How to be a behavioural therapist

What is a Behavioral Therapist?

Behavioral therapists, or behaviorists, work with patients who have behavior problems such as anorexia, phobias, obesity, and troubled interpersonal relationships.

Behaviorists concentrate on the maladaptive behavior and what caused it to help clients learn new, more appropriate behaviors. Earlier work showed that behavior is learned when a certain stimulus is paired with a certain behavior. For instance, learning that smoking cigarettes brings satisfaction during a restful break might be unlearned so that break time can involve healthier habits.

Behavioral therapists communicate with patients on a one to one basis, learning what difficulties patients are having and what led up to those difficulties. Communication continues as the patient and therapist work to alter the patient’s behavior.

Therapists steadily maintain documentation of what is being done and how well the patient is responding. Behavioral therapists also attend meetings with other members of the team to discuss the patient’s progress and alter therapy if necessary.

Where Does a Behavioral Therapist Work?

Behavioral therapists work in a variety of environments. Hospitals, schools, juvenile detention facilities, the correctional system, probation offices, and clinics are some of the workplaces where behaviorists can make a difference.

Related: How to Become a Cognitive Behavioral Therapist

What are the Requirements to Become a Behavioral Therapist?

Behavioral Therapist Education

There are three levels of behaviorists, all of which require a university education. Board Certified Behavior Analyst (BCBA) requires a master’s degree. A Board Certified Behavior Analyst with a doctorate is designated BCBA-D. A Board Certified Assistant Behavior Analyst (BCaBA) requires a bachelor’s degree.

A university bachelor’s degree takes four academic years to complete. A typical program might consist of general education, philosophy, life science, physics or chemistry, math or computer science, basic psychology, and upper division psychology courses in various specialties. Some upper division courses might include abnormal psychology, clinical psychology, and developmental psychology, to name just a few.

Students should check university catalogs to learn which schools offer undergraduate courses in behavioral psychology. The University of California in San Diego, for instance, offers an undergraduate program in the discipline.

If the course you want is not listed, many universities may allow independent study under the supervision of a professor with knowledge in your particular interest. Internship courses allow students to acquire supervised experience in clinical settings, schools, and other “real life” facilities.

Related: Becoming a Behavioral Psychologist

Master’s programs prepare students for supervisory roles in behavioral science. Typical programs offer courses that help students to understand the theoretical and practical aspects of behavioral psychology. At East Michigan University, for example, philosophy, science of behavior, and statistics are included, along with electives.

Students who are research oriented have the chance to write a thesis if they are so inclined. A practicum gives students the opportunity for supervised interaction with patients. A master’s degree helps students who want to prepare for a supervisory role.

PhD programs also exist, almost exclusively for those who want to teach behavioral therapy or perform research. Some individuals with doctoral degrees also become supervisors of clinics.

PhD candidates perform research to add to the body of knowledge in behavioral science and counseling. A new candidate to the program chooses a committee of professors to guide him or her in designing, executing, and communicating a thesis.

Students should check graduate school catalogs and speak to faculty to find a schools emphasizing subjects of particular interest.

Johns Hopkins Bloomberg School of Public Health, for instance, offers two research routes. One emphasizes health education and communication while the other emphasizes social and psychological influences on health. Students should start early researching which schools offer the kinds of studies that particularly interest them.

Behavioral Therapist Licensure and Certification

State licensure is required in order to practice as a behavior therapist in a given jurisdiction. Individual state boards of health care have varying requirements for licensure in their jurisdictions. Illinois is one state that requires an exam administered by the Behavior Analyst Certification Board, as well as verification of education, supervised experience, and a written care plan that the candidate has produced for a patient.

Arizona, on the other hand, requires a graduate degree and supervised experience. Students should look up requirements in states where they intend to practice and check periodically for changes.

Behavior Analyst Certification board exam typically covers:

• Measurement in behavioral science
• Experimental design
• Fundamental elements of Behavior change
• Specific behavior change procedures
• Behavior change systems
• Identification of problems
• Assessment
• Intervention
• Implementation, management and supervision
• Client-centered responsibilities

Another credentialing body is the National Association of Cognitive-Behavioral Therapists (NACBT). Certified Cognitive-Behavioral Therapist and Diplomate in Cognitive-Behavioral Therapy are two relevant credentials provided by the NACBT. A graduate degree as well as a number of years of experience in the field are required for either credential.

What Skills are Required for a Behavioral Therapist?

Interpersonal skills and leadership ability are important in the profession. Behavioral therapists need to be able to create a trusting, safe environment where patients feel free to discuss their problems without being judged. They need to listen actively while directing conversation to problem areas in the patient’s life.

Analytical skills are important for assessing patients’ problems and needs for intervention. Therapists need to be able to plan intervention, assess how well the process is working, and decide either to stay the course or implement a new plan.

Behavior therapists need to work as integral members of a team and show confidence so that the patient will feel assured that his or her treatment will be effective. Business and accounting skills are important for behavior counselors who go into private practice.

What is the Salary and Job Outlook for Behavioral Therapists?

Individual salaries vary according to work settings, states, and patient load. As the need for therapists increases, salaries are also likely to increase. According to Payscale, a Board Certified Behavior Analyst (BCBA) on average earns $68,399 per year. Some professionals earn over $90,000 per year (December 2022 data).

The outlook for health care professions is good. The Affordable Care Act has made universal health care possible. As the baby boomer generation continues to mature, many patients will need help dealing with with the changes that come with age. Jobs in mental health are expected to grow faster than the general job market at least up until the year 2031 (BLS).

What Can You Do With a Degree in Behavioral Psychology?

Behavioral psychology is a widely varied field in which qualified psychologists can find work of all manner and sorts. Many behavioral psychologists work in research, conducting studies and experiments on crucial psychological questions, such as the nature of behavioral health disorders or the efficacy of behavioral interventions to address such disorders.

Other behavioral psychologists work in school settings. In this capacity, a behavioral psychologist might work with special populations of students, such as those with severe behavioral difficulties, to design and implement treatment and intervention programs to help the pupil be more successful in school and in life in general.

Other behavioral psychologists in the education field might work at colleges or universities to teach undergraduate, graduate, and doctoral-level courses, and to conduct research as well.

Many behavioral psychologists work in private practice. Doing so allows them to use their skills and training in behavioral psychology to help their clients address problems or issues in their life. In this setting, behavioral psychologists often work with clients on a one-on-one basis to develop a treatment program that addresses any number of behavioral issues such as phobias, addictions, or even anxiety or mood disorders.

Another popular career for behavioral psychologists is in medical settings, such as hospitals or clinics. Here, behavioral psychologists would most likely work as a member of a much larger team that includes medical doctors, nurses, and other health specialists to devise and carry out treatments for patients that have both medical and mental health needs.

For example, a behavioral psychologist might work with a patient that has terminal cancer to help them develop effective ways of dealing with the stress and anxiety that results from their medical diagnosis.

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This guide is a deep dive into what it takes to become a behavioral therapist. The guide will outline what a behavioral therapist does and how to pursue this career, as well as information that potential behavioral therapists will want to know, such as salary ranges, important certifications, and the overall job outlook for the field of behavioral therapy. 

Behavioral therapy includes many different therapeutic approaches, ranging from aversion-therapy to cognitive-behavioral therapy.  (More information about different types of behavioral therapy can be found here).

The common goal of all behavioral therapy is to help individuals identify unhealthy or potentially self-destructive behaviors and figure out ways to change them. Behavioral therapists begin with the understanding that all of a person’s behaviors are learned and unhealthy actions can be changed.

Therapists following a behavioral approach will focus on each individual’s current problems and behavior. A behavioral therapist then works to help a person better understand his or her behavior and learn techniques to correct it. This approach is different from other therapeutic strategies that focus on the underlying causes of problems, such as traditional psychodynamic therapies that examine unresolved issues from childhood.  As a result, many people choose behavioral therapy because it gives them the opportunity to focus their efforts directly on changing the behavior that is disrupting their life.  

Behavioral therapists work with children and adults in a range of settings. This could include individual or group meetings with clients in hospitals, medical clinics, rehabilitation settings, and private practice.  According to healthline, behavioral therapy can be used to treat depression, anxiety, panic disorders, and anger issues. This approach is particularly useful for conditions and disorders that include concerning behavior, such as eating disorders, attention deficit hyperactivity disorder (ADHD), phobias, obsessive-compulsive disorder (OCD), self-harm, and substance abuse.  

When considering this profession there is some important information to keep in mind.  

How to become a behavioral therapist

1. Obtain a bachelor’s degree  Most employers will require a bachelor’s degree in social work (BSW) or a related field, such as counseling or psychology. 
2. Gain relevant work experience  Practical experience working with a  specific population (such as children with autism or ADHD, or adults struggling with substance abuse) or in the applicable setting (such as hospitals or schools) can be important and is sought by many employers.  Some students gain this experience through internships during bachelors or masters degree programs.
3. Pursue a master’s degree  Some behavior therapist positions require that applicants hold a master’s in social work (MSW), psychology, counseling, or related degree. 
4. Obtain professional certifications  As this guide explores, there are many different certifications that behavioral therapists can pursue. These certifications may, in some instances, be required by employers as a means of  demonstrating competency in a behavioral treatment model.
5. Earn clinical licensure  To work in private practice, behavioral therapists are required to hold licensure as a clinical social worker (abbreviated as LCSW, LICSW or LISW) or in their area of specialty (such as licensed professional counselors (LPC) or Psychology license).  The specific requirements for clinical licensure vary by state, but for social workers this generally requires at least two years post-MSW experience, passing the ASWB clinical examination, and a specified number of hours of supervision by a licensed social worker. 

What is a behavioral therapist?

As explained by the Association for Behavioral and Cognitive Therapy, behavioral therapists  hold the perspective that each individual’s current environment is the most important factor impacting their behavior. The therapist teaches procedures that are generally needed to improve each individual’s self-control by learning new skills and abilities. Individuals using behavioral therapy are often challenged to practice new behaviors between therapy. To ensure therapy is effective, an additional emphasis of treatment is to monitor and evaluate progress.

A behavioral therapist will meet with an individual experiencing a problematic behavior. This includes behaviors such as hair-pulling or skin-picking that can cause people harm and embarrassment, as well as phobias, anger or substance abuse concerns. In all instances, the therapist observes and measures the behavior to create a plan for change.

The next task of a behavioral therapist is to design an intervention to target the behavior. There are a wide variety of behavioral interventions. This could include classical conditioning interventions, such as token economy systems in which students are given reward for good behavior), and operant conditioning interventions, such as aversion therapy (negative stimuli with the unwanted behavior).  

Systematic desensitization is another behavioral intervention that helps people to gradually reduce their fear response to a phobia.  Cognitive-behavioral therapy (CBT) is a popular approach that includes behavioral therapy. CBT combines a focus on moods and thoughts with interventions that target actions and behaviors. More information about these and other behavioral therapy interventions can be found here.

As the behavioral therapist designs and implements an intervention, the individual (and parents or families for some) are helped to understand ways to change their behavior. This often involves teaching skills, such as deep breathing or other coping techniques, that the client practices outside of session. The intervention may require learning and practicing a series of skills that are combined to allow the individual to change behavior that brought them to treatment.

A behavior therapist will then work to monitor and evaluate each client’s progress. This may require revisiting interventions and making any changes needed to increase their effectiveness.  By continually measuring progress in the context of the actual problem behavior, clients better understand treatment effectiveness as well as the factors in their environment that lead to the behavior.

Behavioral therapist requirements and skills

Educational requirements

• Bachelor’s degree, often in social work, counseling, psychology or a related field
• Masters degree in social work or counseling (and in some instances doctoral degrees) are required for positions that provide more services with less supervision

Background knowledge

• Behavioral therapy theories, such as classical and operant conditioning
• Behavioral treatment interventions, such as aversion therapy, cognitive-behavioral therapy, dialectical behavioral therapy, etc.
• Mental health conditions of the population being served, such as obsessive-compulsive disorder, autism, substance abuse disorder, etc.
• Research methods and design, such as ability to measure effectiveness of treatments

Skills

• Listening, empathy, and interpersonal skills
• Ability to engage and motivate clients
• Verbal and written communication skills
• Problem-solving, particularly to help clients identify solutions to complex problems
• Patience and ability to work with clients who are in distress or angry
• Attention to detail to observe and record behavioral changes

What do behavioral therapists do?

The job of a behavior therapist will vary depending on the clients they are helping and work setting. For example, therapists that work with children will need to work closely with parents to implement and monitor the effectiveness of treatments. (An article detailing the use of behavioral therapy for children with ADHD can be found here.).  

In many instances, behavioral therapists assist clients with fears or behaviors that are disrupting their lives. This hypothetical explores a behavioral therapist’s role in helping a client overcome his phobia:

A new client arrives seeking help for his phobia of elevators. He began a new job in a building with an elevator and has relied on taking the stairs. Recently, he experienced an embarrassing incident of overwhelming anxiety when trying to ride up the elevator with work colleagues. Now, even entering the lobby of his work has led to surges of fear. The client visits the behavioral therapist desperate for a solution, but even thinking about elevators has become overwhelming.

The behavioral therapist has a private practice that specializes in treating phobias using exposure therapy. The therapist begins by understanding the client’s behavior and the circumstances in which it arises. In gaining this background, the therapist and client come to a shared understanding of the concerning behavior.

Here, the therapist notices that even the thought of elevators overwhelms the client. The first step becomes helping the client identify or learn a couple basic coping strategies to use when the fear starts building. The therapist models two breathing and ground techniques that the client will continue to practice between sessions.

The behavioral therapist is also beginning to form the longer-term plan for helping this client.  The exposure therapy model will involve gradually exposing the client to elevators so he can begin to overcome his phobia. The therapist will start with some pictures of elevators and a video about how elevators work.

In the next session, the client begins with reviewing the pictures and video, while taking breaks to calm when his anxiety builds.  He leaves empowered after overcoming this first step. The therapist continues to plan the exposure process that will unfold over a series of meetings. This includes the client going to look at an elevator, followed by stepping into one, riding an empty elevator with the therapist, and eventually overcoming the phobia.  By the end of his work with the behavioral therapist, the client has built the ability to ride in the elevator.

Behavioral therapist job description

Behavioral therapists work in different settings, such as hospitals, community health centers, medical clinics or private practice. The precise duties will vary depending on the setting.  As explained by jobhero.com, the most common functions of behavioral therapists in clinical settings, this job can include:

• Collecting data about client’s behavior through observation, interviews and counseling sessions
• Diagnosing specific disorders, such as anxiety or obsessive-compulsive disorders (such as hair-pulling)
• Assess how client behavior impacts personal and professional functioning
• Design treatment interventions to help with targeted behavior
• Assist clients in building skills to manage their disorder, such as communication or coping skills
• Help clients implement treatment interventions in meetings and in between sessions
• Maintain documentation to ensure treatments are effective
• Collaborate with families to implement or evaluate treatment
• Evaluate potential alternative treatment plans

Additional behavioral therapist special training and certifications

As this guide explores, behavioral therapists commonly focus on specific behavioral conditions (such as hair pulling or skin-picking) or utilize certain treatment models (such as systematic desensitization or cognitive-behavioral therapy). Social workers or other mental health professionals seeking careers as behavioral therapists often pursue specialized training that is specific to the condition or treatment model.

Behavioral therapists working with obsessive-compulsive disorder (OCD) and related conditions can pursue relevant training with the International OCD Foundation’s Behavior Therapy Training Institute. This includes two levels of training in a specific behavioral therapy model (known as exposure and response prevention therapy (ERP)), and a specialized course for therapists working with children and adolescents.

Behavior therapists will often utilize professional associations to advance their knowledge.  The Association for Contextual Behavioral Science is a key resource for information on two core behavioral treatment models: Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT).  There is no formal certification for ACT and behavior therapists can learn more here.  The Association for Behavioral and Cognitive Therapy (ABCT) is another key resource for professionals, including how to gain competency in evidence-based behavioral practice (EBBP).

The popularity of cognitive-behavioral therapy treatment models has led to a wide variety of training and certification options. This includes the National Association of Cognitive and Behavioral Therapist’s four levels of certification and training at the Beck Institute. Those wanting to learn more should reference the Academy of Cognitive and Behavioral Therapies list of training programs, which includes opportunities in every region of the United States, as well as distance and international options.

Multiple options also exist for training in dialectical behavioral therapy (DBT), including through the Evergreen Certification Institute and the Treatment Implementation Collaborative. 

Behavioral therapist career outlook

The Bureau of Labor Statistics predicts a 22 percent increase in jobs for substance abuse, behavioral disorder and mental health counselors for the 2018-2028 period. This increase translates to 68,500 new jobs. This rate of growth is significantly higher than the 12 percent expected growth for counselors, social workers and other community and social service specialists during this same time period.

The career outlook for behavioral therapists is driven by the popularity of behavioral techniques, particularly cognitive-behavioral therapy, for many populations and settings. One such example is the  increased use of behavioral therapy for a range of juvenile and adult offenders in the criminal justice settings (both in institutions and community). Behavioral therapy is also a key treatment for veterans experiencing a number of mental health conditions. (Those wanting to learn more can visit Veteran’s Administration for information on treatments for anxiety, depression and substance abuse).

Behavioral therapist salary  

According to data prepared by the Bureau of Labor Statistics, in 2018 counselors working with behavioral disorders earned a median salary of $44,630. The work setting was a key variable impacting salary.  Behavioral therapists in government industries earned more (median salary of $51,690) than those in hospitals (median salary of $48,310) or mental health and substance abuse facilities (median salary of $43,120 for outpatient and $38,190 for residential).  

The pay for behavioral health therapists will vary by region. The highest annual mean wages are in Utah ($66,330), Alaska ($62,290), District of Columbia ($59,850), Oregon ($59,390), and New Jersey ($58,410). The Bureau of Labor Statistics can be consulted for a state-by-state breakdown of this salary data.