What is behavioral therapy?
Behavioral therapy is an umbrella term for types of therapy that treat mental health disorders.
This form of therapy looks to identify and help change potentially self-destructive or unhealthy behaviors. It’s based on the idea that all behaviors are learned and that behaviors can be changed. The focus of treatment is often on current problems and how to change them.
Types of behavioral therapy
There are a number of different types of behavioral therapy.
Cognitive behavioral therapy
Cognitive behavioral therapy is extremely popular. It combines behavioral therapy, which focuses on patterns of action, with cognitive therapy, which focuses on patterns of thought.
Treatment is centered around how your thoughts and beliefs influence your actions and moods. It often focuses on your current problems and how to solve them. The long-term goal is to build thinking and behavioral patterns that help you achieve a better quality of life.
Cognitive behavioral play therapy
Cognitive behavioral play therapy is commonly used as a treatment for mental health conditions in children. By watching a child play, a therapist is able to gain insight into what a child is uncomfortable expressing or unable to express.
Children may be able to choose their own toys and play freely. They might be asked to draw a picture or use toys to create scenes in a sandbox. Therapists may teach parents how to use play to improve communication with their children.
In this form of play therapy, the therapist also takes a more direct approach by working with both the child and the caregivers to teach the child how to cope well and achieve their defined goals. The therapist is doing more than just watching the child play.
Acceptance and commitment therapy (ACT)
ACT is a type of psychotherapy that includes behavioral analysis performed by a mental health clinician. While sometimes compared with CBT, ACT has its own specific approach. ACT is based on relational frame theory, which focuses on mental processes and human language.
In ACT, people are taught mindfulness skills and acceptance strategies with the goal of increasing psychological flexibility. Additionally, commitment and behavior change methods are used.
Dialectical behavioral therapy (DBT)
DBT was created by Dr. Marsha Linehan to help treat the symptoms of borderline personality disorder (BPD), an emotional regulation disorder marked by suicidal behavior, depression, unstable personal relationships, and other symptoms.
DBT can also be helpful for conditions other than BPD.
DBT consists of four elements, known as modules:
- core mindfulness
- interpersonal effectiveness, which is used to improve relationships with others and yourself
- emotional regulation
- distress tolerance
People receiving DBT are taught skills and coping strategies to help them lead healthier, happier lives.
Some techniques used in behavioral therapy
Systematic desensitization
Systematic desensitization is a process that helps you to become less sensitive to certain triggers. It relies heavily on classical conditioning, a type of unconscious and automatic learning that creates behavior. It’s often used in the treatment of phobias.
During treatment, you’re taught to replace your fear responses with relaxation responses, which begins with learning relaxation and breathing techniques.
Once you’ve mastered these techniques, your therapist will have you face your fear or fears at slowly increasing levels while you use these techniques.
Aversion therapy
Aversion therapy is often used to treat disorders like substance use disorder and alcohol use disorder. It works by teaching people to associate a stimulus (something that triggers a response) that’s pleasant but unhealthy with an extremely unpleasant stimulus.
The unpleasant stimulus may be something that causes discomfort. For example, a therapist may teach you to associate alcohol with an unpleasant memory.
Is behavioral therapy effective?
Behavioral therapy has successfully been used to treat a large number of conditions. It’s considered to be extremely effective.
About 75 percent of people who enter cognitive behavioral therapy experience some benefits from this treatment.
A 2012 study found that cognitive behavioral therapy is most effective when treating:
- anxiety disorders
- general stress
- bulimia
- anger-related disorders
- somatoform disorders, like somatic symptom disorder, in which bodily symptoms without an underlying physical cause are experienced
- depression
- substance use disorders
Studies have shown that play therapy is very effective in children ages 3 to 12 years. But this therapy is increasingly being used in people of all ages.
Behavioral therapy for children
Applied behavioral therapy and play therapy are both used for children. Treatment involves teaching children different methods of responding to situations more positively.
A central part of this therapy is rewarding adaptive behaviors that benefit a child’s functioning and discourage maladaptive behaviors, or those that interfere with a child’s best possible functioning.
This therapy often requires multiple people in a child’s environment to be committed to the process, including parents, teachers, and other important figures.
It may take children some time to trust their counselor. This is to be expected.
With time, patience, and focus on building trust, a child may warm up to the point of being able to fully express themselves. This also is heavily dependent on the age of the child.
Autistic children with ADHD often benefit from behavioral therapy.
How to find a behavioral therapist
Finding a therapist can feel overwhelming, but there are many resources that can make it easier.
When finding a therapist or mental health professional, you can choose from:
- social workers
- faith-based counselors
- non-faith-based counselors
- psychologists
- psychiatrists
You should make sure that the therapist you choose has the necessary certifications and degrees. Some therapists will focus on treating certain conditions, like eating disorders or depression.
If you don’t know how to get started with finding a therapist, you can ask a general practitioner, a doctor who treats a broad range of conditions, for a recommendation. The general practitioner may recommend a psychiatrist if this is appropriate for you.
Psychiatrists are able to write prescriptions for medication if they think you might benefit from it. The Healthline FindCare tool can also provide options in your area if you need help finding a therapist.
Most insurance plans will cover therapy for mental health conditions. Some therapists offer grants or sliding-scale payment options for individuals from low-income households.
A therapist will ask you many detailed questions in order to accurately assess your concerns and formulate a specific treatment plan.
You’ll know you’ve found the right therapist when you feel comfortable talking with them and are experiencing the gains or improvements you’ve been looking for. You may have to meet with several therapists before you find the right one.
Learn how medication-assisted treatment (MAT) is used to treat substance use disorders as well as sustain recovery and prevent overdose.
Congress has taken action in the recent Consolidated Appropriations Act, 2023 that impacts federal requirements for Drug Enforcement Administration (DEA) registrants, including those involved in OUD treatment. SAMHSA and DEA are actively working to develop further guidance related to these changes. Please frequently check this webpage for further updates and guidance.
Medication-assisted treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Medications used in MAT are approved by the Food and Drug Administration (FDA) and MAT programs are clinically driven and tailored to meet each patient’s needs.
Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery. MAT is also used to prevent or reduce opioid overdose.
Learn about many of the substance use disorders that MAT is designed to address.
MAT is primarily used for the treatment of addiction to opioids such as heroin and prescription pain relievers that contain opiates. The prescribed medication operates to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative and euphoric effects of the substance used.
MAT Effectiveness
In 2018, an estimated 2 million people had an opioid use disorder which includes prescription pain medication containing opiates and heroin.
MAT has proved to be clinically effective and to significantly reduce the need for inpatient detoxification services for these individuals. MAT provides a more comprehensive, individually tailored program of medication and behavioral therapy that address the needs of most patients.
The ultimate goal of MAT is full recovery, including the ability to live a self-directed life. This treatment approach has been shown to:
- Improve patient survival
- Increase retention in treatment
- Decrease illicit opiate use and other criminal activity among people with substance use disorders
- Increase patients’ ability to gain and maintain employment
- Improve birth outcomes among women who have substance use disorders and are pregnant
Research also shows that these medications and therapies can contribute to lowering a person’s risk of contracting HIV or hepatitis C by reducing the potential for relapse. Learn more about substance misuse and how it relates to HIV, AIDS, and Viral Hepatitis.
Learn more about co-occurring disorders and other health conditions.
MAT Medications
FDA has approved several different medications to treat alcohol and opioid use disorders MAT medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. Medications used for MAT are evidence-based treatment options and do not just substitute one drug for another.
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Alcohol Use Disorder Medications
Acamprosate, disulfiram, and naltrexone are the most common medications used to treat alcohol use disorder. They do not provide a cure for the disorder, but are most effective in people who participate in a MAT program. Learn more about the impact of alcohol misuse.
Learn more about MAT for alcohol use disorders and view Medication for the Treatment of Alcohol Use Disorder: A Brief Guide – 2015.
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Opioid Dependency Medications
Buprenorphine, methadone, and naltrexone are used to treat opioid use disorders to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. These MAT medications are safe to use for months, years, or even a lifetime. As with any medication, consult your doctor before discontinuing use.
Learn more about MAT for opioid use disorders.
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Opioid Overdose Prevention Medication
Naloxone is used to prevent opioid overdose by reversing the toxic effects of the overdose. According to the World Health Organization (WHO), naloxone is one of a number of medications considered essential to a functioning health care system.
MAT Medications and Child Safety
It’s important to remember that if medications are allowed to be kept at home, they must be locked in a safe place away from children. Methadone in its liquid form is colored and is sometimes mistaken for a soft drink. Children who take medications used in MAT may overdose and die.
Find MAT Treatment
MAT Medications are administered, dispensed, and prescribed in various settings such as a SAMHSA-accredited and certified opioid treatment program (OTP) or certified practitioners depending on the medication.
OTP Regulations Notice of Proposed Rulemaking
On December 13, 2022, SAMHSA published a Notice of Proposed Rulemaking (NPRM) to update the regulations governing Opioid Treatment Programs, in order to remove barriers that have impeded Americans’ treatment for opioid use disorders. For more information, read Frequently Asked Questions about the NPRM.
MAT and Patient Rights
SAMHSA produced a brochure designed to assist MAT patients and to educate and inform others (PDF | 415 KB). Under the Confidentiality Regulation, 42 Code of Federal Regulations (CFR) 2, personally identifiable health information relating to substance use and alcohol treatment must be handled with a higher degree of confidentiality than other medical information.
Contact Us
For information on buprenorphine waiver processing, contact the SAMHSA Center for Substance Abuse Treatment (CSAT) at 866-BUP-CSAT (866-287-2728) or [email protected].
For information about other medication-assisted treatment (MAT) or the certification of opioid treatment programs (OTPs), contact the SAMHSA Division of Pharmacologic Therapies at 240-276-2700. [email protected].
For assistance with the Opioid Treatment Program Extranet, contact the OTP helpdesk at [email protected] or 1-866-348-5741.
Contact SAMHSA’s regional OTP Compliance Officers to determine if an OTP is qualified to provide treatment for substance use disorders.
