Jun 1, 2024

Treatment modalities in behavioral health

Treatment modality


Cognitive Behavioral Therapy (CBT)

Based on the principle that our thoughts/beliefs about ourselves, others, and situations can affect our emotions and behavior.


In collaboration with a therapist, clients work to identify and challenge their negative, faulty thoughts and replace them with more objective, realistic thoughts (which can result in improved emotional well-being and coping)


Clients are often given homework assignments where they apply skills that they have acquired in therapy to situations in real life.

Dialectical Behavioral Therapy (DBT)

Focuses on the balance between acceptance and change (“dialectical”).


DBT helps clients to change their outlook/mindset by teaching them how to accept the current situations and recognize their emotions, while still working towards the change that is required to enhance their well-being.


There are four core skills in DBT:

  • Distress tolerance – learning to manage overwhelming feelings in healthier ways, rather than self-destructively

  • Mindfulness – Being aware and focused on the present moment instead of on the past

  • Emotional regulation – Regulating and managing emotional extremes

  • Interpersonal effectiveness – Learning to manage conflict, set limits, and manage emotional reactivity in relationships

Acceptance and Commitment Therapy (ACT)

Clients learn to accept and experience their emotions without judgement, rather than avoid them.


There are six key principles in ACT:

  • Acceptance – Acknowledging and embracing the full range of one’s thoughts and emotions.

  • Being present – Being aware of what is happening in the present moment.

  • Cognitive defusion – Observing your thoughts as they are, without trying to change or dispute them

  • Committed action – Taking action to make changes that match your values.

  • The observing self – People have an identity beyond their thoughts, feelings, and experiences

  • Values – Identifying what you truly value and care about


Couples Therapy

A type of counseling that helps romantic partners resolve relationship problems, enhance communication, and strengthen their emotional and physical bond.


Therapy sessions usually involve both partners, but sometimes individual sessions can be a part of the process. 


May employ techniques from variety of modalities. 

Family Systems Therapy

While traditional therapy focuses more on the individual, family therapy addresses the behaviors of all family members and the way these behaviors affect not only individual family members, but also relationships between members and the family unit as a whole.


Getting other family members involved in the therapeutic process will result in more effective solutions. This therapy is goal-oriented and work toward an establish end result. 

Group Therapy

Group members learn effective ways to deal with certain issues from one or more psychologists who have specialized training. Group topics may focus on a mental health condition, substance use, interpersonal skills, bereavement, etc.


Benefits of group therapy:

  • Groups can act as a support network.

  • Listening to others can help you gain better insight and perspective into your own challenges.

  • It can be helpful to listen to others share their experiences and understand you’re not alone.

  • You can learn from the way that other people solve problems and improve their own situations.

Exposure and Response Prevention (ERP)

A form of Cognitive Behavioral Therapy (CBT) that is used to treat a variety of conditions, including anxiety, phobias, eating disorders, and Obsessive-Compulsive Disorder (OCD).


ERP works to gradually reduce the anxiety that drives obsessions and compulsions.

  • Individuals are directly exposed to stimuli that generally evoke fear, distress, obsessive thoughts, or compulsive/ritualistic behavior (exposure component).

  • They learn therapeutic techniques to help prevent their usual maladaptive response; as a result, they learn that they can manage triggers without having to engage in their compulsive rituals (response-prevention component).


People discover with time that the triggers, thoughts, and emotions that cause compulsions are less distressing than they expected, and that being exposed to their fears does not actually lead to the outcome that they fear. 


Eye Movement Desensitization and Reprocessing (EMDR)

A type of structured therapy that treats individuals who have experienced and/or witnessed a traumatic event(s). It is based on the notion that when traumatic memories are not processed, they can manifest in the form of anxiety, depression, PTSD, and other trauma-related conditions.


In an EMDR session, the therapist leads the patient through a set of standard processes that aim to activate both sides of the brain. This bilateral activation can be done in different ways, but the most usual one is moving the eyes from side to side. Other methods include switching sounds or taps. 


EMDR aims to alter how the brain stores the memory, which can reduce and eliminate and troublesome symptoms. 

Motivational Interviewing (MI)

This intervention helps individuals become motivated to change the behaviors that are preventing them from making healthier choices in their lives. It can be beneficial for individuals who may not be ready to commit to making a change.


Motivational Interviewing is guided by four key principles.

  • Expressing empathy – The therapist listens carefully to the patient and conveys that they understand the patient’s feelings, beliefs, and experiences.

  • Encouraging self-efficacy – The therapist supports the patient’s belief in themselves that they can change even if previous efforts at change may have not succeeded. 


Medication Assisted Treatment

The Food and Drug Administration (FDA) has approved several different medications to treat Alcohol Use Disorders (AUD) and Opioid Use Disorders (OUD). These medications help to balance brain chemistry, prevent the pleasurable effects of alcohol and opioids, reduce physical cravings, and regulate body functions without the harmful and addictive effects of the substance used, which can assist with recovery. 


Medications for Alcohol Use Disorder include:

  • Acamprosate

  • Disulfiram

  • Naltrexone


Medications for Opioid Use Disorder include:

  • Buprenorphine

  • Methadone

  • Naltrexone

Transcranial Magnetic Stimulation

A non-invasive method of delivering electrical stimulation to the brain. TMS is generally indicated as a treatment for depression and other psychiatric/neurological brain disorders for individuals 18 years of age or older, who despite adequate trials of evidence-based psychotherapy and pharmacotherapy, have demonstrated a lack of significant improvement in symptoms. 


TMS involves placement of small coil over the scalp and passing a rapidly alternating current through the coil wire, which produces a magnetic field that passes unimpeded through the scalp and bone, resulting in electrical stimulation of the cortex. 


The use of TMS is typically recommended for up to 30 visits over a seven-week period followed by six taper treatments.


Sources: psychologytoday.com; verywellmind.com; mayoclinic.org; apa.org; samhsa.gov; bcbsri.com

Behavioral Health Case Management program highlight

The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and substance use professionals who can help members find the care they need, provide education and support, and provide assistance when transitioning from acute levels of care, closing gaps related to social determinants of health and coordination with healthcare professionals.   

Behavioral Health Case Managers are available Monday through Friday from 8 a.m. to 4:30 p.m. To refer a patient to the BCBSRI BH Case Management Program, please call 1-800-274-2958 or email bh_care_management@bcbsri.org.

You may also use our automated referral form at BCBSRI.com by following these easy steps: 

1. Log on to the provider portal of BCBSRI.com.

2. Click on Tools and Resources.

3. Click on Forms.

4. Click on Case Management Request.

5. Complete the required fields and click Go!

For additional information, please contact Monica Ross at monica.ross@bcbsri.org