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Behavioral Therapy

Behavioral Therapy (also known as Behavior Therapy) is a form of psychotherapy that is rooted in Behaviorism, which is a theory that argues that psychological matters can only be studied and understood by looking at a person's overt behavior and emotional expressions, rather than exploring their internal mental states such as their thoughts, attitudes and intentions.

The idea is that people's thoughts and intentions are totally subjective, and so trying to study these internal states scientifically will always be difficult because it is not really possible to measure accurately and reliably something that is so subjective. Instead, if you want to know if someone is depressed, or anxious, or fearful of a certain situation, all you need to do is to observe their behaviors and emotional expressions and you will see if they in fact have any of these problems.

Behavioral Therapy thus views mental health conditions as problems of behavior, and tries to bring improvement and relief to clients (ie. patients) by helping them to change their behaviors. For example, if a depressed individual is not sleeping or eating properly, has withdrawn from friends and family and is no longer participating in their usual activities, then the goal of treatment would be to have them reestablish a normal sleep and eating pattern, and getting them to be active once again in their activities and relationships. Similarly, if someone has a fear of a certain situation and is avoiding that situation, then this behavior would need to be modified by having the person to confront this feared situation.

According to Behaviorism, behaviors are learned through the process of conditioning, or associative learning. Situations that are neutral can come to elicit a strong behavioral or emotional reponse in a person by being paired with an event that causes a powerful emotional response. For example, whereas for most people being in a bank will not cause much of an emotional reaction, someone who witnessed a violent bank robbery may experience intense fear any time they reenter a bank. This process is knowns as classical conditioning. In operant conditioning, behaviors can be reinforced or extinguished to the extent that that they are paired with rewards or punishments.

Uses of Behavioral Therapy

Behavioral Therapy will use the above principles to help individuals unlearn certain negative behaviors and avoidance patterns and replace these with more beneficial behaviors. This therapy tends to be time-limited and short-term, usually in the order of 10-20 sessions, where very specific goals are established at the start of the therapy based on the symptoms that the client wishes to change.

Behavioral Therapy has been found to be effective for treating Major Depression, Simple Phobias, Generalized Anxiety Disorder (mainly when using Applied Relaxation Therapy), Obsessive-Compulsive Disorder (mainly when using ERP), PTSD (mainly when using Systematic Desensitization), Social Phobia, Panic Disorder, Addictions, and ADHD.

Forms and Methods of Behavioral Therapy

There are various specific forms and methods of Behavioral Therapy that have been developed for managing various typical clinical situations.

Systematic Desensitization

Also known as Graduated Exposure Therapy, this form of Behavioral Therapy is used to help individuals overcome feared situations by exposing them in gradual steps to conditions that more and more closely resemble the situations that they fear. This technique will often make use of Applied Relaxation Training as a way to reduce anxiety during these progressive steps.

Exposure and Response Prevention (ERP)

This form of Behavioral Therapy was developed for Obsessive-Compulsive Disorder (OCD), where individuals fall into the unhealthy pattern of trying to reduce the anxiety caused by their obsessions by engaging in certain ritualistic compulsions. Exposure and Response Prevention (ERP) tries to help individuals unlearn this pattern by having the person resist engaging in their compulsions, and instead try to manage their anxiety using other means. This is done in progressive steps, where at each point the individual is encouraged to tolerate more intense obsessions and higher levels of anxiety without resorting to a compulsion. For example, a person who has obsessions over cleanliness may be asked to come into contact with progressively more dirty objects and situations without resorting to compulsions of excessive hand-washing or bathing. ERP can also be used for other conditions with similar kinds of symptoms, such as Body Dysmorphic Disorder.

Furthermore, exposure techniques can be used to treat a variety of conditions that involve some element of fear or anxiety in regards to a particular situation, such as in Phobias, PTSD, and Social Anxiety Disorder. In these cases, the goal is to expose the individual in a gradual, progressive and supportive fashion to the given situation or the memories that are causing them fear, with the idea that in this way they can learn to tolerate the situation or the memories with greater ease and eventually overcome their fears.

Behavioral Activation

This approach is used mainly for Depression as a way to get depressed individuals to regain their interest and motivation to do their usual activities. The participant decides on a list of activities that they will do, ranked in terms of level of difficulty or of energy required, and the therapist then motivates the client to perform these activities in part by providing rewards for each task that is accomplished.

Applied Relaxation Training

This form of Behavioral Therapy involves a variety of techniques designed to lower an individual's anxiety level and physical tension. This includes slow and deep breathing excercises, muscle relaxation, relaxing imagery, and meditation practices. The therapist teaches these techniques to the client, who then practices them regularly on their own, and uses them in situations where they anticipate or experience stress and anxiety.