ABA vs CBT: What is the difference?

What is Applied Behavior Analysis (ABA)?

Applied Behavior Analysis focuses on improving specific behaviors, such as social skills, communication, and academics, as well as adaptive learning skills such as fine motor dexterity, hygiene, and job competence. ABA therapists understand how human behaviors are learned and can be changed over time.

ABA is commonly used for children with autism. According to the Center for Autism, ABA helps autistic children improve social interactions, learn new skills, and reduce challenging behaviors. ABA is currently the most well-researched and effective treatment for reducing severe challenging behavior like kicking, hitting, and self-injurious behavior. 

How does ABA work?

ABA therapy includes many different techniques, all with the goal of increasing helpful behaviors and decreasing behaviors that are harmful or affect learning. The techniques focus on antecedents (what happens before a behavior occurs), and on consequences (what happens after the behavior). Positive reinforcement is one of the main strategies used in ABA.

A board-certified behavior analyst (BCBA) designs and oversees the program. After conducting a Functional Behavior Assessment (FBA) to determine the cause of the unwanted negative behavior, the BCBA develops an individualized treatment plan that includes teaching adaptive behaviors that serve the same purpose for the child as the negative behavior. As the child learns that the new adaptive behavior results in positive reinforcement, the frequency of the new adaptive behavior increases while the negative behavior decreases.

Parents, family members, and caregivers also receive training so they can support learning and skill practice throughout the day. The child will have many opportunities to practice the adaptive behaviors in naturally occurring situations. For the greatest results, ABA requires heavy monitoring and continuous evaluation to modify treatment as it progresses. 

What is Cognitive Behavior Therapy (CBT)?

Cognitive behavioral therapy is a form of talk therapy counseling that can help children learn techniques for managing emotions, communicating, resolving conflicts, and coping with stressful situations. CBT is considered one of the most effective treatments for depression and anxiety because it helps patients recognize and change the thought processes that are causing the problem.

CBT can be very helpful in treating mental health disorders. But not everyone who benefits from CBT has a mental health condition. CBT can help anyone better manage stressful life situations by giving them the power to cope with their situation in a healthy way. The coping skills children learn can help them manage and conquer negative feelings and fears. 

How does CBT work?

In CBT, the child works with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. The rationale behind CBT is that a person's negative thoughts produce negative emotions and behavior. During the sessions, the therapist helps the child examine the relationship between emotions, behaviors, and thoughts.  CBT helps the child become aware of inaccurate or negative thinking so they can view challenging situations more clearly and respond to them in a more effective way. CBT also often includes practicing techniques such as relaxation, coping, resilience, stress management, and assertiveness. 

There's little risk in getting CBT, but because it explores painful feelings, emotions, and experiences, the child may feel emotionally uncomfortable at times. The child may cry, get upset, or feel angry during a challenging session. Some forms of CBT, such as exposure therapy, may ask the child to confront situations they would rather avoid. This can lead to temporary stress or anxiety. However, working with a skilled therapist will minimize any risks.

Conclusion of ABA vs CBT

Both ABA and CBT are considered evidence-based best practice treatments by the U.S. Surgeon General and by the American Psychological Association. “Evidence-based” means that the treatment has passed scientific tests of its usefulness, quality, and effectiveness. So, depending on your child’s particular needs, either or both of these therapies might be good options for you to discuss with your child’s team at school.

In subsequent articles, we will delve further into more specifics pertaining to ABA and CBT as individual articles going forward as each one has its place in better serving children with special needs.