Behavior Therapy for Kids: 9 Fun Games and Techniques

In its many forms, behavior therapy is a powerful tool for treating a wide range of psychological disorders in children, aiming to increase their skills and give them more options for how to respond to situations and events (Stallard, 2021; Corey, 2013).

As counselors and therapists, we can take many of its tools and techniques to create powerful yet fun interventions to help our young clients with depression, anxiety, post-traumatic stress disorder, and more.

This article explores behavior therapy for kids, its modern interpretations, and its potential for working with toddlers, young, and older children to support their mental wellbeing and develop effective coping and behavioral strategies.

Before you continue, we thought you might like to download our three Positive CBT Exercises for free. These science-based exercises will provide you with detailed insight into positive Cognitive-Behavioral Therapy (CBT) and give you the tools to apply it in your therapy or coaching.

Using Behavior Therapy for Kids and Toddlers

Behavior therapy has developed over many years and takes several different forms, yet it still plays a vital role in treating children’s psychological problems (Corey, 2013; Stallard, 2021).

Indeed, having evolved into Cognitive-Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and mindfulness-based stress reduction, it remains successful in treating behavioral and mental health problems in many young people (Kallapiran et al., 2015; Stallard, 2021; Zalewski et al., 2020).

Such therapy is vital. “Therapists are increasingly called on to provide evidence-based treatments to the children and families with whom they work,” with research suggesting that young minds function similarly to adults in many respects (Flessner & Piacentini, 2017, p. 3).

CBT, in particular, includes various interventions focusing on the “relationship between cognitions, emotions, and behaviors” and is the most well-evaluated and established approach of all child psychotherapies (Stallard, 2021, p. 16).

Research consistently shows CBT’s effectiveness in treating a range of problems in children, including (Stallard, 2021):

• Emotional problems
• Post-traumatic stress disorder
• Anxiety
• Obsessive-compulsive disorder

Studies also document the success of third-wave positive CBT interventions, such as mindfulness, DBT, and ACT, in treating children (Stallard, 2021).

Check out this video explaining how behavioral modification can help children make better choices.

In the following video, we gain a deeper understanding of behavior therapy as a treatment to improve children’s self-esteem and self-control.

3 Helpful Techniques

Behavioral therapy offers a wide range of techniques, many of which are based on classical and operant conditioning.

They support and reinforce helpful, positive ways of behaving and are beneficial for treating children in various challenging situations (Stallard, 2021).

For example, systematic desensitization can help young people confront their fears, while response prevention and exposure treatments can support overcoming obsessive-compulsive disorders (Stallard, 2021).

In more detail, here are several behavioral techniques (Stallard, 2021).

Developing fear hierarchies

Skill development is vital for helping children manage challenging situations and is often facilitated by a process of graded exposure (Stallard, 2019).

“The process of breaking down challenges or fears involves generating a list of the small steps that will take the young person towards their goal of overcoming their fear or challenge” and understanding the situations in which they occur (Stallard, 2021, p. 77).

For example, a child afraid of crowds may avoid busy situations such as boarding a train or going to the movies.

Once identified and understood, the therapist can help the child select a goal they can begin with and work toward, such as meeting a friend for a playdate. The child then rates their anxiety when considering each step or task involved in reaching their goal.

Walking down the street on a quiet Sunday morning may only score 60 out of 100, while entering the playground at peak time reaches 90.

Developing a fear hierarchy helps the child (and their parents) target particular actions and recognize successes one step at a time (Stallard, 2021).

Graded exposure

Having established a fear hierarchy, the child can move on to a process of graded exposure, where they begin facing their fears, albeit gradually (Stallard, 2021).

Through slowly and increasingly exposing the child (according to a plan agreed upon by them) to a higher degree of fear, they learn what they can handle without recourse to avoidance (of particular situations or events) or relying on unhealthy habits.

However, the child must be clear on the rationale behind the process and why facing their fear is beneficial. The therapist will help the child understand (Stallard, 2021):

• Why they have been avoiding situations and relying on repetitive behaviors to manage their anxiety
• How avoidance and habits offer short-term relief but do not ultimately help them cope
• How facing their fears is a different approach that may help them reclaim their life
• That they can take their fears with them rather than letting anxiety stop them from doing things they want
• How learning to tolerate unpleasant feelings will reduce their anxiety

A full explanation of the rationale helps the child feel less apprehensive.

Additionally, each step toward the chosen goal must be manageable and achievable.

The child may wish to rate their anxiety using a score out of a hundred during and after the exposure to increase their sense of control and recognize its decline when they stay in the situation (Stallard, 2021).

Once the graded exposure exercise is complete, it may help them to reflect on what they discovered, celebrate their achievements, and set their next goal.

Response prevention

Young people experiencing obsessive-compulsive disorder (OCD) often engage in safety behaviors — repetitive and compulsive habits to prevent bad things from happening (Stallard, 2021).

These might include excessive cleaning (of oneself or objects), endless checking (faucets are off, doors are locked), or counting (performing actions a set number of times).

Such behaviors can bring temporary relief from anxiety but do not last.

The goal of response prevention is to face the fear without engaging in the safety behavior.

The nature of the intervention depends on the fear experienced by the child. Examples for a child with OCD might involve the following (Stallard, 2021):

• If they fear contamination, ask them to touch a toilet seat and delay washing their hands.
• If they feel the need to maintain order or arrange objects to avoid a bad thing happening, change the sequence of something, such as favorite books or toys.
• If they have a fear of a particular event, such as a running faucet causing a flood, leave it on until they have dried their hands.

Again, the child must have a clear rationale and understanding of why the process helps.

For example, explaining that while continually repeating their habits may temporarily make them feel better, they can learn that they don’t need it when they notice their worrying thoughts.

Behavior Therapy in Schools: 4 Strategies

Addressing mental health issues in schools is recognized as valuable in promoting a thriving learning environment and supporting academic achievement (Crenshaw & Stewart, 2015).

Several well-proven strategies include the following.

Rewards strategies

“It is common for young people with psychological problems to ignore or overlook their achievements” (Stallard, 2021, p. 88). Without a reward, children may not reproduce what led to the positive outcome.

Therefore, positive consequences can help increase the likelihood of a behavior happening, while harmful consequences can reduce it.

Incentives can take various forms and are not limited to money or prizes. They might include self-praise, recognition from others, extra time for doing fun things, etc. (Stallard, 2021).

The following steps can help set up reward systems in school (or home settings):

1. Define clear, positive behaviors. Identify specific and positive target behaviors.

Rather than vague or negative terms like “being good” or “not fighting,” use precise, affirmative language such as “sitting quietly during mealtime” or “sharing toys graciously.”

2. Establish meaningful rewards. Work with the child to choose a motivating and attainable reward, ensuring it holds personal value for them.

It doesn’t have to be extravagant or costly. Consistent praise and recognition are equally crucial in reinforcing positive behavior.

3. Set achievable targets. Agree on how often the expected behavior should happen and a suitable reward.

Consider the nature of the behavior, ensuring the goals are reachable within a short enough period to hold the child’s motivation.

4. Be consistent. Maintain a uniform approach by consistently recognizing and rewarding the agreed-upon behavior.

Being consistent can be challenging, as it involves unwavering adherence to the reward system rules, positively reinforcing the desired behavior, and avoiding reward withdrawal due to unrelated misbehavior.

5. Emphasize importance and encouragement. Use the reward chart to draw attention to progress and offer frequent praise and acknowledgment.

Even on challenging days, it’s essential to encourage the child to persevere. Remind them of their progress and the rewards they can achieve through positive behavior.

Both educators and caregivers can help reinforce good behaviors by implementing reward systems, making the desired behaviors attractive and rewarding.

Role-play

While role-play is often used in therapy, it can be helpful in school settings (Saptono et al., 2020).

When used effectively, playing out roles can help practice coping and communication skills and work through what has happened or could occur in the future (Stallard, 2021).

For example, role-play a particular incident: “I got upset when working on the team project last week. What could I do differently next time?” or more generally, “I get annoyed when I don’t get something right the first time, but going forward, I will try to accept that learning takes time.”

Problem-solving

Problem-solving is a vital aspect of learning. Frustration, anxiety, and fear may hinder decision-making, leading to emotive rather than rational choices that delay or avoid addressing educational issues and challenges (Juandi, 2021).

For younger schoolchildren, a red, yellow, green traffic light strategy offers a simplified, three-step approach to tackle challenges (Stallard, 2021):

1. RED – Stop and identify. Encourage the child to pause and clearly articulate their problem. It’s about ensuring they understand the issue before rushing to solve it.
2. YELLOW – Think and consider. Prompt them to brainstorm possible solutions. They can then evaluate each one, weighing its pros and cons, and decide which seems most promising.
3. GREEN – Act and reflect. Lastly is the action phase, where children proceed with the chosen solution. Encourage them to seek any necessary assistance and, importantly, to reflect upon the outcome. Was the solution effective? Would they use it again? Such post-action reflection helps reinforce the problem-solving process.

The easy-to-remember traffic light method structures problem-solving into distinct phases, guiding children through a deliberate thinking process rather than allowing them to act impulsively (Juandi, 2021).

Play therapy

Behavioral aspects of CBT can remove many of the limitations of verbal treatment in younger children (Crenshaw & Stewart, 2015).

Cognitive-Behavioral Play Therapy is a particularly effective treatment for anxiety and, therefore, helpful in school settings. It leverages children’s natural means of expression — play — to help them process and cope with their emotions and experiences, offering (Crenshaw & Stewart, 2015):

• Insightful problem-solving
  Children learn to understand and solve problems on a deeper level through play, gaining valuable insights into various, often complex, situations.
• Flexible thinking
  This encourages adaptability, allowing children to approach problems from multiple angles and understand possible ways to tackle challenges.
• Divergent thinking
  Children expand their imagination and creativity, exploring possible solutions and ideas.
• Alternative coping strategies
  Play scenarios and environments enable children to develop different methods of managing daily issues, providing them with practical coping mechanisms.
• Positive emotional experiences
  Allows children to experience joy, which can be therapeutic and contribute to emotional wellness.
• Exploration of emotions
  Such therapy creates a safe space for children to express and think about various emotional themes, both positive and negative, helping them process how they feel.
• Empathy and perspective taking
  During interactions, children learn to understand others’ emotions and view situations from their standpoint, fostering empathy and social understanding.
• General adjustment
  This supports children’s ability to adapt, helping them become well-rounded individuals capable of handling various social situations and life changes.

Play therapy offers a holistic approach to children’s behavioral therapy by tapping into multiple processes simultaneously, “helping children address emotional and behavioral problems” (Crenshaw & Stewart, 2015, p. 84).

6 Fun Games and Exercises for Your Clients

Games offer young clients a helpful and energizing tool for engaging in things they enjoy, socializing, feeling a sense of achievement, and spending less time on negative thoughts (Stallard, 2021).

The following is a sample of several fresh and fun games and exercises that can be used to encourage engagement, build upon skills, and improve emotional awareness in children:

1. Future Forecast: Decision Impact Exercise
   In this fun exercise, children role-play scenarios and explore decision-making and their consequences. In doing so, they list options, predict outcomes, and reflect on their choices.
2. Choose Your Path Adventure
   In this playful activity, the child embarks on imaginary adventures, facing challenges and making decisions. Along the way, they explore actions, discuss outcomes, and review their journey.
3. Magic Detective Game
   A young client investigates (apparently) “silly” or troubling thoughts, testing their validity. Using detective play, they search for evidence to confirm or refute these beliefs.
4. Fear Ladder Challenge
   For this task, the child identifies fears and sets gradual and incremental challenges to confront them. A ladder helps track their progress and reflect on their bravery.
5. Fun Detective Diary
   During this enjoyable exercise, children become “detectives” to rediscover activities that boost their mood. They document them and observe their impact on emotions.
6. Body & Mind Superheroes Activity
   Clients explore dilemmas based around superheroes, learning to recognize warning signals. Next, they work through positive behaviors to build a helpful toolkit for finding solutions to tricky situations.

If you’re looking for more science-based tools to help others through CBT, check out this collection of 17 validated positive CBT tools for practitioners. Use them to help others overcome unhelpful thoughts and feelings and develop more positive behaviors.

A Note on Behavior Therapy for Autism

Behavioral therapy has proven helpful in clients with autism who experience anxiety during treatment (Stallard, 2021).

Research has shown that approaches such as CBT, ACT, and mindfulness are effective and practical for addressing anxiety, disruptive behaviors, and other symptoms in clients with autism, ultimately enhancing their psychological wellbeing (Danial & Wood, 2013; Byrne & O’Mahony, 2020; Cachia et al., 2016).

A Take-Home Message

As a therapist, understanding and embracing tools and techniques for behavior therapy for kids can be transformative in helping children overcome psychological challenges.

Rewards are powerful for reinforcing positive behaviors in children. They involve using clear definitions, meaningful incentives, achievable targets, consistency, and encouragement to make change appealing to children.

Role-play can also be effective in therapy, at home, and in school. Supporting and engaging with young clients as they act out a scene as themselves or others in their lives can offer helpful insights when trying out coping and communication skills.

Children also benefit from becoming better problem-solvers, particularly in their education. Learning the skills and mindset involved supports deliberate thinking and decision-making and can reduce the likelihood of impulsive actions.

Play helps address anxiety in school and home settings, promoting problem-solving, flexible thinking, emotional exploration, empathy, and general adjustment in children.

Therapists can create engaging, effective, and enjoyable interventions to support children’s mental wellbeing and enhance their coping strategies by embracing these fresh and fun ideas.

Try out several of the fun activities and exercises to empower your young clients on their path to better mental health.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free.