Home » Anxiety » Blogs » Anxiety and OCD Exposed » Challenges in Behavior Therapy

Challenges in Behavior Therapy

I’m pretty sure that I came out of the womb as a cognitive behavioral therapist. Well, maybe a behavioral therapist—I guess I wasn’t using language those first few months. But, I’ve always been acutely aware of how rewards, lack of rewards, and thinking all interact and influence feelings and behavior.

In my early training, I considered myself a radical behaviorist. I still do pretty much. I believe that the words we use and the thoughts we think can be considered verbal behavior. But, those beliefs are much more complex than what I wish to discuss today.

What I’d like to convey in today’s blog is that many people think that rewards, encouragement, planned ignoring, and sometimes small punishments are the simple answers to getting people to do what you want them to do. Well, it’s not so simple. We don’t always have the full deck to play with when it comes to behavior modification.

When I work with kids, parents, and teachers, I work from a Cognitive Behavioral Model. Yet, I can’t always tell teachers or parents to reward one behavior or ignore another and get the results that I expect. Sometimes, there are other aspects of a child’s environment that strongly influences his or her behavior. It could be a sibling, a friend, a parent, or a strong belief that the child has that no one has really uncovered. Those other influences can be tough to figure out.

I like to tell stories to illustrate my points. When my twins were 2 years old, I really wanted them to stop throwing food at each other (and on the floor, the high chairs, the counters and sometimes me). So, I decided to ignore them. That principle is called extinction. If a parent stops giving a child attention for misbehavior, the behavior should first get worse, and then gradually fade over time. When I implemented this procedure for my twins, I expected the throwing to increase—a last ditch effort to get mom’s attention. And it did, I was strong—tried not to laugh (not always so easy to do by the way). But after a few days, I noticed that the ignoring was having absolutely no effect. The girls were still hurling food and giggling away. Eventually, I realized that I had nothing to do with it.

You see, I was not the chief reinforcer—my kids were reinforcing each other. There was not much to be done about that other than separate them or punish them. I chose not to separate or punish them. Eventually, throwing food became less fun. My kids are now adults; and guess what? I rarely (actually never) see them throw food at each other—but they can still make each other laugh—more so than anyone else in the world. And when I hear them laugh today and get a little silly, I remember the lesson they taught me about behavior modification and I smile.

Challenges in Behavior Therapy

Laura L. Smith, Ph.D.

Laura L. Smith, Ph.D. is a clinical psychologist who specializes in the assessment and treatment of adults and children with obsessive compulsive disorder, as well as personality disorders, depression, anxiety, ADHD, and learning disorders. Dr. Smith is a widely published author of articles and books to the profession and the public, including: Overcoming Anxiety For Dummies (2E), Obsessive Compulsive Disorder For Dummies, Seasonal Affective Disorder For Dummies, Anxiety and Depression Workbook For Dummies, Depression For Dummies, Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth, and Why Can’t I Be the Parent I Want to Be? Her website is:

11 comments: View Comments / Leave a Comment



APA Reference
Smith, L. (2012). Challenges in Behavior Therapy. Psych Central. Retrieved on October 1, 2020, from


Last updated: 20 Jan 2012
Statement of review: Psych Central does not review the content that appears in our blog network ( prior to publication. All opinions expressed herein are exclusively those of the author alone, and do not reflect the views of the editorial staff or management of Psych Central. Published on All rights reserved.