather aloe vera gel on a sunburn to prevent the burn from hurting. Applying the gel prevents
an aversive outcome (pain), so this is an example of negative reinforcement. Because engaging in the behavior
minimizes an aversive outcome, you will also be more likely to use aloe vera gel again in the future.
Punishment
 Punishment is a term used in operant conditioning psychology to refer to any change that occurs after a
behavior that reduces the likelihood that that behavior will occur again in the future. While positive and
negative reinforcements are used to increase behaviors, punishment is focused on reducing or eliminating
unwanted behaviors.

 Punishment is often mistakenly confused with negative reinforcement. The difference:

Reinforcement increases the chances that a behavior will occur and punishment decreases the chances that a
behavior will occur.
Types of Punishment
 Behaviorist B. F. Skinner, the psychologist who first described operant conditioning, identified two different kinds
of aversive stimuli that can be used as punishment:

 Positive punishment: This type of punishment is also known as "punishment by application." Positive punishment
involves presenting an aversive stimulus after a behavior has occurred. For example, when a student talks out of
turn in the middle of class, the teacher might scold the child for interrupting.​​

 Negative punishment: This type of punishment is also known as "punishment by removal." Negative punishment
involves taking away a desirable stimulus after a behavior has occurred. For example, when the student from the
previous example talks out of turn again, the teacher promptly tells the child that they will have to miss recess
because of their behavior.
Operant conditioning

 Contingency management: This approach uses a formal written contract between a client and a therapist (or parent
or teacher) that outlines behavior-change goals, reinforcements, rewards, and penalties. Contingency contracts can be
very effective in producing behavior changes since the rules are spelled out clearly, preventing both parties from
backing down on their promises.

 Extinction: Another way to produce behavior change is to stop reinforcing behavior in order to eliminate the
response. Time-outs are a perfect example of the extinction process. During a time-out, 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.
Rather than relying simply on reinforcement or punishment, modeling allows individuals to 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 often use token
economies, allowing kids to earn tokens for engaging in preferred behaviors and lose tokens for undesirable
behaviors. These tokens can then be traded for rewards such as candy, toys, or extra time playing with a favorite toy. 4
What Behavioral Therapy Can Help With

 Behavioral therapy can be utilized to treat a wide range of psychological conditions and
disorders, including:
 Bipolar disorder5

 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) 6
 Behavioral therapy is problem-focused and action-oriented. For this reason, it can also be useful for addressing specific
psychological concerns such as anger management and stress management. 7
 Treatments that incorporate behavioral techniques are usually focused on producing results in a relatively short period of
time.