What is behavioral therapy?
Behavioral therapy developed as a counter-movement to psychoanalysis. It emerged from the school of so-called behaviorism, which shaped psychology in the 20th century. While Freudian psychoanalysis concentrates primarily on interpretations of unconscious conflicts, behaviorism focuses on observable behavior. The aim is to examine human behavior objectively.
Classical conditioning
The experiments of the Russian psychologist Ivan Pavlov were decisive for the findings of behaviorism and today’s behavioral therapy. He found that appropriately trained dogs responded directly to the ringing of a bell with salivation if the bell was always rung immediately before feeding. The dogs had learned to associate the ringing of the bell with food.
The technical term for this learning process is “classical conditioning”. This learning principle also works in humans.
Behavioral therapy attaches great importance to a scientific approach. Therapy successes should be made measurable by documenting changes in the patient’s behavior. In addition, behavioral therapy is based on current scientific findings. Research findings from biology and medicine are also taken into account.
Cognitive behavioral therapy
Behavioral therapy was expanded in the 1970s to become cognitive behavioral therapy. It is based on the assumption that thoughts and feelings have a decisive influence on our behavior. The content and nature of our thoughts can trigger unfavorable beliefs and behaviors. Conversely, changing unfavorable thought patterns can positively change behavior and feelings.
Cognitive therapy aims to question and work on previous ways of thinking. Personal attitudes and assumptions play an important role here. For example, some people believe that they always have to be perfect in order to be liked. Sooner or later they despair of their unrealistic expectations. Cognitive therapy is about replacing such unhealthy beliefs with realistic ones.
When do you do behavioral therapy?
Behavioral therapy can be offered on an outpatient, day-care (e.g. in a day clinic) or inpatient basis. A place in therapy is usually obtained through a referral from your GP. However, waiting times of several weeks must sometimes be expected.
Behavioral therapy requires the active cooperation of the patient. The therapy therefore only makes sense if the person concerned is prepared to deal with themselves and work on themselves. Cooperation is not only required during the therapy sessions, but also in everyday life: The patient is expected to put what they have learned into practice and is given homework, which is discussed during the sessions.
This very direct approach to therapy, which focuses on current problems, does not suit everyone. Those who like to think intensively about themselves and seek a deep understanding of the causes of their problems may feel more comfortable with a depth psychology-oriented therapy, such as depth psychology-based psychotherapy.
Behavioral therapy: children and adolescents
Behavioral therapy methods can also be used successfully with children and adolescents. The therapist often involves the family. The cooperation of the caregivers is particularly important for the success of therapy with children.
What do you do in behavioral therapy?
The concept of behavioral therapy requires good cooperation between therapist and patient. The aim is to promote the patient’s independence and self-efficacy. This means that the therapist actively involves the patient in the therapy process and presents all procedures transparently.
In contrast to psychoanalysis, the focus of behavioral therapy is not so much on past, causal events. Rather, it is about overcoming existing problems through new ways of thinking and behaving.
Diagnosis and therapy plan
At the beginning, a precise diagnosis is made. The therapist then explains the disorder to the patient in detail. Many sufferers find it relieving when they are informed in detail about the typical symptoms, explanatory models for the development of their mental disorder and the treatment options.
The therapist and patient then jointly determine the goals of the therapy and draw up a treatment plan. The general aim is to change unfavorable behavioral and thought patterns that are stressful or limit the person affected.
The actual behavioral therapy
For example, exposure or confrontation therapy has proven successful for anxiety disorders. Patients confront fear-inducing situations and learn that they are less difficult to bear than they feared. Patients face this confrontation together with the therapist and later alone until the feared situation no longer triggers any or hardly any anxiety.
Preventing relapses
Relapse prevention involves preparing the patient well for the time after therapy. The therapist discusses the fears associated with the end of therapy with the patient. The patient is also given specific instructions on how to deal with any problems that arise again. At the end of behavioral therapy, the patient has a range of strategies and methods in their repertoire that they can use in the future to cope with difficult situations.
Duration of behavioral therapy
The duration of behavioral therapy depends, among other things, on the type and severity of the mental disorder. Specific phobias (e.g. arachnophobia) can sometimes be overcome within a few sessions. The treatment of severe depression, on the other hand, can take several years. As a rule, however, behavioral therapy involves 25 to 50 sessions.
What are the risks of behavioral therapy?
Sometimes patients feel overwhelmed by the exercises. Even if certain challenges are part of the therapy concept – behavioral therapy must not become an additional burden!
In the past, behavioral therapy focused exclusively on the symptoms and not on possible triggers – which was often criticized. Nowadays, behavioral therapists pay attention not only to current problems but also to possible causes in the patient’s history.
The fear that problems would only be treated superficially as part of behavioral therapy and that the symptoms would shift to other areas has not been scientifically confirmed.
What do I need to consider after behavioral therapy?
Many people with mental health problems are reluctant to start therapy. They are afraid of being stigmatized as “crazy” or believe that no one can help them. However, once they have found the right therapist, many find it just as difficult to manage without him or her once therapy is complete. There is a great fear that the problems could return.
Preventing relapses
Relapse prevention is an important part of behavioral therapy. The therapist discusses with the patient how they can avoid relapses and what strategies they can use in the event of a relapse.
It is considered an unfavorable outcome of therapy if the patient feels lost without the therapist. In behavioral therapy, great importance is therefore attached to the patient’s independence. Ultimately, the patient must be able to cope with life on their own in the long term.
The skills that the patient has learned in behavioral therapy should also be practiced after therapy. This means, for example, continuing to face up to their fears and questioning negative thoughts.
As the body and mind are connected, sport, a healthy diet, sufficient sleep and as little stress as possible are the basis for a permanently healthy mind.
