Introduction to CBT
Cognitive Behavioral Therapy (CBT) for children and adolescents usually is short-term treatment focused on teaching specific skills. CBT is based on the idea that behaviors, thoughts, and feelings are dynamically related.
Examples of skills used in CBT:
- Behavioral activation for depression: Depression takes away interest and motivation. In CBT for depression, a teen will be coached to take small, measurable steps toward pleasant activities: I will take a shower. I will walk the dog for 5 minutes. I will shoot 10 baskets. These behaviors tend to make us feel a little better and teach us the thought that we can feel better, even for a few minutes.
- Exposure therapy for social anxiety: We try to avoid things that scare us. Kids with social anxiety avoid social interaction because they fear they will fail and be humiliated or rejected. The more they avoid others, the less others engage with them, reinforcing the sense of social inadequacy. In CBT for social anxiety disorder, a teen may be encouraged to try looking at a peer in the eyes and saying hello at least twice a day. The teen finds that more often than not, people smile and say hello back, and they begin to gain confidence.
- Cognitive restructuring: Depression and anxiety both distort thought processes. The internal monologue of kids with depression is full of thoughts of hopelessness and failure ("I am ugly and stupid and matter to no one"). That of anxious kids is full of thoughts of disaster and future failure ("If I fail this test, I will fail out of school and disappoint my parents"). Cognitive restructuring involves looking carefully at distorted anxiety and depression thoughts, assessing their validity, and practicing new, more balanced ways of thinking.
CBT has been studied and found effective for:
- anxiety disorders
- depression
- obsessive compulsive disorder (OCD)
- post-traumatic stress disorder (PTSD) and other trauma- and stressor-related disorders
- specific phobias, including needle phobia
- substance use disorders
- helping parents manage their children's disruptive behaviors (Parent Management Training)
Cognitive behavior therapy models, or types, include
- Cognitive Therapy
- Acceptance Commitment Therapy
- Dialectical Behavior Therapy
- many others