Introduction to CBT
Cognitive Behavioral Therapy (CBT) is a type of therapy that focuses on identifying and changing negative behaviors and thought patterns that lead to emotional distress. CBT is a widely utilized treatment modality and has been thoroughly researched. In this post, I will discuss some background on the origins of CBT, its key elements, and how I specifically apply CBT in my sessions with children and teens. By understanding CBT, you can feel more informed and empowered to make educated decisions about your mental health treatment and decide which types of therapy might be the best fit for you.
Brief Background on CBT
CBT was first introduced in the 1960’s by a psychologist named Aaron Beck. Beck discovered that many people struggling with depression engaged in “automatic thoughts” that were often negative in nature. Further, Beck and other researchers determined that individual’s perceptions of situations impact their emotional and behavioral responses. Since its introduction, CBT has become one of the most thoroughly researched and applied models of therapy. Many studies since the 1960’s have focused on understanding how CBT impacts individuals with various diagnoses including anxiety, depression, phobias, OCD, and PTSD. But what exactly is cognitive-behavioral therapy?
What exactly is CBT
When explaining CBT to my clients, I usually begin by teaching them about a concept called the “CBT Triangle” (see image on post). This triangle is a visual representation of the connection between thoughts, feelings, and behaviors. The idea is that each element directly influences the other, which leads to a cycle that can increase distress.
For example, if someone has a thought such as “I am not good at making friends”, they may begin to feel lonely or anxious. These thoughts and feelings may then lead this person to withdraw from social situations, which can increase their anxiety further. As the person continues to avoid social situations, they are reinforcing their negative thoughts and end up creating a self-perpetuating cycle that ultimately increases anxiety.
The goal of CBT is to interrupt these cycles by working on thoughts, feelings, and behaviors to initiate positive change. By understanding the connections in the CBT triangle, clients become more aware of their mental and emotional states and can then begin to take steps towards positive change.
How Jordan Uses CBT with Children and Teens
When I work with children and teens, my approach to CBT is adaptable to the individual needs of each client. I always want to meet my clients where they are at. When starting treatment, my first step is to help clients to increase their emotional awareness and begin building a toolbox of coping skills that they can use at home and during treatment. These foundational skills will help us to understand our emotions throughout the treatment and utilize skills as we begin to process more difficult topics. Below are several ways in which I use elements of CBT throughout the therapeutic process.
Setting a Baseline with Behavior Tracking
Within the first few sessions, I often will have the client (or client’s parents) track different behaviors so that we can create a baseline. This baseline will help us to measure progress as treatment progresses. The different behaviors that we will measure are based on the different goals that you may set. For example, if a child is struggling with aggressive outbursts (hitting and yelling), I will ask parents to track how frequent the child is engaging in these behaviors and how long each outburst lasts. Over time, the goal is to reduce these outbursts and increase the use of different coping skills. Similarly, if a client is struggling with anxious thoughts, I may ask them to track what those thoughts are, how often they are occurring, and what events trigger those thoughts.
Psychoeducation: Understanding the Process
Psychoeducation means learning about different therapeutic topics. I believe that it is incredibly important for the client and parents to understand every step of the treatment process. By teaching kids about what we are doing in session and why, we are able to build trust and rapport. It can also help to increase the client’s engagement with session content. With children, this can involve me teaching clients different coping skills, discussing the CBT triangle, or learning about negative thought patterns. I always aim to make psychoeducation age appropriate so that clients can fully grasp the topics.
Targeting Negative Thought Patterns and Behavior Change
One of the biggest goals of CBT is to address and modify negative thought patterns. Different exercises, such as cognitive restructuring, can help clients to notice unhelpful thought patterns and replace them with more balanced or realistic ones. We also want to target behavior change. For example, if a teen client is struggling with social engagement due to depression and anxiety, we may begin treatment with behavioral activation and exposures. These components of CBT work to empower the client to engage in enjoyable activities and gradually increase their involvement in social activities. As client’s begin to work on changing their thoughts and behaviors, they are also building resilience and self-confidence.
Conclusion
CBT can be a great fit for children and teens because it is structured and emphasizes measurable results. As a therapist, my goal is to help each client to better understand their emotions and empower them to utilize different strategies that they can use throughout their lives. The skills that we work on, utilizing CBT, can carry them forward into adulthood and set them up for future success.
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Written By,
Jordan Adamson, LPC
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