Basic concepts of behavioral therapy, also called "behavior therapy," were first used in the 1920s. In the 1950s and 60s, more systematic and comprehensive forms of behavioral therapy emerged with Joseph Wolpe in South Africa, Hans Jurgen Eysenck in Great Britain, and BF Skinner in the United States. Behavioral therapy generally is of shorter duration and less expensive to administer than most other therapies, tries to change behavior without worrying about a person's inner conflicts; it strives to unlearn problem behaviors and teach new, more adaptive behaviors. This therapy is usually used as a treatment for phobias, separation anxiety, obsessive-compulsive disorder, alcohol dependence, eating disorders (e.g., anorexia nervosa or bulimia nervosa), hyperventilation, attention deficit-hyperactivity disorder, and conduct problems.
Goals of Behavior Therapy:
When using behavioral therapy, the therapist, child, and child's family must answer the following questions:
What are the problems and goals for the therapy?
How will progress be measured or monitored?
What outside influences are enabling the problem to continue?
Which interventions will be most effective?
Behavior Therapy Training Courses
Because many current practitioners - social workers, psychologists, psychiatrists, and counselors were not trained during graduate school in behavioral therapy procedures, and have not acquired these clinical skills, the REACH Institute offers many psychotherapy training courses (including behavior therapy training courses) for established therapists in practice. The REACH Institute accepts registrations from any licensed practitioner wishing either to become a psychotherapist (such as pediatricians, family practice doctors, and nurses), or who want to increase their psychotherapy and behavior therapy skills. All of our psychotherapy and behavior therapy training courses provider coaching to qualified healthcare practitioners, with or without previous psychotherapy experience. Training is available that is accredited for continuing education. Clinical training in behavior therapy consists of an initial 3-5 day period of training, where students learn about the current theoretic approaches underpinning behavior therapy and other psychotherapy approaches. Students learn how to work therapeutically with children and families, using a combination of hands-on practice of skills, engaging lectures that are applicable to your daily work, role-play, experiential exercises, small group practice sessions, video demonstrations, and skills practice exercises. The total training period is up to 12 months, done using distance learning methods and conference calls in small peer learning groups. The ultimate goal is actual change in students' therapy models and daily practices. For further psychotherapy training and to increase your skills as a psychotherapist, go to REACH's Child Psychotherapy Training programs link on this website. See below for the types of behavior therapy techniques offered in our psychotherapy training courses.
Behavior Therapy Techniques
Systematic Desensitization (usually progresses in three steps):
Relaxation Training. Relaxation will inhibit anxiety. Relaxation is usually achieved through training the person in progressive relaxation, hypnosis, or thinking of pleasant or relaxing mental images.
Hierarchy Construction. Determine the conditions that cause the anxiety; then create a list of such scenes in order of increasing anxiety.
Desensitization of Stimulus. Over time and while relaxed, the person is exposed to the anxiety invoking scenes they listed while in deeply relaxed state until "exposure" (visualization) no longer causes undue anxiety.
This intervention is similar to the systematic desensitization described above, but uses exposure of the person to the real-life feared situations (as opposed to imagery) and no relaxation.
Exposure and Response Prevention:
The child/adolescent deliberately and voluntarily confronts the feared object or idea, either directly or by imagination. At the same time, he or she is strongly encouraged to refrain from doing any symptom-like habits, compulsions or rituals, with support and structure provided by the therapist.
This technique is based on the theory that escaping an anxiety-evoking situation reinforces the anxiety. Therefore, the child is directed to confront their fear directly and remain in the situation until the fear subsides.
The child learns new behavior (new ways to deal with a situation) by watching someone else approach the feared object or situation and by observing how that person interacts or reacts with the anxiety-inducing object/situation.
The child is given a reward when he or she does the desired behavior (e.g., attending to a task, facing a fear), or refrains from showing an undesirable behavior (e.g., aggression, temper outbursts, etc.).
The child is penalized by removing points or some other type of positive item if he or she shows an undesirable behavior. Commonly, the response cost technique may be combined with a positive reinforcement system, so that appropriate behaviors are "rewarded," while negative behaviors are penalized, all using the same system. When the rewards and "punishments" are put into a common system of points (or stickers, stars, smiley faces, etc.), such a system is called a "token economy."
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