Behavioral techniques: systematic desensitization, flooding, token economies and the rest.
The technique names, who they are attached to, and the scenario each one fits.
By Dr. Andrew Wichterman · September 15, 2026 · 5 min read · Updated October 4, 2026
Behavioral techniques are tested by description: an item describes a procedure and asks for its name, or names a client problem and asks for the technique. The list is finite.
Anxiety and exposure
- Systematic desensitization (Wolpe): relaxation training, an anxiety hierarchy, and gradual paired exposure, usually imaginal. Based on reciprocal inhibition and counterconditioning.
- In vivo exposure: real-life, graduated.
- Flooding: prolonged exposure to the most feared stimulus without gradual steps. Implosive therapy (Stampfl) is the imaginal version with psychodynamic themes.
- Exposure and response prevention: for OCD; exposure to the trigger while blocking the compulsion.
- Interoceptive exposure: inducing the physical sensations of panic deliberately.
- Relaxation training: progressive muscle relaxation (Jacobson), diaphragmatic breathing, autogenic training. Biofeedback uses instruments to show physiological state.
Reinforcement-based
- Token economy: tokens earned for target behaviors, exchanged for reinforcers; used in institutions and classrooms.
- Contingency contracting: a written agreement specifying behaviors and consequences.
- Shaping: reinforcing successive approximations. Chaining: linking behaviors in a sequence.
- Differential reinforcement of other, alternative or incompatible behavior, to reduce a problem behavior without punishment.
- Premack principle: a high-probability behavior reinforces a low-probability one ("Grandma's rule").
- Extinction: withholding reinforcement; expect an extinction burst first.
- Time-out: removal from reinforcement (negative punishment). Response cost: loss of a reinforcer. Overcorrection: restitution and positive practice.
Aversive and covert
Aversion therapy pairs the target behavior with an unpleasant stimulus (disulfiram for alcohol is the medical version); ethically constrained. Covert sensitization (Cautela) does this in imagination. Thought stopping. Behavioral techniques relying on imagery are called covert conditioning.
Skills and self-management
Assertiveness training, social skills training, behavioral rehearsal and role play, modeling (Bandura), self-monitoring, stimulus control (changing the environment to remove cues), and behavioral activation (scheduling reinforcing activities, first line for depression). Habit reversal training for tics and hair pulling.
Matching the technique to the problem
Specific phobia: systematic desensitization or graduated in vivo exposure; flooding if the stem emphasizes rapid, intense exposure. Panic disorder: interoceptive exposure plus breathing retraining and psychoeducation about the panic cycle. Obsessive-compulsive disorder: exposure and response prevention, and the stem will mention blocking the ritual. PTSD: prolonged exposure or trauma-focused approaches with an exposure component. Depression: behavioral activation, scheduling activities that are mastery- or pleasure-producing, before or alongside cognitive work. Social anxiety: social skills training with behavioral rehearsal and exposure.
Child noncompliance or tantrums: differential reinforcement, planned ignoring with an expected extinction burst, and time-out used briefly and consistently. Tics and hair pulling: habit reversal training, with awareness training and a competing response. Insomnia: stimulus control, the bed for sleep only, and sleep restriction. Smoking or problem drinking: stimulus control, contingency management and, historically, aversive or covert sensitization. Institutional settings and classrooms: token economies. Couples: contingency contracting and behavioral exchange. When the item names a problem, the technique is usually one of these, and the distractors are techniques for the neighboring problems.
What makes a technique behavioral
Behavior therapy defines the problem in observable, measurable terms, assesses it with a functional analysis of antecedents, behavior and consequences, sets specific goals, applies a technique derived from learning theory, measures the result against the baseline and adjusts. It is present-focused, and insight is not required for change. That last point separates it from psychodynamic approaches and shows up in items that ask what a behavior therapist would not do: explore childhood origins, interpret the symptom's meaning, or wait for the client to understand the problem before acting on it.
It also separates behavioral from cognitive techniques, which target thoughts, though the two are usually combined in practice and the exam will say "cognitive-behavioral" when it means the combination. A technique is behavioral when the change mechanism is a new association, a consequence, or observation of a model, and when progress is measured in frequency, duration or intensity of a behavior. Items that use the phrase "empirically supported treatment" are usually pointing at a behavioral or cognitive-behavioral protocol, because those are the approaches with the most controlled-trial evidence.
Three items, worked
A client with a fear of elevators is taught progressive muscle relaxation, builds a list of situations from looking at an elevator to riding one alone to the top floor, and works through the list in imagination while relaxed. Systematic desensitization, Wolpe, counterconditioning. If the counselor had taken him directly into an elevator for an hour, it would be in vivo flooding. A client with compulsive hand-washing touches a doorknob in session and is asked to wait, without washing, while her anxiety rises and then falls. Exposure and response prevention.
A client with depression who has stopped doing anything she enjoys agrees to schedule a twenty-minute walk and a phone call to a friend for each of the next three days and to rate her mood before and after each. Behavioral activation. The distractors will include cognitive restructuring, which works on the thoughts about the activities rather than the activities, and systematic desensitization, which is for anxiety. Name the mechanism, name the target, and the technique has a name.
Assessment
Functional behavioral assessment identifies antecedents, the behavior and consequences (the ABCs). Baseline measurement precedes intervention. Single-case designs (ABAB) evaluate it. Behavioral goals are specific, measurable and observable, and the exam prefers them written that way in treatment plans.
Practice this. The flashcards and practice tests on this site are sorted by content area, so you can drill this one until it holds.
Gradual is desensitization, all at once is flooding, tokens are an economy, and everything else follows from the four-cell reinforcement table.