Applied Behavior Analysis in the Treatment of Anxiety Disorders

The National Institute of Mental Health (NIMH) says that anxiety is a normal response to stress. During any twelve-month period, NIMH says, over 18 percent of adults in the U.S. experience anxiety disorders. About 40 million Americans have anxiety disorders serious enough to affect their daily lives, including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and phobias. Women are 60 percent more likely than men to experience an anxiety disorder over their lifetime. Children may also experience anxiety disorders, including those with diagnoses on the Autism Spectrum (ASD).

Related resource: Top 15 Best Applied Behavior Analysis Online Programs

Behavioral Problems Related to Anxiety in Children Can Have Behavioral Solutions

Anxiety disorders are so widespread and varied that research into effective applied behavior analysis (ABA) and anxiety in general is limited. Some therapists describe the cause of anxiety in children as “the bully in the brain.” One technique using ABA to help the child learn coping techniques which can reduce fear and anxiety includes encouraging the child to visualize and name his or her internal “bully” or voice which tells them fears and increases anxiety. The child is encouraged to call the bully a name like “Mr. Mean” or “Mrs. Witch” and talk back whenever the anxiety-causing fears are internally expressed.

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Exposure Therapy Helps Children Cope With Fears

Children with anxiety have daily living activities that are limited by their fears. Exposure therapy enables children to face their fears in a safe, controlled environment. The process shows children how their anxiety can increase and how they can develop techniques to overcome their fears until the anxiety subsides.

One technique used in exposure therapy asks children to rate their response to various triggers for their anxiety. As an example, if a child has a fear of teasing at school, he or she might be asked to rate how afraid they would feel watching a video of another child being teased on a scale of one to ten. Then, the child will be asked to rate how they’d feel when they are teased. Exposing the child to a series of mild triggers such as a story about teasing, a video about teasing, and increasingly strong triggers will help the child’s anxiety in real-world situations to subside.

Using Applied Behavior Analysis For Anxiety in PTSD

Post-traumatic Stress Disorder (PTSD) is an anxiety disorder resulting from exposure to traumatic stress. Traumatic stress can be combat-related, or experienced by victims of crime, domestic abuse, or natural disasters. Several studies in 2012 and 2013 showed that exposure therapy conducted using applied behavioral analysis techniques helped to reduced PTSD symptoms experienced by returning Veterans.

ABA was also used to help the PTSD patients increase mindfulness skills. Applied Behavioral techniques were also incorporated into an intensive seven-week treatment program that improved symptoms of anxiety and depression among a group of military veterans with PTSD who were referred through mental health providers in the Veterans Administration.

Obsessive-Compulsive Disorder (OCD) and Applied Behavioral Analysis

Obsessive-Compulsive Disorder (OCD) and behaviors such as hoarding and excessive collecting are the second-most frequent disorders that impact individuals on the Autism Spectrum, and they also affect millions who are not on the spectrum. OCD is diagnosed when repeated thoughts and behaviors occur regularly, and interfere with daily living.

ABA techniques have been shown to be effective in assisting people with OCD to overcome repetitive, obsessive behaviors and thoughts. Of conditions related to OCD, hoarding has not been as responsive to applied behavioral analysis techniques such as functional analysis, and research continues to seek techniques that can be effective in anxiety treatment.

Applied Behavior Analysis and Panic Attacks

Sudden anxiety responses have caused many visits to emergency medicine providers because their symptoms can mimic heart failure. A sudden experience of an elevated heart rate, rapid, shallow breathing, sweating, choking, and trembling, cause many people to believe they are at risk of sudden death.

When the cause of the symptoms is revealed as a panic attack, many people become even more anxious, fearful and avoidant of the situations causing the problem, from visiting crowded places to supermarket shopping to driving to work. ABA can help patients to understand the triggers for panic attacks, and develop a repertoire of ways to cope.

Anxiety Treatment and Behavioral Activation (BA) Techniques

The main methodology used in ABA for anxiety treatment that encompasses many types of anxiety-related problems and behavior is behavioral activation (BA). Originally developed to treat symptoms of depression, behavioral activation helps patients to identify patterns of negative and anxious emotional responses. After they identify negative and anxious emotions and behaviors, the patients are then assisted to identify positive, pleasurable activities.

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Patients are then asked to participate in the positive activities, including a series of steps which guide them into initiating, enacting, and repeating positive behaviors. Other techniques that reinforce positive activities include mentally rehearsing positive behaviors, role-playing, and mindfulness training and relaxation.

Benefits of Using Applied Behavioral Analysis for Anxiety Symptoms

Patients with anxiety disorders, including generalized anxiety, PTSD, OCD, and phobias, can experience greatly reduced quality of life and many serious impacts on their daily living. If a person can’t complete a normal commute to work without suffering a panic attack, they are at risk of losing their job.

Children who are fearful of bullying, being in group activities, or speaking up in class will experience many negative impacts in school. A young parent with obsessive-compulsive disorder may find that repetitive activities or thoughts are interfering with normal parenting and care activities.

Effects of Using ABA For Anxiety Treatment

Using applied behavioral analysis techniques, including exposure therapy and behavioral activation, can reduce all of these negative symptoms. ABA can help to educate clients and patients. The process can help patients to identify triggers that are leading to anxiety and undesirable responses and behaviors.

Applied Behavioral Analysts can help clients with anxiety to create a schedule for activities which will help to reduce anxiety and increase positive, healthful behaviors. They can also help clients to transition from moderate activities to more challenging activities that will lead to significant reductions of anxiety and improved quality of life.

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