Behavioral Therapy Explained: A Proven Path to Mental Wellness
Clinically Reviewed by: Katie Moran, LCSW
More and more of us are becoming aware of the benefits of caring for our mental health. In fact, the 2024 Public Perception of Mental Health and Suicide Prevention Poll found that 63% of adults feel comfortable discussing mental health in public. If you’re considering therapy to care for your mental health, behavioral therapy might be on your radar. It’s the most widely used type of therapy and the most studied. It’s the first-line treatment for anxiety, depression, attention-deficit hyperactivity disorder (ADHD), and eating disorders.
Behavioral therapy is a type of psychotherapy that focuses on unhelpful or maladaptive behavior. It includes identifying the behavior and working to change it to a more helpful or healthy behavior. Your therapist might use methods like positive reinforcement, journaling, or role-playing. These techniques can help you introduce new behaviors.
In this article, we’ll explain the types of behavior therapy, the techniques used, and the conditions it treats. We’ll also outline what a typical behavioral therapy session might look like, so you can feel more comfortable going into your first session.
What is Behavioral Therapy?
Behavioral therapy began in the early 20th century and draws from behaviorism, a school of thought that says behavior is the result of the environment and learning. You might have heard of Pavlov’s dogs, the classic experiment that paired the dog being fed with the sound of the bell, until the dog salivated in response to the sound of the bell. This experiment showed how behaviors are learned. B.F. Skinner further expanded on Pavlov’s work by investigating how reinforcement and punishment affect how behaviors are learned and changed.
Behavioral therapy is based on behaviorism’s main idea: behaviors are learned. This means that behaviors can be changed or unlearned. This focus on behavior makes behavioral therapy different from other types of therapy. For example, psychodynamic therapy focuses on unresolved childhood issues and repressed emotions. Humanistic therapy is based on the understanding that humans are inherently good and capable of healing. Compared to these other therapies, behavioral therapy is more goal-oriented and introduces practical strategies to apply to daily life.
As previously mentioned, behaviorism was a way to understand behavior, but it wasn’t a treatment method. From this understanding, behavioral therapy evolved into the different types of behavioral therapy we have today. For example, cognitive behavioral therapy (CBT) recognizes that thoughts and feelings also impact behavior, while dialectical behavior therapy (DBT) teaches skills to develop emotional regulation and distress tolerance. Acceptance and commitment therapy (ACT) focuses on acceptance and values, and is more flexible than traditional behavioral therapy.
Key Types of Behavioral Therapy
There are several different types of evidence-based behavioral therapy. These have different techniques and focuses, so some might be more helpful for some people than others. Here are some more details:
Classical Behavioral Therapy: Classical behavioral therapy uses the principle of classical conditioning. This means a stimulus triggers a certain behavioral response. In classical behavioral therapy, your therapist will use techniques like reconditioning, exposure therapy, and systematic desensitization to help change or eliminate unwanted or unhelpful behaviors.
Cognitive Behavioral Therapy (CBT): CBT examines how thoughts, feelings, and behaviors interact. In CBT, you’ll work to identify negative thought patterns, which impact your feelings and behaviors, and change them.
Dialectical Behavioral Therapy (DBT): DBT helps people accept their current situation. It also focuses on improving resilience and relationships. In DBT, you’ll learn skills in mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation.
Acceptance and Commitment Therapy (ACT): ACT helps you accept your thoughts and feelings without judging them. You’ll also learn more about your values and commit to making choices that align with these values.
Exposure Therapy: Exposure therapy helps people with anxiety or fear. It reduces distress by gradually exposing clients to feared situations or activities in a safe, controlled way. In session, you’ll learn techniques to help you cope with feelings of anxiety or distress.
Social Learning Theory-based interventions: Social learning theory suggests that people learn by observing and imitating the behaviors of others. Social Learning Theory-based interventions might include helping individuals learn social skills. Social learning therapists might also help parents create an environment to develop positive social behaviors in their children, or help teachers build a classroom environment that improves student behavior and academic performance.
Core Techniques Used in Behavioral Therapy
While techniques might differ based on the type of behavioral therapy that you are receiving, some common techniques include:
Positive and negative reinforcement: Positive and negative reinforcement are used to help increase the frequency of desired behaviors. Positive reinforcement refers to a reward or other desired stimulus being given after a desired behavior. For example, your therapist might help you see the progress that you’ve made as a way to positively reinforce the work that you’ve done. Negative reinforcement means removing an unpleasant stimulus after the desired behavior is performed. An example would be a teacher removing homework after students behave well in class.
Modeling and role-playing: Modeling and role-playing are both used to help you learn new behaviors or change existing ones. In modeling, your therapist will demonstrate the behavior while you observe. In role-playing, you’ll practice the desired behaviors. Your therapist may play different roles to mimic real-life situations. For example, you might practice having a difficult conversation so that you feel more prepared for a similar real-life conversation.
Exposure and response prevention: Exposure means that an individual is gradually exposed to a situation that triggers anxiety or distress. They’ll engage in response prevention, which means avoiding the behaviors they usually engage in to ease their anxiety. For example, an individual who is fearful of germs might abstain from the repeated handwashing they typically perform. The goal is that this repeated exposure will help reduce the stress and anxiety associated with a particular situation.
Token economies: In a token economy, individuals receive tokens for positive behaviors. These tokens can then be exchanged for larger rewards. These systems are often used in classrooms, or by parents at home, to encourage certain behaviors. Therapists may also use token economies when working with children with developmental disorders.
Behavioral activation: Behavioral activation involves engaging in positive activities. You’ll track your activities and mood to figure out what activities are enjoyable or hold meaning for you. Then, you and your therapist will develop a plan to help ensure that you engage in these activities regularly. Behavioral activation is based on the idea that doing enjoyable activities can help improve mood and motivation.
Self-monitoring and journaling: Self-monitoring and journaling are both methods of recording that can help you learn more about your thoughts, feelings, and behaviors. This can help you identify repeated thoughts and feelings and become more aware of thoughts, feelings, and behaviors that are not helpful. Your therapist will then help you develop coping methods to manage these thoughts, feelings, and behaviors.
Conditions Commonly Treated
Behavioral therapy is an evidence-based approach that is used to treat several different conditions. These include:
Anxiety disorders: Behavioral therapy, especially CBT, is commonly used to treat anxiety disorders like generalized anxiety disorder, social anxiety disorder, and panic disorders. Studies indicate that CBT may be more effective than medication for treating anxiety disorders.
Depression: Behavioral therapy has been found to be as effective as medication for treating depression in the short term. However, behavioral therapy provided better long-term results than medication, as it gave individuals the skills necessary to cope.
Obsessive-Compulsive Disorder (OCD): Exposure and response prevention is often used to help treat OCD. About 50-60% of individuals with OCD who participated in exposure and response prevention therapy saw long-term benefits.
Eating disorders: CBT is the most effective evidence-based treatment for bulimia. A new type of CBT, CBT-E (cognitive-behavioral therapy enhanced), is effective in treating other types of eating disorders, including anorexia nervosa and binge eating disorder. CBT-E has four key stages that help clients understand their eating disorders. They’re also designed to help clients track their progress and change thoughts and behaviors linked to disordered eating.
Attention-Deficit Hyperactivity Disorder (ADHD): Behavioral therapy can help adults with ADHD learn skills like time management, organization, and emotional regulation. Research has found that CBT helps reduce the core symptoms of ADHD in adults, while also improving self-esteem and quality of life. Behavioral therapy is also effective for treating ADHD in children.
Substance Use Disorders: Behavioral therapies have been shown to be effective for treating a range of substance abuse disorders. They are even more effective when combined with medication or other therapy.
What to Expect in a Behavioral Therapy Session
It can feel intimidating to start therapy. In this section, we’ll go over what behavioral therapy might look like so that you can feel more prepared and comfortable going into your first session. It’s important to note that your first session is an information-gathering one. In this initial session, your therapist will ask you why you chose to attend therapy and how issues you are facing impact your daily life. They’ll also explore thoughts, behaviors, and feelings related to these issues or situations. This information will help your therapist develop a treatment plan for you, including the frequency and number of sessions. While the number of sessions can vary based on your unique situation, between 5 and 20 sessions is common. Sessions generally last between 30 and 60 minutes.
Behavioral therapy is designed to be collaborative. This means that you and your therapist will work together to create plans for each session to help you work towards your goals. This could include learning ways to handle stress, change negative thoughts, solve problems, or better speak up for yourself. Homework is also common in behavioral therapy to help you practice skills in your daily life. Your therapist might also encourage you to use a worksheet, diary, or an app to track your progress. This can help you stay motivated and also gives you information to adjust your treatment plan if needed.
Benefits of Behavioral Therapy
There are several benefits of behavioral therapy. These include:
Practical, results-focused approach: Behavioral therapy includes setting goals, which can help you cope better in your daily life.
Short-term treatment option: Behavioral therapy is considered a short-term treatment option. Most individuals attend between 5 and 20 sessions.
Strong evidence base for treatment: Behavioral therapy is an evidence-based treatment. This means that it has been proven effective.
Empowerment through skills and self-awareness: Behavioral therapy helps you notice unhelpful thoughts and behaviors. It also teaches skills like stress management, conflict resolution, and social skills that can help improve your quality of life.
Behavioral Therapy vs. Cognitive Therapy vs. Psychodynamic Therapy
Behavioral therapy, cognitive therapy, and psychodynamic therapy are all evidence-based treatments. However, they differ in their approach. Here’s a quick chart to easily compare them:
| Goals | Methods | Duration | Common Uses | |
|---|---|---|---|---|
| Behavioral Therapy | Identify unproductive behaviors and replace them with healthy, productive ones | Exposure therapy, modeling, shaping, and positive and negative reinforcement | 5-20 sessions | Anxiety disorders, depression, eating disorders, ADHD, and substance abuse disorders |
| Cognitive Therapy | Identify and change thoughts that are leading to painful emotions and unhelpful behaviors | Cognitive restructuring, journaling, behavioral activation, and relaxation techniques | 5-20 sessions | Anxiety, depression, post-traumatic stress disorder (PTSD), substance abuse disorders, and phobias |
| Psychodynamic Therapy | Understand how past experiences impact the present and develop healthier coping strategies | Interpretation, transference, free association, examination of defense mechanisms, and dream analysis | 20-30 sessions | Depression and anxiety, eating disorders, personality disorders, and relationship issues. |
Choosing between behavioral therapy, cognitive therapy, and psychodynamic therapy depends on your goals and needs. Both behavioral therapy and cognitive therapy are shorter-term treatment options that work towards specific goals. Psychodynamic therapy can be a bit of a longer-term treatment option and works on understanding the underlying reason behind the current thoughts, feelings, and behaviors. There is more evidence behind behavioral therapy and cognitive therapy for specific mental health conditions, like anxiety, depression, eating disorders, and substance abuse issues. However, psychodynamic therapy can be helpful when long-term emotional insight is needed, such as for personality disorders, attachment issues, and interpersonal problems.
It’s also important to note that many therapists use a combination of methods. This can help you get therapy that is tailored to your needs. Explore Other Therapy Modalities
Is Behavioral Therapy Right for You?
To help you determine if behavioral therapy is a good fit for you, try asking yourself these questions:
Do you have a specific habit or behavior that you want to change?
Have you been diagnosed with a mental health condition like anxiety, depression, OCD, or ADHD?
Do you enjoy a structured approach when working towards goals?
Are you able and willing to do homework between sessions?
Can you commit to regular sessions over the next few weeks?
Are you wanting to learn skills that you can apply in your daily life?
If you answered “yes” to most or all of these questions, then you may want to look into behavioral therapy. When you do this, ensure that you’re working with a licensed professional who has training in behavioral therapy. Common credentials include Board Certified Behavior Analyst (BCBA), Certified Cognitive Behavior Therapy (CCBT), Licensed Professional Counselor (LPC), and Licensed Clinical Social Worker (LCSW).
How Behavioral Therapy is Practiced at Octave
Octave offers personalized, evidence-based care. Our Care Navigators can help to pair you with a licensed behavior therapy professional based on your personality and needs. Types of behavioral therapy offered include:
Acceptance and Commitment Therapy (ACT)
Cognitive-Behavioral Therapy (CBT)
Cognitive-Behavioral Therapy for Insomnia (CBT-i)
Cognitive Processing Therapy (CPT)
Integrative Behavioral Couples Therapy (IBCT)
Dialectical Behavior Therapy (DBT)
Exposure and Response Prevention Therapy (ERP or EXRP)
Prolonged Exposure Therapy
Some therapists who offer behavioral therapy at Octave include:
Joey Kaufman, LCSW: A New York-based therapist who offers CBT and ACT and specializes in anxiety, depression, and stress. Joey uses a client-centered approach.
Navdeep Bhullar, LCSW: A solutions-oriented therapist based in California. Navdeep offers ACT, CBT, CPT, and DBT to help clients with ADHD, anxiety, and stress.
Jessica Keith, PhD: A Florida-based psychologist with a collaborative and empowering approach. Jessica offers ACT, CBT, CBT-i, CPT, and DPT.
Lauren Evans, LMFT: A Texas-based therapist who has a collaborative approach. Lauren offers CBT and DBT and has experience working with parents and first responders.
Getting Started with Therapy
Once you fill out a quick questionnaire and find a therapist, you can schedule an appointment at a time that fits your schedule based on your therapist’s availability. If you prefer to see a therapist in person, you can make an appointment at your therapist’s office. Or, if you prefer the convenience and flexibility of online therapy, you can choose to meet virtually.
We know that insurance can also be a factor when choosing a therapist. Our search tool allows you to select your state and insurance provider to determine any out-of-pocket costs.
FAQs About Behavioral Therapy
Q: Is behavioral therapy effective for children?
A: Yes, behavioral therapy is effective for children. It’s commonly used to help children with conditions like ADHD, anxiety, and depression.
Q: How long does it take to see results with behavioral therapy?
A: Most individuals complete between 5 and 20 sessions of behavioral therapy. However, the number of sessions required can depend on the type of behavioral therapy and your unique situation. For example, dialectical behavioral therapy (DBT) can take six months to a year.
Q: What if I don’t like my behavioral therapist?
A: If you feel like your behavioral therapist isn’t the right fit for you, you can change your therapist. You can also try communicating your feelings to your therapist, as they may be able to adjust their approach to better suit you.
Q: Can behavioral therapy be combined with medication?
A: Yes, behavioral therapy can be combined with medication. Sometimes, combining behavioral therapy with medication works better than using either one by itself.
Q: Does behavioral therapy work online/virtually?
A: Yes, studies have shown that behavioral therapy is just as effective virtually as it is in person. Some individuals prefer the convenience and flexibility of virtual therapy.
Conclusion
Behavioral therapy can help you learn to identify unhealthy or unhelpful behaviors and replace them with more positive and productive behaviors. It’s commonly used to treat anxiety, depression, OCD, eating disorders, ADHD, and substance use disorders.
Choosing to start behavior therapy can be a difficult decision, but it’s a brave and powerful choice that can help you learn skills to feel better in your daily life. Choosing a therapist whom you feel comfortable with can make the process easier.
Ready to take the first step? Connect with a behavioral therapist at Octave today.