Formerly known as behavior analysis, behavior modification is a kind of psychotherapy that can be used during addiction recovery. It compliments other therapies because it addresses certain aspects of addiction that other therapies don’t. Also known as behavior therapy, it helps to reduce or get rid of negative behaviors through conditioning techniques that help a person make positive changes. The behavior of abusing substances is often based on a coping mechanism. We feel anxious or are working through uncomfortable emotions that drive one to abuse substances. Through behavior modification, an addict learns the coping mechanisms to behave differently. Through strategies like systematic desensitization, modeling, reinforcement, and aversive conditioning, there is evidence to prove behavior modification can be a great compliment in addiction recovery.
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The Definition of Behavior Modification
By definition, behavior modification is a form of therapy that alters how you behave. Therapists will incorporate techniques to help those with mood disorders and substance addiction. This type of therapy was developed based on B.F. Skinner’s theory of operant conditioning. The basis of operant conditioning is understanding a person’s behavior and finding the reasons they act in a certain way. The conclusion is to note the consequences of the behavior. The theory by Skinner was that there are three responses available. Neutral, reinforcing, response and punishing. Neutral bears no positive or negative response. Reinforcing is positive while punishing responses are considered negative. Response is like punishment because the positive stimulus is taken away. In behavior modification therapy, there is a process of learning for the addict. The goal is to change how the person behaves and deals with their external world.
The Theory Behind Behavior Modification
Behavioral therapy doesn’t concentrate on thoughts or feelings. Instead, there is a heavy focus on antecedents which are the conditions that happen before the behavior occurs. There is also concentration on consequences once the behavior has happened. There are reasons addicts will continue to use drugs or drink alcohol despite everything they have lost. At some point, there was an association with a reward, a reinforcing response. Maybe drugs or alcohol allowed them to feel less inhibited if they felt shy. Behavioral therapy has developed a variety of techniques to change how an addict manages their lives and thinks of substances when used in conjunction with other therapies.
Behavior Modification Programs
Behavior modification strategies in addiction therapy will observe and measure behavior to create positive change. Addicts learn how to reduce negative behaviors through a variety of ways. The goal in behavior modification therapy in addiction recovery is to learn how to properly respond to stimulus. There are quite a few offshoots to help alter negative behavior. This type of therapy has been successful for many afflictions. Anxiety, autism, ADHD, phobias and disruptive behavior are some examples. This form of psychotherapy aims to get rid of habits and actions that are destructive and unhealthy. We are conditioned by our surroundings. Behavior modification works to get addicts to keep doing behaviors that are positive and stopping those that aren’t. Behavioral techniques are incorporated to accomplish this goal. Some of the techniques and strategies include:
- Systematic desensitization
- Modeling
- Reinforcement
- Aversive conditioning
While psychoanalysis therapy focuses on unconscious processes that are causing addiction, behavior therapy incorporate conditioning techniques to create change for the positive.
Reinforcement
Reinforcement is used to help increase the likelihood that a specific behavior will occur in the future by delivering or removing a stimulus immediately after a behavior. This behavior can be Another way to put it is that reinforcement, if done correctly, results in a behavior occurring more frequently in the future.
Positive Reinforcement
Positive reinforcement involves presenting an addict with a motivating or reinforcing stimulus if they can abstain from substance abuse. This in theory should create a likelihood of the behavior happening again. The behavior of course would be the act of not using substances or making healthier choices. A series of 30 studies found “voucher based reinforcement therapy” to be quite effective. This was a variety of monetary offerings for behavior that promoted abstinence.
Negative Reinforcement
Negative reinforcement in therapy is when aversive stimulus is removed when the addict behaves in a certain way. This increases the likelihood that the behavior will happen again. Psychologically, we related it to avoiding the negative consequence by acting in a certain way. It isn’t the same as punishment. Punishment reinforcement is a decreasing of behavior for desired effect. Negative is increasing the behavior to avoid what you don’t want.
Consequences
Consequences in the context of behavior modification is considered good or bad. They can be used as reinforcers to make the desired behavior stronger or punishments to weaken negative behavior. Response cost involves the positive stimulus being removed which is considered a punishment reinforce. There is also extinction when the behavior doesn’t come with the reinforcement to continue the negative behavior. This weakens the response.
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Behavior Modification Techniques
Everybody has different behaviors and reasons they execute such behaviors. It goes without saying that there would have to be a variety of techniques to assist those in addiction recovery. Here are various types of behavior modification approaches:
Modeling
Modeling is when you learn the right behavior by looking at others coping with the same situation. It allows you to learn new skills through imitating another person behaving appropriately. It can help to promote simple or complex skills. This form of therapy within behavior modification can be used generally for dealing with underlying reasons one abuses substances. It can also be used to help abstain from using substances in certain situations where one would normally use.
Systematic Desensitization
This type of therapy within behavioral modification addresses the fear response of phobias. It works by substituting anxiety with a relaxation response. There are three phases that include:
- In the first step, you will learn to breathe to create relaxation in the body as well as a deep muscle relaxation technique. This might include meditation or control over breathing. This is important in the process because phobias and fears cause tension. If you can remain relaxed, the fear has less power over you.
- In the second step, there will be a fear hierarchy. Stimuli that causes the least amount of fear will be incorporated. It will build up in stages where it will eventually show the things that scare you the most.
- This process will be completed over and over until there is no more fear or anxiety in the patient. If necessary, the patient can go back down the fear hierarchy list if fear becomes too intense.
Systematic desensitization works in helping those recovering from addiction by addressing fears that caused substance abuse. This is a useful type of therapy for someone who started drinking because they had social anxiety. This therapy tends to the mood disorder aspect of co-occurring disorder. Studies have found that once patients have eliminated social anxiety, they were then able to abstain from drinking alcohol for over one year.
Cueing
Cueing in behavioral modification is to remind the addict to perform specific actions at a certain time. Cues can work negatively for addicts as its considered relapse triggers. Like the name suggests, cueing is reminding a person to perform a certain action at a given time. Cueing can involve repeated relapse triggers that are forced. If the addict doesn’t engage throughout these triggers, the cues will lose their power and reduce cravings. Triggers will be always there and create relapse risk. By reducing the power the triggers have, it is a powerful way to help addicts recover.
Discrimination
Discrimination guides a person to behave in a certain way to obtain stimuli. The reward is only given once the right response has occurs.
Satiation
Satiation is allowing the addict to do the undesired behavior in hopes they will tire of it. This usually doesn’t work in regards to addiction therapy. As there are so many other things to consider when it comes to addiction, this wouldn’t be a helpful route for most.
Avoidance
Avoidance is teaching the addict to avoid an unpleasant situation. This is dependent purely on the type of substance the patient is addicted to.
Fear reduction
Fear reduction helped addicts manage phobias. This is where the person is exposed to stimulus that is terrifying for them. It may have occurred through past trauma. In the case of an addict who is afraid of social situations, this can be a way to stave those feelings and reduce emotions that cause someone to use substances.
Cognitive Behavioral Therapy
Years of psychiatric research has proven that anxiety and substance use disorders will co-occur together at high rates. One of the most effective means of pinpointing thoughts which lead to anxiety is through Cognitive Behavioral Therapy (CBT). The treatment is about analyzing thoughts and then looking for ways to replace those thoughts. CBT includes Dialectical Behavioral Therapy and Scheme-focused Cognitive therapy. Sometime therapists will also use paradoxical interventions where the tactics would be much like playing devil’s advocate. A therapist might tell an addict to restrain from making changes. The main focus on CBT is to focus in on the thoughts that create negative feelings. The belief in cognitive therapy is that our main problems occur from the thoughts we have. By changing the thoughts and core beliefs, there is a place for improvement in all parts of our life. This will then change emotions and how one behaves. Through this type of therapy, addicts can identify the thoughts and behaviors that drove them to addiction in the first place. This increases the outcome of making changes through understanding. Anger management, relaxation training and assertiveness changing are some of the tools used within this therapy. Intensive behavior modification treatment is often provided to those in an inpatient rehabilitation program. It can also be done through outpatient addiction programs too. During the initial stages of addiction recovery, these behavioral modification will be executed often. This type of therapy is not the only solution and does not stand alone in getting people through recovery. Prior to this type of approach, other aspects of recovery would come in to play. This includes detox, talk therapy, and addiction education. Addicts need to have a scope of what situations are triggers points for relapse. Then they can work with a behavioral modification therapist to manage those situations. A plan of action will be put in place that will allow the addict to manage the hard road to recovery.
