Behavioral Treatments at a Glance
An overview of behavioral treatments, how they work, and how they can help
If your child has an emotional or behavioral problem, you might be told that behavioral therapy would be a good treatment for her. 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 kids 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 insure that the techniques are use 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.
Applied behavior analysis:
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? Children and adolescents who are struggling with depression.
What is it? Behavioral activation 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 behavioral activation 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 your child increased access to positive reinforcement. The goal is also for your child to learn to see the link between his activities and mood, understand avoidance patterns, and learn to choose more adaptive patterns.
Cognitive behavior therapy:
Who is it for? Cognitive behavioral therapy (CBT) is used to treat 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 your child identify how her thoughts influence her behaviors, or change her behaviors, which in turn can help her change the way she manages unwanted feelings and thoughts.
Dialectical behavior therapy:
Who is it for? Dialectical behavior therapy (DBT) is used to treat 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? Dialectical behavior therapy, (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.
Exposure and Response Prevention:
Who is it for? Children with OCD, social anxiety, specific phobias, panic disorder, and generalized anxiety disorder.
What is it? Exposure and response prevention involves exposing your child to the things that trigger his 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 your child slowly gets used to dealing with things that trigger his anxiety. As the therapy progresses, he’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.
Habit Reversal Therapy:
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 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 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? Interpersonal psychotherapy is a form of short-term therapy that focuses on helping your child explore how her relationships with peers and family positively (and negatively) affect her mood and behavior.
How does it work? Interpersonal therapy helps your child identify things that might be adversely affecting her mood—including conflicts, transitions, grief, and negative patterns in relationships—and make improvements that can positively impact her feelings and behavior.
Who is it for? Motivational interviewing 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 focuses on exploring and resolving ambivalence to treatment in order to increase motivation to change problematic behavior.
How does it work? In a motivational 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 his behavior.
Parent-child interaction therapy:
Who is it for? Parents and children who are struggling to interact in a positive, productive way.
What is it? Parent-child interaction therapy is a therapeutic technique that restructures the interaction between you and and your child to reduce conflict, improve the attachment relationship, and reduce disruptive behaviors.
How does it work? A therapist will help teach you to give effective positive reinforcement for desired behaviors and consistent consequences for undesirable behaviors. Once you’ve learned these new skills, you’ll receive live coaching (via a bug in the ear) from a therapist who watches from behind a one-way mirror as you and your child interact. The goal of parent-child interaction therapy 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? 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 him learn to stay calm. Eventually, your child will become desensitized to the situation or thing that was causing his anxiety and learn to manage it in a healthier way.
Trauma-focused cognitive behavior therapy:
Who is it for? Children and adolescents who have experienced trauma.
What is it? 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 trauma-focused cognitive therapist will teach your child skills that will help him manage distressing thoughts and feelings, rather than avoiding them, and allow him to recover his sense of well-being.