The Behavioral Component of Cognitive-Behavioral Therapy
The behavioral component of cognitive-behavioral therapy seeks to change people's reactions to anxiety-provoking situations. A key element of this component is exposure, in which people confront the things they fear.
An example would be a treatment approach called exposure and response prevention for people with OCD. If the person has a fear of dirt and germs, the therapist may encourage that person to dirty his or her hands and then go a certain period of time without washing. The therapist helps the patient to cope with the resultant anxiety.
Eventually, after this exercise has been repeated a number of times, anxiety will diminish. In another sort of exposure exercise, a person with social phobia may be encouraged to spend time in feared social situations without giving in to the temptation to flee. In some cases, the individual with social phobia might be asked to deliberately make what appear to be slight social blunders and observe other people's reactions. If they are not as harsh as expected, the person's social anxiety may begin to fade.
For a person with PTSD, exposure might consist of recalling the traumatic event in detail, as if in slow motion, and in effect re-experiencing it in a safe situation. If this is done carefully, with support from the therapist, it may be possible to defuse the anxiety associated with the memories. Another behavioral technique is to teach the patient deep breathing as an aid to relaxation and anxiety management.
Behavioral therapy alone, without a strong cognitive component, has long been used effectively to treat specific phobias. Here also, therapy involves exposure. The person is gradually exposed to the object or situation that is feared. At first, the exposure may be only through pictures or audiotapes. Later, if possible, the person actually confronts the feared object or situation. Often the therapist will accompany him or her to provide support and guidance.