Behavioural therapy
Behavioural therapy focuses on identifying and changing undesirable or unhelpful behaviours, replacing them with healthier alternatives. This process is guided by a trained behavioural therapist.
Here, we will explore the role of behavioural therapy in more detail, including the key principles and techniques used, and how it can foster positive personal growth and change.
What is behavioural therapy?
Behavioural therapy is a therapeutic approach that uses a range of techniques to foster positive behaviour change. Also known as behaviour therapy, it focuses on identifying and changing undesirable or unhelpful behaviours. Unlike many therapies that explore past experiences, behavioural therapy centres on current behaviours and how they can be improved. The underlying principle is that behaviours are learned, which means they can also be unlearned through therapy.
In this video, CBT therapist Gul-E-Rana Hameed (BA, MSc, MPhil Psychology, PGCert, PGDip, EMDR, TCTSY) explains what behavioural therapy is and explores some of the common techniques used in sessions.
What can behavioural therapy help with?
Behavioural therapy is widely used to treat a range of mental health conditions that involve unwanted or maladaptive behaviours. It is especially effective for individuals struggling with anxiety disorders, such as generalised anxiety disorder (GAD), panic disorder, social anxiety disorder, and specific phobias.
In these cases, the therapy focuses on identifying and addressing the underlying behaviours that fuel anxiety. For example, it may involve helping individuals challenge irrational fears, gradually exposing them to anxiety-provoking situations in a controlled way, or teaching relaxation techniques and coping strategies to manage physical and emotional responses to stress.
Behavioural therapy is also beneficial for treating conditions that involve unwanted behaviours such as addiction and obsessive-compulsive disorder (OCD). By focusing on practical strategies to change harmful behaviour patterns, it helps individuals develop healthier responses and coping mechanisms, improving overall mental well-being.
What does a behavioural therapist do?
Behavioural therapists help individuals identify and learn new, positive behaviours to replace or minimise undesirable ones. As well as focusing on the behaviour itself, therapists also explore the thoughts and emotions that contribute to or result from these behaviours, aiming to understand the underlying patterns.
By examining both the behaviour and the emotional factors involved, therapists can create personalised strategies to promote healthier habits. There are various ways this is achieved, and the methods used will vary depending on the concerns and goals of the individual.
Techniques used in behavioural therapy
Behavioural therapy is grounded in two fundamental learning principles: classical conditioning and operant conditioning. Classical conditioning involves learning through involuntary associations – linking a stimulus to a response without conscious effort. In contrast, operant conditioning focuses on learning through the consequences of voluntary actions, using techniques like positive reinforcement or punishment to encourage or discourage specific behaviours.
These core principles shape the various techniques used by behavioural therapists, helping individuals replace unhelpful behaviours with more adaptive ones.
1. Classical conditioning techniques
Flooding
Flooding is an intensive exposure technique generally used for those with phobias and anxiety, which involves rapidly exposing the individual to the source of their fear. An example of this would be exposing a person who is afraid of dogs to a dog for an extended period of time. As time passes without any negative outcome, their fear response diminishes.
While this method can be highly effective, the idea that the person cannot escape may be overwhelming or distressing for some individuals. Therefore, it is typically reserved for situations where the client has been thoroughly informed, given their consent, and prepared for the process in advance.
Systematic desensitisation
This technique works on a similar premise to flooding, however, it is more gradual. It helps individuals face their fears step-by-step. The process begins with the client creating a hierarchy of fears, starting from the least to the most anxiety-inducing. The therapist then teaches relaxation techniques, such as deep breathing or progressive muscle relaxation, to help the individual stay calm while thinking about or confronting their fears.
An example of this would be a person who is afraid of small spaces. They may start by thinking about a small space, or looking at an image of a small space while utilising relaxation techniques, practising until they are ready to physically be in a small space. This pairing of the fear-inducing item and newly learned relaxation behaviour aims to reduce and eliminate the phobia or anxiety.
Aversion therapy
Aversion therapy aims to reduce undesirable behaviours by associating them with negative stimuli. This technique is often used in cases such as substance abuse. For example, an individual struggling with alcohol dependency might be prescribed a medication that induces nausea, anxiety, or headaches when alcohol is consumed. Over time, the unpleasant physical reactions discourage the person from drinking, reshaping their perception of alcohol from a source of pleasure to one of discomfort.
Modern behavioural therapists, including those in the NHS, may use additional techniques such as virtual reality exposure therapy (VRET). This has become increasingly popular, particularly for treating phobias and PTSD. VRET allows patients to confront their fears in a safe, controlled virtual environment, which can be adjusted to the patient’s tolerance level.
Exposure therapy is also believed to be efficient and effective, making it a useful tool for patients needing quick relief. Deep breathing, mindfulness and progressive muscle relaxation are examples of other relaxation techniques that are often used.
2. Operant conditioning techniques
Token economies
Token economies use positive reinforcement by rewarding individuals with tokens, which can later be exchanged for privileges or items they desire when they demonstrate positive behaviour. This approach is commonly used by parents, teachers, and therapists to encourage desirable behaviour, particularly in children. It provides immediate and tangible rewards that reinforce good behaviour, making it a useful tool in both educational and therapeutic settings.
Contingency management
A more structured approach, contingency management involves a written agreement between the therapist and the client, outlining clear goals, rewards, and penalties. This method helps establish accountability by providing a transparent framework for behaviour change. For many individuals, having explicit expectations and incentives can motivate lasting improvements in behaviour, as they understand the direct connection between actions and consequences.
Modelling
Modelling involves learning through observation and imitation of others. By observing a positive role model, such as the therapist or someone else the individual respects, they can learn new behaviours to adopt. This approach provides a real-life example of desired behaviours, making it easier for individuals to visualise and implement changes in their own actions. Modelling is often particularly effective in demonstrating coping strategies, social skills, and conflict resolution.
Extinction
Extinction is the process of reducing undesirable behaviour by removing any reinforcement or rewards associated with it. For example, a disruptive child may be given a "time-out" or removed from a rewarding situation to stop the behaviour. By withdrawing attention or any form of reinforcement, the behaviour is less likely to be repeated. While commonly used with children, extinction is also effective for managing behaviours in adults, especially in scenarios where attention or external rewards reinforce undesirable actions.
Operant condition techniques are frequently used in schools to improve student behaviour and promote positive learning environments. These techniques encourage students to behave appropriately and reinforce positive actions, especially for younger children who are still developing self-regulation skills.
What's the difference between behavioural therapy and cognitive therapy?
Behavioural therapy focuses primarily on changing observable behaviours. It operates on the principle that behaviours are learned and can be unlearned or replaced with healthier ones, through techniques such as reinforcement, exposure, and conditioning to modify specific behaviours in the present.
In contrast, cognitive therapy aims to change unhelpful or distorted thinking patterns that contribute to negative emotions and behaviours. While cognitive therapy can address current issues, it also considers how past experiences, thought patterns and beliefs influence current behaviours and emotional responses.
In summary, behavioural therapy targets behaviour modification directly, while cognitive therapy focuses on altering the thought patterns that drive those behaviours. Cognitive behavioural therapy (CBT) is an integrative approach combining elements of both.
There are many different types of therapy, and what works for one person may not work for you. It will also depend on your situation, what you want to gain from therapy and the therapist themselves. If you feel that behavioural therapy may help you, you can find a behavioural therapist using our advanced search. Do your research and take your time, don’t be disheartened if the first method doesn’t work. Keep going and you’ll find what works for you.
