Behavioral Therapy

In behavioral therapy, the goal is to reinforce desirable behaviors and eliminate unwanted or
maladaptive ones. Behavioral therapy is rooted in the principles of behaviorism, a school of
thought focused on the idea that we learn from our environment. The techniques used in this type
of treatment are based on the theories of classical conditioning and operant conditioning.

One important thing to note about the various behavioral therapies is that unlike some other
types of therapy that are rooted in insight (such as psychoanalytic and humanistic therapies),
behavioral therapy is action-based. Behavioral therapists are focused on using the same learning
strategies that led to the formation of unwanted behaviors.

Because of this, behavioral therapy tends to be highly focused. The behavior itself is the problem
and the goal is to teach clients new behaviors to minimize or eliminate the issue. Old learning led
to the development of a problem and so the idea is that new learning can fix it.

There are also three major areas that also draw on the strategies of behavioral therapy:
1. Cognitive-behavioral therapy relies on behavioral techniques but adds a cognitive
element, focusing on the problematic thoughts that lie behind behaviors.
2. Applied behavior analysis utilizes operant conditioning to shape and modify problematic
behaviors.
3. 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.

Brief Background
Edward Thorndike was one of the first to refer to the idea of modifying behavior. Other early
pioneers of behavior therapy included psychologists Joseph Wolpe and Hans Eysenck.

Behaviorist B.F. Skinner's work had a major influence on the development of behavior therapy
and his work introduced many of the concepts and techniques that are still in use today.

Later on, psychologists such as Aaron Beck and Albert Ellis began adding a cognitive element to
behavioral strategies to form a treatment approach known as cognitive-behavioral therapy
(CBT).

Foundation of Behavioral Therapy

In order to understand how behavioral therapy works, let's start by exploring the two basic
principles that contribute to behavioral therapy: classical and operant 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.

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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.

Behavior Therapy Based on Classical Conditioning

Classical conditioning is one way to alter behavior, and a number of techniques exist that can
produce such change. Originally known as behavior modification, this type of therapy is often
referred to today as applied behavior analysis.

Some of the techniques and strategies used in this approach to therapy include:

1. 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.

For example, flooding might be used to help a client who is suffering from an intense fear of
dogs. At first, the client might be exposed to a small friendly dog for an extended period of time
during which he or she cannot leave. After repeated exposures to the dog during which nothing
bad happens, the fear response begins to fade.

2. Systematic Desensitization
This technique involves having a client make a list of fears and then teaching the individual to
relax while concentrating on these fears. The use of this process began with psychologist John B.
Watson and his famous Little Albert experiment in which he conditioned a young child to fear a
white rat. Later, Mary Cover Jones replicated Watson's results and utilized counterconditioning
techniques to desensitize and eliminate the fear response.

Systematic desensitization is often used to treat phobias and other anxiety disorders. The process
follows three basic steps:
1. First, the client is taught relaxation techniques.
2. Next, the individual creates a ranked list of fear-invoking situations.
3. Starting with the least fear-inducing item and working their way up to the most fear-
inducing item, the client confronts these fears under the guidance of the therapist while
maintaining a relaxed state.

For example, an individual with a fear of the dark might start by looking at an image of a dark
room before moving on to thinking about being in a dark room and then actually confronting his
fear by sitting in a dark room. By pairing the old fear-producing stimulus with the newly learned
relaxation behavior, the phobic response can be reduced or even eliminated.

3. 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 suffering from
alcoholism might utilize a drug known as disulfiram, which causes severe symptoms such as

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headaches, nausea, anxiety, and vomiting when combined with alcohol. Because the person
associates becoming extremely ill when they drink, the drinking behavior may be eliminated.

Behavior Therapy Based on Operant Conditioning

Many behavior techniques rely on the principles of operant conditioning, which means that they
utilize reinforcement, punishment, shaping, modeling and related techniques to alter behavior.
These methods have the benefit of being highly focused, which means that they can produce fast
and effective results.

Some of the techniques and strategies used in this approach to behavioral therapy include:

4. Token Economies
This type of behavioral strategy relies on reinforcement to modify behavior. Clients are allowed
to earn tokens that can be exchanged for special privileges or desired items. Parents and teachers
often use token economies to reinforce good behavior. Kids earn tokens for engaging in
preferred behaviors and may even lose tokens for displaying undesirable behaviors. These tokens
can then be traded for things such as candy, toys, or extra time playing with a favorite toy.

5. Contingency Management
This approach utilizes a formal written contract between the client and the therapist that outlines
the behavior change goals, reinforcements, and rewards that will be given and the penalties for
failing to meet the demands of the agreement. These types of agreements aren't just used by
therapists—teachers and parents also often use them with students and children in the form of
behavior contracts. Contingency contracts can be very effective in producing behavior changes
since the rules are spelled out clearly in black-and-white, preventing both parties from backing
down on their promises.

6. Modeling
This technique involves learning through observation and modeling the behavior of others. The
process is based on Albert Bandura's social learning theory, which emphasizes the social
components of the learning process. 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. In some cases, the therapist might model the desired behavior.
In other instances, watching peers engage in sought-after behaviors can also be helpful.

7. Extinction
Another way to produce behavior change is to stop reinforcing a 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. For example, a child who starts
yelling or striking other children would be removed from the play activity and required to sit
quietly in a corner or another room where there are no opportunities for attention and
reinforcement. By taking away the attention that the child found rewarding, the unwanted
behavior is eventually extinguished.

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NOTE: When it comes to treating specific behavioral issues, behavioral therapy can sometimes
be more effective than other approaches. Phobias and obsessive-compulsive disorder are
examples of problems that respond well to behavioral treatments.

However, it is important to note that behavioral approaches are not always the best solution. For
example, behavioral therapy is generally not the best approach when treating certain serious
psychiatric disorders such as depression and schizophrenia. Behavioral therapy might be
effective at helping clients manage or cope with certain aspects of these psychiatric conditions,
but should be used in conjunction with other medical and therapeutic treatments.