How Is Cognitive Behavioral Therapy (CBT) Different for Kids?
Cognitive behavioral therapy (CBT) is a type of talk therapy that can help people of all ages, including younger children and teens. CBT focuses on how thoughts and emotions affect behavior. Your child doesn’t need to have a diagnosed mental health condition to benefit from CBT.
Therapy usually involves an agreed upon goal and a set number of sessions. The therapist will help your child learn to replace negative thought patterns with more productive ones. Through role-playing and other methods, your child can practice alternate ways of handling stressful situations.
We’ll explore what you need to know about CBT for kids, as well as how to find a qualified therapist.
What is cognitive behavioral therapy?
CBT is a form of talk therapy designed to help people recognize unhelpful thoughts and behaviors and learn how to change them. Therapy focuses on the present and the future, rather than on the past.
While CBT isn’t designed to “cure” conditions such as ADHD, it can be used to complement other therapies and to help improve specific symptoms.
CBT for kids has practical everyday applications. This therapy can help your child understand the negativity of their thought patterns and learn how to replace them with more positive ones. Discovering new ways of looking at things helps a child learn how to respond differently and improve rather than worsen stressful situations.
This type of therapy can give your child realistic strategies to improve their lives in the here and now. Once these strategies become habit, the new skills can follow them throughout their lives.
CBT can help children learn to control:
Replacing negative reactions with:
new coping mechanisms
How does CBT for children work?
Usually, a parent or caregiver, the child, and a therapist will discuss goals and develop a treatment plan.
CBT involves a structured approach to solving problems in a specified number of sessions. It can be as few as six sessions or as many as 20 or more, depending on the child and the particular goals.
While CBT is a type of talk therapy, it’s so much more than talk. The therapist will work to provide tangible ways for your child to take control and empower themselves. They will teach skills that can be put into practice immediately.
Your child can have CBT alone or in combination with medications or any other therapies they might need. The treatment plan can be adapted to meet cultural or regional differences.
Play therapy. Arts and crafts, dolls and puppets, or role-playing are used to help the child address problems and work out solutions. This can also help keep younger children engaged.
Trauma-focused CBT. This method is used to treat children affected by traumatic events, including natural disasters. The therapist will focus on behavioral and cognitive issues directly related to trauma the child has experienced.
Modeling. The therapist may act out an example of the desired behavior, such as how to respond to a bully, and ask the child to do the same or to demonstrate other examples.
Restructuring. This technique is a way for a child to learn to take a negative thought process and flip it to a better one. For example, “I stink at soccer. I’m a total loser” can become “I’m not the best soccer player, but I’m good at a lot of other things.”
Exposure. The therapist slowly exposes the child to the things that trigger anxiety.
Whatever the technique, CBT can be conducted a number of ways, such as:
Individual. Sessions involve only the child and the therapist.
Parent-child. The therapist works with the child and parents together, teaching specific parenting skills so their children make the most of CBT.
Family-based. Sessions can involve parents, siblings, or others who are close to the child.
Group. Includes the child, therapist, and other children who are dealing with the same or similar problems.
Conditions that CBT may help
Your child doesn’t have to have a diagnosed mental health condition to benefit from CBT. But it can be quite effective in dealing with specific conditions, such as:
Attention deficit hyperactivity disorder (ADHD)
Children with ADHD may have a hard time sitting still and may engage in impulsive behaviors. While there are medications to treat this disorder, sometimes they’re not the first or only choice of treatment.
Even with medications, some children have persistent symptoms. Research showsTrusted Source that for some teens, adding CBT works better than medication alone.
Anxiety and mood disorders
CBT has been shown to be an effective treatment for children and adolescents with anxiety and mood disorders.
A 2015 reviewTrusted Source found “substantial support” for CBT as an effective first-line treatment for children with anxiety disorders.
Parents may have a role to play, too. A 2010 studyTrusted Source found that CBT with active parent involvement showed promise as an effective therapy for those ages 3 to 7 with anxiety. The study involved only 37 children, but they showed significant improvement in an average of 8.3 treatment sessions.
Anxiety with autism spectrum disorder
Many adolescents with high functioning autism spectrum disorder have anxiety. In a 2015 studyTrusted Source, a CBT program was designed for preteens with autism spectrum disorders plus clinical anxiety. The program focused on:
challenging irrational beliefs
behavioral support provided by caregivers
treatment elements specific to autism spectrum disorder
The small study involved only 33 children from 11 to 15 years old. Parents reported a positive effect of CBT on the severity of anxiety symptoms.
Trauma and PTSD
CBT is a first-line treatment for post-traumatic stress disorder (PTSD) in children and adolescents and has been shown to have short-term and long-term benefits.
A 2011 reviewTrusted Source found significant improvement at an 18-month follow-up and a 4-year follow-up. CBT has been found to be effective for acute and chronic PTSD after a range of traumatic experiences, even for young children.
CBT may also be helpful in treating:
adolescent substance use
obsessive-compulsive disorder (OCD)
CBT worksheets for children
Explaining the idea of CBT to younger children must be done in simple terms. To make things easier, some therapists use worksheets to help children visualize certain concepts.
For example, a worksheet may have drawings with blank thought bubbles for the child to fill out. The therapist may ask the child what the person in the picture is thinking about. Worksheets may include stop signs, to help the child recognize signs that they’re about to lose control.
Worksheets can help children and adolescents understand how thoughts, feelings, and actions are connected. Through these worksheets, they can solidify what they’ve learned. CBT for children may also involve planners, checklists, or a rewards chart to help children remember and complete tasks.
How effective is CBT for kids?
CBT is an evidence-based practice shown to be effective for a variety of issues.
Meta-analyses show that up to 60 percentTrusted Source of youth treated with CBT for anxiety disorders recover with significant decrease in symptoms following treatment. Follow-up studies of children treated in community mental health clinics show that those recovery rates are likely to continue at 4 years post-treatment.
Studies show that many adolescents with ADHD who received CBT had a significant reductionTrusted Source in symptom severity.
Among children with PTSD who receive individual trauma-focused CBT, there can be a great improvement of symptoms of PTSD, depression, and anxiety. In one studyTrusted Source, 92 percent of participants no longer met criteria for PTSD after CBT. This gain was still seen at a 6-month follow-up.
Finding CBT for a child
While there are many therapists trained in CBT, it’s important to look for one who has experience working with children. Here are some things to look for:
Credentials. Look for a licensed counselor, family therapist, clinical social worker, psychologist, or psychiatrist. Licensure indicates a professional has met the legal standards to practice in your state.
Experience. Look for a professional who has worked with children or adolescents.
Transparency. Look for a professional willing to state goals and offer a treatment plan after an initial assessment or session with you and your child.