Behavioural Therapy: Techniques, limitations & its role in eclectic therapy

Behavioural psychology, or behaviourism, arose early in the 20th century. John B. Watson is regarded as the father of behavioural psychology.

Behaviourism works on the following principles –

  • Maladaptive behaviours are not merely symptoms of underlying problems but are problems
  • Problem behaviours are learned in the same way as normal behaviours, and 
  • Maladaptive behaviours can be unlearned by applying principles derived from research on classical conditioning, operant conditioning and behavioural modelling. 

The behavioural approach to therapy focuses on changing the behaviour of clients to reduce dysfunction and to improve the quality of life. It works on a methodology, or behaviour analysis, for strategic change, such as modifying antecedents or consequences or giving instructions. Systematic desensitisation, relaxation training, and aversion therapy form the basis of behaviour therapy. 

Let us look at each of these techniques before we go ahead.

Behavioural Therapy Techniques

  1. Systematic desensitisation

    Systematic desensitisation is a learning-based treatment for anxiety disorders. The goal here is to reduce or eliminate anxiety, using counter conditioning. Since anxiety is often associated with an event, the therapy focuses on changing the association with the event, which eventually leads to a change in the response. The client is initially exposed to a less intense trigger or stimulus. The intensity of the stimulus is gradually increased. This is usually achieved through imagination and not the real, feared stimuli. 

    After systematic desensitization, comes the final step desensitization. Here, the focus is to proceed from the least sensitive to the most anxiety-provoking scene while in a deeply relaxed state. When patients can vividly imagine the most anxiety-provoking scene of the hierarchy with equanimity, they in a way experience little anxiety in the corresponding event in real life.

  2. Relaxation training

    It mostly helps to control physiological responses in stressful situations. Although there are a variety of relaxation methods available, most of the methods use progressive muscle relaxation. This provides a means of voluntarily reducing or preventing a high level of arousal. Using this method, clients relax major muscle groups in a fixed order, beginning with the small muscle groups of the feet, and working towards shoulders, neck, face, head etc. 

  3. Aversion Therapy

    Aversion therapy helps to change unwanted behaviours. The process involves conditioning a painful or uncomfortable response with the current, unwanted behaviour in order to prevent the person from continuing it. It is carried out by repetitive pairing of undesirable behaviour with discomfort. For example, a person undergoing traditional aversion therapy to stop smoking might be given a mild electrical shock every time they look at the image of a cigarette.

By now we have already discussed the core techniques in behavioural therapy, it is time for us to quickly talk about the limitation of these techniques.

Limitations of the Behavioural Approach

  1. Behaviour therapy doesn’t take into account the client’s emotions. Since emotions play a significant part in behavioural responses, the behavioural approach alone may not help the client change or the client may relapse. 
  2. Behaviour therapy ignores the significance of self or self-consciousness and does not consider the resourcefulness and imagination of the individual. 
  3. Behaviour therapy tends to focus on treating symptoms (behaviour) rather than causes (thoughts, emotions, beliefs, positive intentions etc.)
  4. Aversive therapy can be a painful process, especially as discussed in the example above.
  5. Systematic desensitization can take a long time to take effect.

While the behavioural approach seems to be effective in creating change in some cases, given the limitations we have discussed, it needs to be used in conjunction with other approaches to therapy for best results.

Overcoming the limitations with Cognitive Hypnotic Psychotherapy

When working with clients, therapists generally realize that most problems are multi-layered. To effectively work with the client, one needs to be able to work with each of these layers.

While Behavioural approach and its techniques can be effective to work with a client’s observable behaviours and for emotional reconditioning, it is important to use other techniques to work with other layers of the problem. This is why we recommend that therapists must learn to use behavioural therapy as a part of an overall eclectic approach to therapy. This is where Cognitive Hypnotic Psychotherapy comes into play.

Cognitive Hypnotic Psychotherapy (CHP) is an eclectic approach that seamlessly integrates all major approaches in Psychology (Cognitive, Behavioural, Humanistic and Psychodynamic), along with Hypnotherapy, NLP, Mindfulness and Metaphors. It is a comprehensive model of change that includes the principles of behavioural therapy with several other therapeutic modalities, in order to help the client create the desired change naturally, effortlessly and rapidly. 

For example, the Cognitive Hypnotic Psychotherapist may induce the client in a highly relaxed and calm, deep hypnotic state, where the client can visualize themselves in a safe, comfortable space. In addition, another level of dissociation from the stimulus can be created. In such a state, the client can be safely desensitized to the stimulus associated with the unpleasant response (fear, phobia etc.). Similarly, in the hypnotic state, aversion to the current undesirable behaviour can be created easily and swiftly with imagined stimuli. This proves highly effective in changing compulsive behaviours, both conscious and unconscious. 

And it doesn’t end there.

Subsequently, a new, desirable response can be installed using, anchoring and future pacing. The underlying thoughts and behaviours can be identified and restructured using when-then statements, belief change process and hypnotic suggestions. In case there are repressed memories or suppressed emotions that are contributing to the client’s current issues, they can be worked upon using free association, regression and inner child work.

Since all this has been carried out in a hypnotic state, there is a lasting effect due to unconscious reprogramming

If you are a mental health professional and would like to develop advanced therapeutic skills based on Cognitive Hypnotic Psychotherapy and learn how the Behavioural and other psychological approaches have been seamlessly integrated into it, check it out HERE.

September 21, 2021

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