The main theraputic approaches part 3 - Behavioural Therapy

The focus of behavioural therapy is isolating and changing unwanted behaviour in the here and now.  They are not interested in the past or what has gone before, just what is happening now.  It is believed that as behaviour is something learnt, it can be unlearnt and then relearnt in a different way. 

Behavioural therapies take a very logical approach to treatment using more of the thinking part of the brain rather than the feeling part.  Treatment often involves practical exercises and the setting of homework for the client.  Below are some of the main areas which a behavioural therapist may concentrate on during treatment:

  • Changing words and phrases from negative to positive, e.g. rather than saying “I hope I won’t be late” (which has the negatives of won’t and late), saying instead, “I hope I arrive on time”.  Both mean exactly the same thing, but one is a more positive way of saying it.  Talking positively forces you to begin to think positively and thinking positively helps you to feel positive.

  • Challenging assumptions, e.g. a male client is struggling to find a girlfriend and makes the statement “women only go for guys with huge muscles”.  The therapist would encourage the client to take a poll, survey or questionnaire in a public place to test their assumption so they could get a rational and balanced view point rather than their current skewed assumption.

  • Challenging negative feelings.  When talking about positive and negative feelings, we do not mean happy and sad feelings, but productive and unproductive feelings.  E.g. a feeling of guilt is a negative, unhelpful feeling as it encourages a person to withdraw, wallow in self-pity and sink lower.  However a feeling of remorse is a positive feeling.  Remorse encourages a person to recognise loss and mistakes and yet take responsibility for their part in those things.  Taking responsibility then allows the person to move forward and improve their lives.

  • Challenging internal thoughts and beliefs.  Encouraging a different thought or belief to a particular situation to produce a different response.  E.g. if someone fears a snake, it is not the actual snake which produces that fear, but their own thoughts and beliefs about that snake.  If you can encourage the client to recognise and change those thoughts and beliefs, then the outcome can be different.  E.g. rather than believing the snake will bite them, believing that the snake is harmless, may produce a feeling of excitement rather than fear. 

The most common behavioural therapy is Cognitive Behavioural Therapy (CBT) which is often used in organisations such as the NHS.  Behavioural therapies tend to be a much quicker form of treatment, sometimes lasting only 6 weeks, which has made it very popular for people and organisations who have time and money restrictions. 

Although very popular, many other branches of psychotherapy and counselling are critical of a pure behavioural approach as it fails to take into account or resolve the original cause of the issue.  E.g. for a male client who struggles to find a girlfriend, behavioural therapies may help him with techniques to improve his confidence to ask a girl out, however they won’t deal with the underlying reasons as to why he lacked the confidence in the first place.  If the client had suffered emotional or psychological trauma in their past which caused the confidence issue, this problem could resurface in the future in a different, possibly more destructive way. 

A pure behavioural approach can often be compared to a sticky plaster.  It can cover up and hide a wound, but that wound is still there and still needs healing. 

I believe that CBT techniques are valuable, but more appropriate to be brought in during the latter stages of treatment with another approach, after the underlying issue has been explored, brought into awareness and worked through.