Cognitive Behavioral Therapy (CBT)

Created on August 5, 2017. Last updated on August 22nd, 2017 at 02:05 pm

COGNITIVE AND BEHAVIORAL THERAPY – Cognitive and behavioral therapy (CBT) for children and adolescents usually are short-term treatments (i.e., often between six and 20 sessions) that focus on teaching youth and/or their parents specific skills. CBT differs from other therapy approaches by focusing on the ways that a child or adolescent’s thoughts, emotions, and behaviors are interconnected, and how they each affect one another. Because emotions, thoughts, and behaviors are all linked, CBT approaches allow for therapists to intervene at various points in the cycle.

These treatments have been proven to be effective in treating many psychological disorders among children and adolescents, such as anxiety, depression, posttraumatic stress disorder (PTSD), behavior problems, and substance abuse.

There are differences between cognitive therapies and behavioral therapies for young people. However, both approaches have much in common, such as:

The therapist and child or adolescent client develop goals for therapy together, often in close collaboration with parents, and track progress toward goals throughout the course of treatment.

• The therapist and client work together with a mutual understanding that the therapist has theoretical and technical expertise, but the client is the expert on him- or herself.
• The therapist seeks to help the client discover that he/she is powerful and capable of choosing positive thoughts and behaviors.
• Treatment is often short-term. Clients actively participate in treatment in and out of session. Homework assignments often are included in therapy. The skills that are taught in these therapies require practice.

Types of Cognitive Behavioral Therapy

Individual CBT
Individual Cognitive Behavioral Therapy focuses solely on the child or adolescent and includes one therapist who teaches the child or adolescent the skills needed to overcome his/her challenges. This form of CBT has been proven effective in the treatment of child and adolescent depression and anxiety disorders, as well as substance abuse in adolescents.

Group CBT
Group Cognitive Behavioral Therapy includes not only the child or adolescent and therapist in the therapy sessions, but also others outside of the child or adolescent’s social groups – usually new acquaintances who are also being treated for the same disorder. Those in the group therapy are often dealing with similar behavioral issues and, unlike individual CBT, the group format allows helpful relationships to form, in addition to learning skills needed to change behavior. Group CBT is often less expensive than individual CBT, and more broadly available. It has been proven effective in the treatment of depression and substance abuse in adolescents.

CBT with Parents
Cognitive Behavioral Therapy that includes parents in the treatment process has been shown through research to be effective in treating children and adolescents with anxiety disorders. Specifically, CBT that teaches parents techniques to help care for anxious youth, including psychoeducation, individual therapy, caregiver coping, and parent training techniques are especially helpful. In this form of therapy, the parents are involved directly in the treatment of their children and are essentially trained in ways to help them handle their children’s fears at home.

CBT with Medication
Research has shown that pairing Cognitive Behavioral Therapy with psychotropic medications can be effective in treating a child or adolescent’s anxiety symptoms or depression. A child’s care team will be able to prescribe the right medication if he/she believes it to be necessary in your child’s therapy process.

Trauma-Focused CBT
Trauma-Focused Cognitive Behavioral Therapy was developed to help children and adolescents affected by trauma. It is effective in treating PTSD but can be effective in treating other trauma-related disorders as well. It is delivered in the same way as Cognitive Behavioral Therapy – usually short-term in six to 20 sessions with the child and his/her parents present. A Trauma-Focused CBT session addresses several factors related to the child’s traumatic experiences, including behavioral and cognitive issues, and depression or anxiety symptoms, and helps improve parenting skills and parents’ interactions with their children to help support and cope with their children’s struggles.

CBT paired with Motivational Enhancement Therapy
Motivational Enhancement Therapy (MET) is a type of evidence-based therapy that motivates adolescents internally to change their behavior. When MET is paired with group-based CBT, it is effective in changing an adolescent’s behavior towards drug and alcohol abuse. This therapy uses discussion, coping strategies and motivational interviewing principles to help the youth initiate a plan to change his/her behavior and motivate the youth to follow through. Throughout the sessions, the therapist will guide the youth through their plan to stop using substances and will continue to motivate and encourage his/her progress. Following MET therapy sessions, the adolescent would participate in group-based CBT to see the best results.

CBT paired with Motivational Enhancement Treatment and Family-Based Behavioral Treatment
In Family-Based Behavioral Treatment, parents set examples for their children in changing their own behavior to help their children change their behaviors in the long run. An important component of this type of therapy is the training of parents on child management and problem-solving skills. This integrated therapy has been proven effective in treating adolescent substance abuse.

Source(s): Daniel J. Tomasulo (2010). What is the difference between individual and group therapy? Psychology Today. https://www.psychologytoday.com/blog/the-healing-crowd/201012/what-is-the-difference-between-individual-and-group-therapy 

Graeme Whitfield (2010). Group cognitive-behavioral therapy for anxiety and depression. Advances in Psychiatric Treatment. Vol. 16 Issue 3, 219-227. http://apt.rcpsych.org/content/16/3/219

Charmaine K. Higa-McMillan, Sarah E. Francis, Leslie Rith-Najarian, & Bruce F. Chorpita (2015). Evidence Based Update: 50 Years of Research on Treatment for Children and Adolescent Anxiety. Journal of Clinical Child & Adolescent Psychology. Vol. 45 Issue 2, 91-113.
http://www.tandfonline.com/doi/full/10.1080/15374416.2015.1046177

No Author (2017). About Trauma-Focused Cognitive Behavior Therapy (TF-CBT). TF-CBT Therapist Certification Program. https://tfcbt.org/about-tfcbt/

Aaron Hogue, Craig E. Henderson, Timothy J. Ozechowski, & Michael S. Robbins (2014). Evidence Base on Outpatient Behavioral Treatment Adolescent Substance Use: Updates and Recommendations 2007-2013. Journal of Clinical Child & Adolescent Psychology. Vol. 43 Issue 5, 695-720. http://dx.doi.org/10.1080/15374416.2014.915550

No Author (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-2

Myra Altman & Denise E. Wilfrey (2014). Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents. Journal of Clinical Child & Adolescent Psychology. Vol. 44 Issue 4, 521-537. http://dx.doi.org/10.1080/15374416.2014.963854

Kendall, P.C. (2016). Child and Adolescent Therapy, Fourth Edition. New York: Guilford.