Behavior therapy refers to a variety of methods of psychotherapy. The goal is to change attitudes, thinking habits, and maladaptive or dysfunctional behaviors such as anxiety, obsessive thoughts or actions, eating and sexual disorders, depression, and also relationship problems. Behavior therapy has its foundation in empirical research findings in learning science, psychophysiology, social psychology, and clinical psychology.
Indications (areas of application)
- Generalized anxiety disorders
- Eating disorders – e.g., anorexia nervosa (anorexia) or bulimia nervosa (bulimia)
- Phobias – anxiety disorders that are triggered by certain objects or situations and are usually unfounded.
- Panic disorders – Mental disorder with unexpected, recurrent, severe panic attacks that are not limited to one situation or specific circumstances. Often followed by fear of another attack.
- Personality disorders – A persistent pattern of behavior that deviates markedly from the expectations of the sociocultural environment.
- Post-traumatic stress disorder – A psychological trauma following a highly stressful experience characterized by deep despair.
- Schizophrenic psychoses – Multifaceted disorder of personality, thinking, perception, and control of reality without impairment of clarity of consciousness. There is no brain organic disease or influence of mind-altering drugs.
- Sexual disorders
- Pain disorders
- Stress management
- Obsessive-compulsive disorder – mental disorder characterized by recurrent compulsive impulses- or actions.
The procedure
Before therapy begins, the patient has already gone through several stages that have led him to seek therapy. These include problem perception, problem assessment, attempts to solve the problem and the decision to seek help. Behavioral therapy is always preceded by a behavioral analysis. The behavior and the resulting problems are examined in context to the maintaining conditions and with regard to the consequences. For this purpose, so-called behavioral models are used, such as Kanfer’s (1976) behavioral analysis, the S-O-R-C-K model:
- S – Stimuli; stimuli or situations that trigger the behavior.
- O – organism variables; prior impairments, innate dispositions, or peculiarities that influence behavior on the stimuli.
- R – Responses; exhibited behavior is studied (learned, cognitive or interpretive behavioral pattern).
- C – Contingency (Contingency); regular relationships between reaction and consequence.
- K – Consequences; measurable repercussions on the behavior.
Behavior therapy is a very broad field and is based on the individuality of the patient and therapist.The following characteristics are hallmarks of this form of therapy:
- Explicit definition of goals – by patient and therapist.
- Action orientation – active cooperation by the patient
- Transferability – the acquired skills must be transferable from the therapy situation to everyday reality
- Condition orientation – the therapy is oriented to the conditions that maintain the problem.
- Transparency – the explanation of the therapy and the changes must be understandable, comprehensible and acceptable to the patient
- Partnership – therapist and patient as partners in the working relationship.
- Help for self-help – self-management of the problem.
- Minimal intervention – Minimal assistance to achieve self-control and problem-solving ability of the patient.
- Positive hedonism – Maximizing personal agency without harming others.
- Timeliness – behavioral therapy is guided by current research in social and developmental psychology, general psychology, clinical psychology, medical psychology, biology, medicine, psychiatry, and psychosomatics
In the final phase of therapy, the patient is taught skills that enable him to ensure and stabilize the success of therapy after the end of therapy or in case of relapse. For this purpose, so-called catamnestic follow-up surveys are scheduled at intervals that make sense in terms of time after the end of therapy.The arsenal of methods is as diverse as the various disorders that can be treated by behavior therapy. The following list describes the most common and important therapy techniques:
- Systematic desensitization in sensu – therapy of phobias and fears; the patient goes through a hierarchy of weakly to strongly fear-triggering situations in his imagination in combination with relaxation techniques.
- Systematic desensitization in vivo – therapy of phobias and fears; the patient gradually experiences his fears directly in reality
- Stimulus flooding/implosion therapy – confrontation of the patient with his fears; after thorough preparation by the therapist, the patient is directly exposed to his fears, only to find afterwards that no catastrophe has occurred
- Operant reinforcement programs – The positive, desired behaviord of the patient is rewarded.
- Model learning programs – Observation and imitation of the model for behavioral deficits, social anxiety, and maladaptive behaviors, e.g., group self-confidence training.
- Cognitive behavior modification – persuasion and distraction from negative attitudes and inappropriate assumptions through reality-based thinking strategies and positive self-instruction (see below “Cognitive behavior therapy”)
- Biofeedback – Biological feedback; consciously bring under control of unconscious body reactions such as muscle tension, blood pressure or sweating.
- Relaxation techniques – exercises for mental and physical relaxation such as meditation, medical hypnosis (synonym: hypnotherapy), autogenic training (AT) or progressive muscle relaxation (PMR).
Behavioral therapy is one of the most effective tools for the treatment of behavioral disorders. The forms of therapy are very diverse and should be performed by an experienced therapist.
