Behavioral Treatments at a Glance

If your child has an emotional or behavioral problem, you might be told that behavioral therapy would be a good treatment for them. But what kind of behavioral therapy? It can be challenging to sort out the different therapies and what they are for.

There are a lot of different kinds of behavioral therapy because each is customized to work effectively with a specific disorder or set of disorders. They have been tested on children with that specific disorder, and they have been manualized — that is, spelled out step-by-step to ensure that the techniques are used in the manner and sequence that have been shown to be most effective. There are also clear measures of a child’s progress, and an estimated duration for the treatment.

Here’s a look at some of the most common behavioral treatments that are effective for kids.

Who is it for? Children with autism spectrum disorders.

What is it? ABA is an intensive intervention designed to help children with autism develop behaviors they don’t pick up the way neurotypical children do, including social, verbal, and motor skills, and decrease behaviors that are problematic or self-injurious.

How does it work? ABA uses close observation of your child’s behavior and positive prompts or reinforcement to increase desired behaviors. Problematic behaviors are addressed by studying what occurs before and after the behavior and altering those triggers or reinforcements rather than focusing on the behavior itself.

Who is it for? Acceptance and Commitment Therapy (ACT) is for teenagers with anxiety or depression. It’s often recommended for older teens who have tried CBT but are still struggling.

What is it? As its name implies, ACT involves two things. First, “acceptance” of negative thoughts and feelings — accepting that they don’t need to be avoided or changed, but they also don’t need to stop you from doing what you need to do to meet your goals. The second is “commitment” to take concrete steps or changes to move towards those goals.

How does it work? ACT is different from CBT, in which teens learn to challenge negative thoughts and feelings. With ACT, teens acknowledge painful emotions without allowing themselves to get caught up in them. That allows them to keep the focus on their values — what matters to them — and take positive steps to move closer to their goals.

Who is it for? Children and adolescents who are struggling with depression.

What is it? Behavioral Activation (BA) is a form of behavior therapy that targets the avoidance and withdrawal that cause depressed kids to stop participating in rewarding activities.

How does it work? In BA therapy, kids who are depressed are asked to participate in activities they may have lost interest in. The therapy uses activities to jumpstart momentum towards reengagement by offering the child increased access to positive reinforcement. The goal is also for the child to learn to see the link between their activities and mood, understand avoidance patterns, and learn to choose more adaptive patterns.

Who is it for? Cognitive Behavioral Therapy (CBT) is used to treat children and teenagers with a wide range of disorders and difficulties.

What is it? CBT is based on the premise that thoughts (cognitions), feelings, and behaviors all influence one another. CBT is an umbrella term for many specific kinds of therapy tailored to specific psychiatric disorders.

How does it work? A therapist can use CBT to help a child identify how their thoughts influence their behaviors, or change their behaviors, which in turn can help them change the way they manage unwanted feelings and thoughts.

Who is it for? Dialectical Behavior Therapy (DBT) is used to treat children and teenagers with a wide range of psychiatric issues. DBT was originally developed for people with borderline personality disorder, but has been used successfully to treat eating disorders, suicidal and self-injurious behavior, depression, and substance abuse.

What is it? DBT focuses on accepting rather than challenging difficult thoughts, while at the same time initiating change.

How does it work? DBT helps individuals focus on accepting — rather than becoming overwhelmed by — difficult thoughts by using what’s called “mindful awareness” while taking steps to improve interpersonal interactions and avoid problematic behavior. It’s called dialectical because it involves balancing both acceptance and change.

 Who is it for? Children with OCD, social anxiety, specific phobias, panic disorder, and generalized anxiety disorder.

What is it? Exposure and Response Prevention (ERP) involves exposing a child to the things that trigger their anxiety in a safe and controlled setting. By introducing the trigger in tiny increments, the therapist helps the child learn to tolerate the anxiety without performing the compulsive ritual, or avoidance behavior.

How does it work? The OCD or anxiety symptoms diminish as the child slowly gets used to dealing with things that trigger their anxiety. As the therapy progresses, they’ll become able to deal with more and more anxiety-provoking stimuli without needing to resort to compulsions or other problem behaviors to escape the stimulus.

Who is it for? Children who have tics, Tourette’s, and other repetitive behaviors, including trichotillomania and skin-picking.

What is it? Habit Reversal Therapy (HRT) is a form of therapy for tics that teaches the child to be aware of what’s called a “premonitory urge,” a fleeting sensation that occurs before the tic.

How does it work? By learning to recognize premonitory urges your child can initiate a what’s called a competing response — a less disruptive or problematic reaction that’s incompatible with the tic.

Who is it for? Interpersonal Psychotherapy (IPT) is often used to treat children and adolescents with depression, but can be helpful with a wide range of psychological issues and disorders.

What is it? IPT is a form of short-term therapy that focuses on helping a child explore how their relationships with peers and family positively (and negatively) affect their mood and behavior.

How does it work? IPT helps the child identify things that might be adversely affecting their mood — including conflicts, transitions, grief, and negative patterns in relationships — and make improvements that can positively impact their feelings and behavior.

Who is it for? Motivational Interviewing (MI) is often used with adolescent substance abusers who have been directed to treatment by parents or authorities and are unlikely to succeed in it unless they perceive a benefit for themselves.

What is it? Motivational Interviewing is focused on exploring and resolving ambivalence to treatment in order to increase motivation to change problematic behavior.

How does it work? In an MI interview, the therapist is collaborative rather than confrontational. The emphasis is on understanding the child’s point of view, eliciting the child’s ideas about change, and emphasizing the child’s responsibility for their behavior.

Who is it for? Parents and children who are struggling to interact in a positive, productive way.

What is it? Parent-Child Interaction Therapy (PCIT) is a therapeutic technique that restructures the interaction between parent and child to reduce conflict, improve the attachment relationship, and reduce disruptive behaviors.

How does it work? In PCIT a therapist helps teach parents to give effective positive reinforcement for desired behaviors and consistent consequences for undesirable behaviors. Once they’ve learned these skills, they receive live coaching (via a bug in the ear) from a therapist who watches from behind a one-way mirror as the parent and child interact. The goal of PCIT is to help kids and parents enjoy a more positive relationship by teaching parents to exercise their authority calmly and consistently, and helping children learn to manage their own behavior more effectively.

Who is it for? SPACE — Supportive Parenting for Anxious Childhood Emotions — is a treatment for all kinds of anxiety, as well as OCD, in children. It is especially helpful for younger kids, whose parents tend to do more accommodating, or protecting kids from the things that make them anxious.

What is it? SPACE is a form of treatment in which the therapist works with parents only, to change the way they respond to anxious behaviors in children. That in turn gradually helps reduce the child’s anxiety.

How does it work? In SPACE, parents are taught to reduce accommodations, or things they do to protect their kids from anxiety, such as staying with them until they fall asleep, or avoiding places and things that they are afraid of. Those accommodations, while well-meaning, actually make childhood anxiety worse. As the parent reduces accommodations, kids learn that they can tolerate anxiety, and their anxiety gradually fades.

Who is it for? Kids who are extremely anxious or fearful, struggling with panic or anxiety disorders.

What is it? A therapeutic intervention that helps patients decrease fear and anxiety by gradually exposing them to the things that trigger those anxieties in a safe environment, while simultaneously substituting a relaxing response.

How does it work? A therapist will help your child work through a hierarchy of fear-inducing situations using relaxation techniques at each step to help them learn to stay calm. Eventually, your child will become desensitized to the situation or thing that was causing their anxiety and learn to manage it in a healthier way.

Who is it for? Children and adolescents who have experienced trauma.

What is it? Trauma-Focused CBT (TF-CBT) is a kind of cognitive behavioral therapy specifically geared to helping children and parents learn to process a disturbing experience in a healthy way.

How does it work? A TF-CBT therapist teaches the child skills that will help them manage distressing thoughts and feelings, rather than avoiding them, and allow them to recover their sense of well-being.