Just as there are numerous ways in which to treat physical ailments, there are also endless modalities to treat mental health. Behavior therapy focuses on the behavior or actions of the client; though thoughts, feelings, and emotions are also discussed. Behavior therapy is based on the idea that all behavior is learned and therefore, can be unlearned if it is considered maladaptive. The goal of behavior therapy is to replace negative behaviors with healthier behaviors.
Sigmund Freud, who is often referred to as the “father of psychology,” is best known for his developments in psychoanalysis. The primary goal of psychoanalysis, also referred to as “talk therapy,” involves bringing the unconscious thoughts and motivations to the conscious, and in doing so, problematic behavior, thoughts, and emotions are changed.
Both behavior therapy and psychoanalysis remain well-researched and effective forms of mental health treatment. Behavior therapy utilizes some aspects of psychoanalysis and vice versa. Depending on the client, their goals, and the therapist’s skill set, one form of therapy may be recommended over the other.
In this article, we will discuss behavior therapy, how it differentiates from psychoanalysis, the different types of behavior therapy, the advantages and disadvantages, and how you can find support for treatment.
There are many different forms of behavior therapy. In this article, we will refer to behavior therapy as an “umbrella” term representative of many iterations. Below are a few representations of the different forms of behavior therapy.
- Cognitive Behavioral Therapy (CBT)
- Mindfulness-Based Cognitive Therapy
- Acceptance & Commitment Therapy
- Exposure Therapy
- Applied Behavior Analysis
- Rational Emotive Behavior Therapy
- Attachment Based Behavioral Therapy
- Dialectical Behavior Therapy
According to some research studies, behavior therapy tends to resolve a client’s presenting issues faster than psychoanalysis. (Riopel, 2019) It is estimated that successful behavior therapy can resolve maladaptive thoughts, feelings, and behaviors in 5-20 sessions.
It is not uncommon for psychoanalysis to go on for several months or even years. Of course, there are a lot of variables to consider with this, such as the issue itself, client compliance, treatment goals, the efficacy of the therapist, and more.
Since behavior therapy typically requires fewer sessions for treatment, it can be considered more cost-effective than psychoanalysis.
Behavior therapy tends to be more focused on the client’s present life and circumstances, whereas psychoanalysis does a deep dive into childhood and other developmental stages.
Utilizing behavior modification techniques produces immediate feedback and therefore clients who struggle with long-term memory or delayed gratification benefit from the instantaneous feedback loop of behavior therapy. Psychoanalysis doesn’t often produce immediate feedback.
In token economies such as residential or correctional facilities, rewards are given for good behavior, and restrictions (or punishments) are given for poor behavior. Giving rewards and restrictions based on behavior reinforces or extinguishes behavior, and serves to provide immediate feedback regarding behavioral expectations. Psychoanalysis alone may not produce as quick of a change in behavior nor elicit direct feedback for those behaviors.
In one study of over 250 men, researchers found “psychoanalytic as well as cognitive-behavioral long-term treatments lead to significant and sustained improvements of depressive symptoms of chronically depressed patients.” (Marianne Bohleber, 2018) Participants were randomly selected to attend either CBT or psychoanalysis and the results found that either modality served the clients positively and resolved their depression.
Behavior therapy utilizes some aspects of psychoanalysis, such as examining the past to help determine when and why the maladaptive behavior originated. Psychoanalysis incorporates elements of behavior therapy as well, such as examining the client’s behavior over the developmental timeline to help pinpoint cause and effect.
Both modalities require the commitment of the client, their willingness to self-examine, and the belief that change is possible. Behavior therapy and psychoanalysis both require a skillful therapist to understand the methods they are using, understand the uniqueness of their client, and they need to be able to document progress to set achievable goals.
The Tenants of Behavior Therapy
Behavior therapy believes that a client’s distress can be markedly improved by eliminating negative behavior and replacing it with positive behavior. Behaviorists believe that all behavior is learned and therefore clients can learn new and more positive behaviors to improve their lives. There are many forms of behavior therapy, below we will look at two and learn about a few of the techniques used in each.
Cognitive Behavioral Therapy (CBT)
CBT is probably the most utilized and well-known form of behavior therapy. CBT is used to treat several different disorders such as anxiety, depression, substance abuse, and more. CBT helps clients to better understand their thoughts, feeling, and behaviors.
Here is an example of how CBT might be used. A client comes into the session and states, “I’m afraid I’m going to get fired, I don’t think my boss likes me.” The therapist might then ask, “What are your thoughts about this? Tell me what feelings come up for you. Do these thoughts seem realistic? What does your behavior around this issue look like?”
Together they will examine the whole picture holistically and evaluate the reality of these thoughts, and see if they can substitute more realistic and adaptive thoughts. Likewise, they will discuss the behavior leading to these thoughts and feelings, and asses if more positive behavior needs to be instilled for a better outcome.
Applied Behavior Analysis (ABA)
ABA takes a research-based and methodical approach to treating clients. ABA is often the chosen form of intervention for clients with limited learning capacity.
Therapists document the current behavior of the client in different environments. They record the number of incidents of positive and negative behaviors, and then develop a treatment plan aimed at curbing negative behavior and instilling positive behavior. Therapists often use a token system of reward, restriction, and extinction (planned ignoring).
For example, a young boy with Autism may need help with potty training. The clinician would observe the client at school and at home to document the number of successes and the number of accidents. After noticing patterns of behaviors that contribute to success, and the behaviors that contribute to accidents, the therapist would put together a treatment plan.
This plan might have the child try and use the bathroom every hour to increase the opportunity for success. Each success would include a reward, such as a sticker. When there is an accident, the behavior would most likely be ignored (extinction) and the process would carry on until the desired behavior is achieved. A maintenance program would then be developed by the therapist to help the client maintain results.
Advantages of Behavior Therapy
- Typically requires fewer session
- Due to fewer sessions, it is considered more cost-effective
- There is an immediate feedback loop of actionable behavior, followed by the result of that behavior
- Behavior therapy is a well-researched modality with data signifying its effectiveness
- Works well for clients with learning difficulties
Disadvantages of Behavior Therapy
- Used in token economies such as correctional facilities, the positive changes from the reward and punishment system often do not translate to the free world, which is why there is a high recidivism rate.
- Behavior therapy can feel like “diving into the deep end” for some clients due to the nature of initiating a new behavior and eliciting an immediate result of that behavior
- One criticism is that behavior therapy treats symptoms rather than causes by not attuning to the past or focusing on the emotions behind the behavior
Is cognitive therapy and CBT the same thing? No, and they are often confused with one another. However, there are a lot of similarities. Cognitive therapy operates on the premise that most problems are caused by errors in reasoning. CBT shares a similar view but also emphasizes behavior as well.
How do I know if behavior therapy is right for me? There are many effective treatments for mental health struggles. Finding the right treatment requires consulting with a couple of different therapists and some self-evaluation. Ultimately behavior therapy will serve most clients well and resolve challenges relatively quickly.
What therapy can I use to examine my subconscious? Psychoanalysis places a lot of emphasis on examining subconscious thoughts and bringing those thoughts to the conscious. Jungian therapy also addresses the subconscious.
Can I combine behavior therapy and psychoanalysis? Many therapists are well-versed in a multitude of techniques and theories. These therapists typically do a thorough intake process with their clients, and collaboratively discuss the issues, goals, and forms of treatment the client is willing to partake in. These therapists believe each client is unique and will benefit from different techniques rather than a “one-size-fits-all” approach. Therefore, yes, some therapists may initially use psychoanalysis with their clients and then move on to behavior therapy.
There are many therapists who are licensed, well-trained, and believe in the effectiveness of the modalities they use with their clients.
Online therapy may be a good match for you if you are struggling to find a therapist in your area, are looking for affordable counseling, and need a qualified therapist.
Using a licensed and skilled therapist is of the utmost importance when embarking on your mental health journey. Make sure you interview your therapist about their experience and skill level. It may take time to feel comfortable with your therapist but if after a few sessions something doesn’t feel right for you, don’t hesitate to keep looking.
Successful treatment depends on many factors but it is achievable. Congratulations on beginning your journey to a more fulfilled life. Take comfort in knowing help is available and positive treatment outcomes are likely.