A Quick Mental Health Treatment Guide for Clinicians: Classic Behavioral Psychotherapies

As healthcare professionals, it’s imperative to acknowledge that maintaining our mental health is absolutely necessary for everyone’s well-being. What was once a conversation-ending, taboo issue has become an everyday topic of discussion for both providers and the general public. Embracing this shift in consciousness improves patient care while creating a more supportive and understanding environment for us all. In addition, by employing helpful and compassionate communication techniques like empathy, active listening, and working with patients to set goals, clinicians create a safer environment.

Ongoing research has helped mental health providers develop evidence-based therapies, giving clinicians the ability to review current research, integrate it with their clinical expertise, and develop treatment plans for each client. By relying on evidence-based practices, clinicians optimize their time and resources, ultimately leading to higher quality care that’s also more cost-effective for patients.

To effectively address someone’s mental health challenges, it’s important to understand the therapeutic options. One of the most common and impactful approaches is psychotherapy, which can be tailored to meet each client’s unique needs. By understanding the best uses of psychotherapy, clinicians can enhance their treatment plans and offer comprehensive care that acknowledges all aspects of our well-being.

There are a variety of types of psychotherapy, and it probably feels overwhelming to consider learning them all. To help you better understand and advise your patients, we’ve created a series of quick guides on mental health disorders and therapies to speak to the unique methods, techniques, and conditions used to treat mental health. By better understanding these therapies, you and your patients can make informed decisions about mental health treatment options while improving patient outcomes.

Understanding Behavioral Psychotherapy

Psychotherapy consists of talk therapy to evaluate, diagnose, and address emotional, cognitive, and behavioral patterns and challenges. It can be paired with medication or employed on its own. The key principles of psychotherapy include effective communication, a strong therapeutic relationship, and emotional support.

Cognitive Behavioral Therapy (CBT) is a therapeutic subset of psychotherapy focused on changing unhelpful thinking patterns using helpful strategies to highlight a client’s distorted ways of thinking, improve confidence, use problem-solving skills to deal with difficult situations, and decrease unproductive behaviors. There are a few standard techniques used in CBT, such as:

Reframing negative thoughts or patterns and transforming them into more positive and helpful ways of looking at a given situation.
Journaling to track and acknowledge their negative thoughts and document their more positive thoughts.
Using stress reduction techniques like deep breathing (e.g., box breathing), meditation, and muscle relaxation to decrease stress and help people feel more in control.
Role-playing with clients to work through behaviors in a situation that may be difficult, as well as improve communication and problem-solving skills.
Guided discovery uses questions to help patients explore their beliefs and assumptions while challenging and expanding their perspectives.

CBT is a highly effective form of psychotherapy used to treat a range of conditions, including:

Additional Behavioral Therapies

In addition to CBT, there’s Dialectical Behavior Therapy (DBT), which employs standard techniques like emotional regulation, mindfulness, distress tolerance, and interpersonal skills to help people struggling with regulating their emotions. DBT can help people come to terms with the reality and effects of their behaviors while learning how to change their lives for the better. It’s a promising treatment option for people who struggle with intense and complex emotions, especially those with the following conditions or behaviors:

Another form of behavioral psychotherapy is Trauma-focused Cognitive Behavioral Therapy (TF-CBT), developed to treat children and adolescents who’ve dealt with childhood trauma, specifically sexual, physical, or mental abuse. TF-CBT involves both the patient and a parent or caregiver who was not involved in the abuse. It begins with separate sessions for both the child and the non-offending caregiver, eventually progressing to having them in the same sessions. Using cognitive behavioral techniques helps clients address unhelpful thoughts or negative behaviors and tackle feelings of guilt or fear. TF-CBT also helps the caregiver learn how to deal with the trauma endured by the child by incorporating stress reduction techniques, effective communication, and parenting skills.

TF-CBT uses gradual exposure to traumatic memories to decrease distress and change patients’ responses to triggers, in addition to learning skills like mindfulness, identifying difficult thoughts, and deep breathing. Involving the caregiver in the sessions helps to rebuild healthy and trusting adult relationships while empowering the caregiver with the resources to support the patient. Overall, TF-CBT is an effective treatment tool for children who’ve experienced trauma and their family members.

Behavioral activation is another therapeutic approach that’s particularly helpful for those dealing with depression and anxiety because it focuses on helping them understand that inactivity can lead to depression while encouraging them to improve their mood through action. Behavioral activation is initiated through activity monitoring, with clients documenting their daily activities and rating their moods during each given activity, helping them determine which activities are energizing and positive versus draining. Patients are also encouraged to identify their life values and look at what’s truly meaningful for them in each area of their lives. Once they’ve determined a path forward, clients develop daily schedules incorporating enjoyable and meaningful activities. The next step is to activate or complete these activities, develop a sense of achievement, reduce negative thinking, and learn to problem-solve so they’re resilient enough to find motivation when facing hardships.

The last type of behavioral psychotherapy we’re discussing is Exposure Therapy, which helps patients confront their fears or phobias and is particularly effective for individuals with anxiety disorders. This form of therapy uses continuous and gradual exposure to their triggers in a safe environment to decrease the extreme fear patients experience and learn techniques to manage their anxiety and any negative feelings that arise. Exposures can begin with the least difficult and progress to the more challenging experience, which is known as graded exposure. The opposite technique, known as flooding, exposes individuals to what they fear the most. Last but not least is systematic desensitization, which combines exposing individuals to their triggers while using relaxation techniques so that the feared object or situation becomes associated with relaxing. Exposure therapy is effective in treating the following conditions:

There are different strategies used in exposure therapy, including:

In vivo exposure requires the client to face the feared activity or object in person.
Virtual reality exposure immerses patients in what they fear and is typically done when in-person exposure is not practical or feasible.
Imaginal exposure helps people visualize the situation, object, or activity in detail and describe it out loud.
Interoceptive exposure purposefully causes the feared physical sensations in the patient to help them confront and manage the physical sensations associated with anxiety and panic.

Comparative Overview of Therapies

Evidence-based psychotherapies share fundamental similarities in that they all work to reduce negative thoughts, feelings, and fears in individuals to improve cognitive and behavioral patterns that help them manage difficult situations and emotions.

Where these therapies differ is understanding when they’re the most effective option and how specific strategies get implemented. Check out the list below for a helpful reference for where each therapy may be most effective:

CBT is helpful with Anxiety Disorders and Depressive Disorders.
DBT is an excellent treatment for Borderline Personality Disorder.
TF-CBT addresses childhood or early-life trauma.
Behavioral activation helps with Major Depressive Disorder.
Exposure Therapy addresses the origin of Anxiety Disorders.

Finding a Therapist

Now that you’ve got a foundational understanding of behavioral-focused therapeutic approaches, it’s time to collaborate with a qualified therapist on treatment. Here are some suggestions for finding a better therapeutic fit:

Be willing to ask for a referral
Get clear on challenges and treatment goals
Assess insurance coverage or out-of-pocket expense
Make time to explore a trusted database to find a provider
Seek out a culturally competent provider

Feeling informed and supported when looking for a provider and considering which type of therapy is also crucial. Here are some resources for support groups, organizations, and more:

Support groups (ADAA)
American Psychological Association (APA)
National Alliance on Mental Illness (NAMI)
Provider directories

Aside from resources, having a clear understanding of what to expect during a therapy session is also helpful, including collaboratively setting treatment goals with a therapist, building trust, opening up about difficult topics, discussing and processing feelings, how to take action to change, and how to get motivated to complete “homework” before sessions.

Want more tips on finding the right therapist? Watch this helpful webinar.

Therapeutic Challenges and Considerations

We’ve discussed the benefits of each type of behavioral psychotherapy, but there are additional challenges to consider. Finding a therapist who’s a good fit can take a few tries. While that can be discouraging, finding the right provider is a game-changer that’s imperative to the treatment journey.

Culturally competent providers truly make a world of difference. Take the time to ask potential therapists if they have an understanding of your culture, race, religion, sexual orientation, or other individual considerations before starting therapy because it factors into whether you connect with a provider. Another aspect to consider is that therapy often stirs up complex emotions and conversations that take time to process. Remember to take some time to consider these potential challenges and contemplate how you’ll handle them.

On Taking the Path to Compassionate Care

We hope this mental health guide provides you with valuable insights into the different behavioral psychotherapies, how they function, and the specific challenges they address. Understanding what treatments are available is crucial because addressing a mental health issue is just as important as treating any other organ system or bodily function. Take some time to explore the field and learn about these effective treatment methods so you can offer well-informed, effective, and compassionate care throughout your healthcare career.

Additional Resources

Feel free to check out these valuable resources to learn more about behavioral therapies below:

References

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