Behavior Therapy

Behavioral therapy, also known as cognitive behavioral therapy, is rooted in the belief that emotional challenges and unproductive behaviors are learned and can, therefore, be changed. In behavioral therapy, troubling situations are identified, and thoughts, emotions and beliefs about those situations are explored, challenged and ultimately altered. Behavioral therapy empowers the individual to respond to challenging situations in a more effective and acceptable manner.

What is behavioral therapy?

Behavioral therapy has a positive influence not only on the quality of life for the child with impairment, but also on those who support and care for the child. Behavioral therapy helps an individual develop life skills, such as the ability to manage stressful situations or events that result in anger or frustration, or that lead to negative outcomes, such as isolation, rejection, low performance, attention deficit, or social-emotional deficiencies. Behavioral therapy can also be helpful in addressing academic and social challenges often experienced in mental illness, learning disabilities, and intellectually impaired individuals.

Behavioral therapy is rooted in the belief that emotional challenges and unproductive behaviors are learned and can therefore be changed. In behavioral therapy, troubling situations are identified and thoughts, emotions and beliefs about those situations are explored, challenged and ultimately altered. Behavioral therapy empowers the individual to respond to challenging situations in a more effective and acceptable manner.

Other benefits to behavioral therapy include:

• Completing task
• Delaying gratification
• Developing friendships
• Excelling academically
• Finding acceptance
• Gaining perspective
• Managing emotions
• Maintaining focus
• Obtaining coping skills
• Overcoming emotional trauma
• Reducing anxiety
• Resisting temptation
• Resolving relationship conflicts
• Treating depression

Who benefits from behavioral therapy?

This type of therapy is found to be helpful for parents and caregivers, as well as the child with impairment.

The parent

For parents, learning their child has a brain injury and resulting physical impairment can be an overwhelming and life-altering event. Substantial financial resources may be required as participation in intensive treatment planning begins. Family relationships may become strained, daily routines may be modified, and hopes and plans for the child’s future may be altered. These are only a few changes a family may experience, but there is hope. Accepting the diagnosis, managing the child’s treatment regimen, and becoming a positive influence on the child’s development can be achieved through behavioral therapy.

The child

In early childhood, emotional, social, attentive and behavioral skills are developing. These learned behaviors influence adulthood. Early on, a child begins to label feelings, understand and express emotions, develop sympathy, care, and react to others. The child’s immediate family as well as friends, teachers and caregivers influence his or her learned behaviors. Emotionally healthy children are provided opportunities to interact with others, develop meaningful friendships, and socialize to their greatest capacity. When a child shows signs of difficulty with play, learning, interacting, or performing, he or she (and, in some cases, the child’s support system) may benefit from screens, evaluations, problem identification, interventions, or focused instruction rendered by those trained in behavioral therapy.

During different stages in the child’s life, and dependent upon the level of severity, a child with Cerebral Palsy may feel ostracized by peers, frustrated with treatment goals, isolated from friendships, embarrassed by medical conditions – incontinence or drooling, for example – and saddened when limited by his or her own abilities. In some cases, the child may be unable to communicate in conventional ways.

When these issues arise, a child is best served by therapies that will help acquire a healthy attitude toward his or her challenges and progress. Behavioral therapy can release depression, mood swings, sadness, loss, anger and frustration, allowing previous negative outcomes to be replaced with empowerment, encouragement, coping skills, alternative interventions, perspective energy, and improved quality of life. Behavioral therapy is even beneficial in conjunction with physical therapy to encourage and reward desired outcomes and discourage negative behaviors and thoughts towards tasks.

When a child with Cerebral Palsy is unable to communicate, a wealth of emotion can become pent up inside, especially if the child is not able to ask for assistance, express pain, socialize with peers, or interact with health care providers. Behavioral therapy seeks ways that will allow the child to interact with their environment and gain control over their emotions. They may employ adaptive equipment or communication devices tailored to meet their specific abilities. Once a child is able to communicate, he or she is more able to enjoy life activities, bond with family and friends, improve academics, participate in care, and contribute more fully during treatment. Increased quality of life and the ability to communicate has been proven to be an important factor in a child’s lifespan.

A child with Cerebral Palsy who also has intellectual impairment may have difficulty performing every day skills required for self-care, hygiene, and within societal norms. Intellectual and cognitive impairment is present in two-thirds of those with Cerebral Palsy. A below average IQ will affect the ability to learn, focus, and socialize. A child in this situation may begin to feel isolated, underperforming, different, and excluded by peers. Behavioral therapy can assist the child with overcoming feelings of inadequacy and meaninglessness. These feelings will be replaced by building their own values, self-worth, and accomplishment. They will sort through their emotions, obtain communication skills, and feel better about themselves and their interactions. With healthy relationships and bonding, the child will gain purpose and fulfillment.

When a child transitions into adulthood many life-altering changes may occur. The individual is no longer guided by the education system, therapies and treatment may have decreased, and he or she is more focused on living as independently as possible. This can be a frightening time. The focus is to concentrate on self-care, provide for future needs, work, remain physically active, and socialize. Behavioral therapy can help empower, focus, and affect life-changing circumstances. With behavioral therapy the adult can obtain a “can-do” attitude, dream, and visualize the future.

The caregiver

For the caregiver, behavioral therapy provides an education and tools to identify at-risk and self-sabotaging behaviors in his or her own, as well as the child’s behavior. Through therapy, a caregiver will learn to recognize attention disorders, identify stressors, prevent meltdowns, remove triggers, and positively affect behaviors. Behavioral therapy educates and empowers caregivers to influence a child’s progress.

Benefits may include development of a consistent behavioral management plan, reward system, positive interactions, and adaptation techniques to fit the child’s ability levels. For instance, classic games can be adapted to a child’s ability level, a Dynavox can be purchased to assist in communication, and other family members can use adaptive equipment when racing or playing basketball to match the child’s abilities.

Parents, caregivers and children with Cerebral Palsy can all benefit from the positive interactions achieved with behavioral therapy to compassionately, respectfully, and appropriately interact with each other in a stable, secure and happy environment.

When is behavioral therapy advised?

The child and/or family may benefit from behavioral therapy if a quality of life – for the child or family members – is compromised or behavior is affecting others. Behavioral therapy can also be helpful if the child may be penalized to the extent they are restricted from socializing with others; when they disrupt others from learning in an educational environment; or when they are not bonding with family. It can also become useful when the child’s peers act in such a way to bully the child into irritability, isolation, rejection, or depression.

Sometimes a child will act in a manner that affects those around them. This can happen in situations where attention-deficit disorder causes disruptions to the class or the teacher’s ability to instruct. It could also occur at times when the child is so frustrated they pinch, hit, or act out against those around them. If they cause harm to others, or are deemed to be a possible threat to themselves, they could benefit from behavioral therapy.

Signs to look for in the child include:

• Anger
• Aggression
• Anti-social behaviors
• Anxiety
• Appetite loss
• Change in sleep patterns
• Depression
• Difficulty in performing tasks
• Distress
• Feelings of helplessness
• Frustration
• Irritability
• Isolation
• Loss of interest
• Low academic performance
• Moodiness
• Peer rejection
• Social-emotional deficiencies
• Whining

Who provides behavioral therapy?

Techniques used in behavioral therapy may include role-playing exercises, life-skill training, conditioning, systematic desensitization, cognitive reversal, journal writing, validity testing, biofeedback, and cognitive-behavioral therapy. This type of therapy can be performed face-to-face, over the phone, on the internet, in a clinical setting, in school, or in the home. Length of therapy sessions is determined by the type or form, the severity of symptoms, length of time coping negatively, response to progress, degree of stress, and the level of support received from others.

These techniques may be administered by one of many specially trained and licensed individuals. Below is a list of specialists trained in behavioral therapy.

• Licensed professional counselor – These individuals usually focus on resolution of specific current life problems. A counselor treats everyday challenges and is usually specially trained in career, mental health, school, or rehabilitation. This person can evaluate, assess and specialize in behavioral therapies and developmental progress.
• Marriage/family therapists – Marriage or family therapists are specifically trained in relationship dynamics.
• Psychotherapists – Specifically trained, certified and licensed to improve mental health and improve group relationship dynamics. They often specialize in handling deep-seated personal issues with profound outcomes. They are trained to expand coping mechanisms, awareness, self-observation, insight, empathy, perception, and perspective. They help an individual to achieve his or her full potential.
• Psychiatrists – A psychiatrist has medical practitioner qualifications and licensing and can administer prescription medication therapy. They primarily use bio-psycho-social models, medical training, practical psychology and applied psychotherapy.

Those seeking treatment should feel a comfort level and trust with the provider. They may wish to meet their clients on a one-to-one basis or offer opportunities for group therapy. Length of treatment depends on the goals and the progress. Expense may or may not be covered by insurance providers. It is always recommended that payment options and billing expectations are agreed upon upfront to avoid future conflicts.