Techniques for changing inappropriate behaviour by substituting new behaviour
The aim of behaviour therapy is to alter abnormal or maladjusted behaviour associated with certain psychological conditions. The therapist works to modify a person’s current behaviour but does not explore the underlying reasons, as would occur in psychoanalytic-based therapy.
Treatment is based on two ideas: desirable behaviour can be encouraged by using a system of rewards, and exposure to a feared experience or object under conditions where you feel safe will make it less threatening. Behaviour therapy is often used in combination with cognitive–behavioural therapy, which explores and can change the thought processes and actions that lead to abnormal behaviour.
When is it used?
Behaviour therapy is useful in the treatment of a person with a phobia, which is an irrational fear that occurs in response to a particular object, creature, or circumstance. For example, a person may have an overwhelming fear of insects or air travel. Some people have a complex phobia, such as agoraphobia, which typically involves multiple fears about being trapped in crowds or being alone in open spaces.
People who have habitual behaviour, such as frequent, repeated handwashing (see Obsessive–compulsive disorder), or who lack assertiveness can also benefit from this therapy.
Behaviour therapy can also be used to treat certain eating disorders, such as anorexia nervosa and bulimia, and it may help people with an anxiety-related problem such as panic attacks (see Anxiety disorders).
What does it involve?
Behaviour therapy begins with the therapist making a detailed analysis of your behaviour by interviewing you at length. You may be asked to rate the severity of your symptoms on a scale of 1 (mild) to 10 (extremely severe). Improvement may also be measured in this way. The therapist will discuss with you the best approach to overcoming your problem. The techniques that might be used include desensitization, and flooding, assertiveness training, and response prevention. Since changing ingrained behaviour often causes anxiety, you will probably be taught to use techniques such as controlled breathing and muscle relaxation to help you cope.
Desensitization and flooding
Both desensitization and flooding are used to treat phobias. Desensitization involves gradually increasing exposure to the object or circumstance of the phobia (see Desensitization therapy) and uses relaxation techniques to help you deal with the anxiety. For example, if you have agoraphobia, in early sessions you might walk just outside your house with the therapist. As sessions continue, you may try walking from the house to the end of the street with your therapist until, over time, you can travel alone without anxiety.
Flooding forces you to confront the focus of your fear directly for prolonged periods. You will be supported throughout by your therapist. After you have confronted the object or circumstance of your phobia, either gradually or in one step, the distress associated with it is reduced and may eventually disappear completely.
This therapy uses role-play to demonstrate the appropriate responses to different situations, for example someone acting aggressively towards you. Your therapist shows you an appropriate response and, by copying it, you become more confident in your ability to deal with real situations.
This technique is used in the treatment of compulsive rituals, such as repeated handwashing. You are encouraged to resist the urge to carry out the action, even though resistance results in intense anxiety. The therapist gives you support and suggests relaxation techniques. If you continue to successfully resist the compulsion, eventually the anxiety will lessen.
What can I expect?
You may find that improvement is slow at first and that it is difficult to avoid returning to your unwanted behaviour when your therapist is not there to support you. Group therapy may be recommended to provide extra support when individual therapy ends.
Improvements in your behaviour can be maintained after your therapy has finished by carrying on with the techniques that you have learned.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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