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
- 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.
- 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.
- 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.
- 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.
- 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.
