While the title may sound complicated, ABA Therapy is an easily adaptable tool to make meaningful changes in many kinds of behaviors. Anxiety can be managed with some of these tools and can be especially helpful for yourself and your children or teens who struggle with particular behaviors due to anxiety-avoidance.
What is ABA Therapy?
In short, ABA stands for Applied Behavior Analysis.
ABA Therapy is the application of an individualized therapy plan based on our understanding of behavior. It is considered the gold star for treating kids with autism. But you don’t have to have autism to benefit from the principles behind ABA Therapy. The basic idea is to increase healthy behaviors and decrease unhealthy or destructive ones.
How Does ABA Therapy Work?
ABA uses observable and measurable data (ABC data) to understand behavior and to look for patterns. ABC data stands for Antecedent, Behavior, and Consequence.
- Antecedent: What happens right before, usually seconds before, a behavior.
- Behavior: The event or action in question.
- Consequence: What happens right after the behavior.
For example, if you have social anxiety, you might have difficulty going into public spaces. When negative things happen while you are out (loud noises, too big a crowd, an anxiety attack, etc.), it can make your anxiety worse causing anxiety-avoidance, meaning you stop going out in public as much – or at all because you want to avoid that feeling of anxiety.
This might look like an attempt at lunch with a friend. Maybe your friend wants to try a new restaurant that is unfamiliar to you and it is very crowded. Because you are trying to connect with your friend, you work hard at calming yourself as you can feel yourself getting more anxious, but not yet at a breaking point.
You try to pay attention to the story your friend is telling you but you are expending a lot of energy at maintaining your composure as you look around the restaurant. You hear all the voices mingling together and they might seem louder than you would expect, making it hard for you to hear what your friend is saying. You hear the clanging dishes and the servers calling out orders. The kitchen door might be flapping back and forth, back and forth, and you realize just how warm it is in there as you remove your sweater.
You laugh nervously as your friend continues her story and adjust yourself in the seat putting an arm up to lean on as you try to block out the noise. You are gaining focus little by little as you close out everything else around you and keep an inner monologue of encouragement to just get through it.
A full tray of food falls to the ground and you jump so hard you hit your leg under the table. Your friend looks at you very concerned as she notices the tears clinging to your eyes. You swallow hard and run to the bathroom as sob erupts from your throat. When you get to the bathroom you lock yourself in a stall and let the flood go. Your heart is racing, your breathing is so labored that your throat hurts, and you are sweating.
Maybe you chastise yourself for being dramatic as you go through tissues trying to calm your nerves.
You just had an anxiety attack.
- A: So what is the antecedent here (the thing that triggered your anxiety attack)? You already struggle with social anxiety so there were many triggers here. In this situation, there was a build-up but you were still managing to some extent. In this case, the antecedent is the dropped tray that pushed you over the edge.
- B: The behavior is the anxiety attack. In ABA Therapy we would work to lessen the occurrence of them because they suck. A lot. Plus, they are hard on your body and often on your daily life.
- C: The consequence might be that you don’t go anywhere for a while and maybe you avoid that friend for a while because you feel embarrassed or you don’t want to explain what happened to you. (Though I recommend confiding in your friends). It could be argued that another consequence might be that your body is now exhausted and you have to recover.
This information is invaluable when trying to figure out triggers and a plan to help manage your anxieties. First, you must understand where your behavior comes from before you can modify it.
Positive Reinforcement is another tool in the ABA toolbox. In ABA terms, positive reinforcement means adding something to the environment that is valued. If you are a person who likes deep physical pressure (think bear hugs and weighted blankets) then you might consider wearing something with pockets (like a hoodie or sweater coat) if you were in the situation above and perhaps put weights in the pockets which will give your body the calming sensation of that weight or pressure.
I know what you are thinking, that’s weird, right? Who wants to walk around with weights in their pocket while they are out with a friend. But you can do this very discreetly and the weights don’t have to be actual weights. Maybe it is just a heavy stress ball or a few rocks. The benefit to something like this is that you can also fidget with your hands in your pockets if you need to draw your attention from the perceived chaos around you. This gives your mind something to focus on to pull attention away from the trigger and onto something where you can then regain control.
Many people feel calmer and safer when they have additional weight over them or on them. We did this with our youngest, he had a weighted “snake” he would sit on his lap to help calm him. It was made from a piece of soft fabric that I sewed a whole bag of beans into. This could be a tool that you bring with you that helps redirect some of the anxiety in order to prevent an anxiety attack and with practice, make your time with your friend more enjoyable – or at least tolerable. Which brings me to my next point.
Exposure Therapy to Lessen Avoidance Behavior
Once you understand ABC data and you have identified some positive reinforcement tools, you can begin working toward lessening your avoidance behavior through the use of exposure therapy.
Exposure therapy is just what it sounds like, you expose yourself to triggers (things that create anxiety or a feeling of unease) a little at a time in a safe way until you build up more tolerance – which often comes from just understanding what it is that triggers you and then working through that with alternative behaviors and tools and having a plan so you feel safe.
Once you have the tools you need, working through situations that are anxiety-inducing gets a little easier each time. One note, don’t ever put yourself in an unsafe situation or push harder than you can tolerate. This is a marathon, not a sprint.
When I worked as a licensed behavior therapist, I worked with a BCBA (Board Certified Behavior Analyst) to provide ABA therapy for our young clients. If we were working on a particularly difficult task for them, I would break it down into smaller tasks, and if necessary, smaller still. I applied this same idea at home with my youngest when he was going through the worst of his anxiety.
He had panic attacks with anything school-related. We went from public school (he had just started middle school) to online school. One day the online school had some technical difficulties on a day he was already at his limit. We couldn’t get him to the computer (where he logged in to do his live class sessions) without full-on hyperventilating anxiety attacks.
Desperate to help him, I told my husband that we need to break the task down for him because he is incapable of logging on to school right now, it was just asking too much of him. So we decided that we would start with a conversation about logging on and talking about the things that make him nervous and what he does like about online school. This was our first step when he was at a place where he was calm enough to have a conversation.
Then later we made the next step and told him all he had to do was just open up his laptop for ten minutes (because he associates the laptop with doing school and it was only used for school). He had to be in the same room as the laptop, which at this time was in the living room in a little nook we created for him, but he didn’t have to sit in front of it. He could do anything he wanted in that room, he didn’t have to even look at the laptop or acknowledge it after he opened. Even sharing a large physical space in the same room as the laptop, his access to school, was anxiety-inducing. But slowly we made progress, and he wasn’t having anxiety attacks that shut down his whole body for hours afterward. THAT is a win. THAT is ABA Therapy.
Putting it All Together
A lot of ABA is reframing your thoughts and ideas on how a thing should be. None of that suck-it-up stuff. Behaviors have antecedents (triggers, reasons for happening). That’s where you focus and apply your knowledge and tools. And doing that will make more meaningful changes than forcing a whole change on a person who is not ready for that step. Imagine if we had just forced our son to sit down and do school. There would definitely be no learning happening and very likely a greater anxiety response. Start wherever you need to, no matter how far away you think it is from the goal. You’ll be surprised at the progress you can make with this model.
If you suffer from severe anxiety or trauma-based anxiety, please work with a professional as untying these knots can be much more intensive and you need to be supported through it. And no matter what kind of anxiety you are suffering, surround yourself with people who understand, who are supportive, and who will help you through this. If you don’t have that kind of support around you, check out resources in your community or online. Get involved in the comments here and support others too. You can check out our Facebook page and talk with other moms who have been there and share ideas and encouragement.
I hope you gained some insight into how to manage anxiety with ABA therapy. There is a lot more to be said and I will continue to add articles on the subject so check back soon.
Now in true ABA style: you did a thing here, you learned something new about how to manage your anxiety and you put in some time to do so. This is the part where you reward yourself for working toward that goal. Congratulations!
Autism Speaks, “Applied Behavior Analysis”
AppliedBehaviorAnalysisEdu.org, “Applied Behavior Analysis in the Treatment of Anxiety”