Explaining CBT to Children

Cognitive behavioral therapy (CBT) is a structured, goal-oriented form of psychotherapy that focuses on helping you manage struggles by changing the way you think/perceive and behave. CBT is based on the foundation that your thoughts, feelings, behaviors, and physiological sensations are interconnected, and that distressing and uncomfortable thoughts and feelings can trap you in a negative cycle. This type of therapy has been found to help people of all ages, including younger children and teens. Specifically, CBT has been found to be successful in the treatment of youth mental health across a variety of disorders, such as anxiety, depression, obsessive compulsive disorder (OCD), autism spectrum disorder (ASD), externalizing disorders, and posttraumatic stress disorder (PTSD).

What does CBT for children look like?

CBT involves a structured approach to solving problems and helping children manage distress. The therapist works to provide tangible ways for your child to take control over their thoughts, feelings, and emotions and increase their ability to empower themselves. They will teach them practical skills that your child can use immediately. Children can have CBT alone or in combination with medications or other therapies they might need, such as group therapy or family therapy. CBT aims to help your child identify and replace unhelpful thoughts, using adaptive coping skills to create and maintain positive moods, healthy relationships, and more realistic thinking patterns.

How do I explain CBT to my child?

Sometimes, getting children on board with therapy is easy and other times, parents may be faced with resistance from their child about the idea of starting therapy. Some common reasons that children may say no to therapy are:

·      They struggle to see the benefits of therapy

·      They may feel that it won’t work for them

·      They may be embarrassed about beginning

·      They may have tried therapy in the past and didn’t like it

·      They don’t think they need help

·      They’re feeling defensive and “forced” to do something

If you are a parent that finds yourself playing tug-of-war with your child to “go to therapy,” we’re here to help. There are a lot of stigmas around mental health and “needing therapy” that might be fueling your child’s resistance. Therefore, talking about CBT in a way that creates curiosity, encouragement, and maybe even a little excitement can be helpful. You can relate CBT to something that your child may already be involved in (e.g., sports, musical groups, clubs). For example, if your child plays football – “even professional football players need coaches to learn new strategies and skills and to help them think about different ways to succeed. In therapy, just like at practice, you learn new skills and practice them over and over, so that eventually you won’t need the therapist/coach anymore.”

CBT can further be explained by saying something like, “helpful thoughts make you feel comfortable, while unhelpful thoughts make you feel uncomfortable.” And then help the child identify what they think you mean by comfortable (“happy,” “good”) and uncomfortable (“sad,” “angry”) feelings. And that sometimes uncomfortable thoughts and feelings might make us react to different things in unhelpful ways (“such as yelling at a classmate for accidentally knocking over your juice cup”). CBT can help us catch when we are having those uncomfortable thoughts and feelings (“I felt angry when my juice cup spilled on my artwork”) and use skills to cope with them in more helpful ways (“Sammy didn’t mean it, it was an accident. I can help clean it up, forgive him, and dry off some of the art that I made”). It is most helpful to explain CBT in simple terms. Let your child know that they will speak with another adult about their thoughts, feelings, and behaviors so that they can ultimately feel better. You can tell them that the therapist, just like a coach, is trying to help them learn skills that will be useful when they have difficult moments.

The Importance of the CBT Therapist:

Additionally, finding the right therapist for your child is key in this process. We encourage both you and your child to be involved in the initial steps of choosing a therapist. This can help create a sense of autonomy and independence, a major goal in childhood. Further, allowing your child to be involved in finding a therapist may help the overall therapeutic process as they may be more inclined to open up to a therapist that they themselves have chosen versus someone their parent is “forcing” them to see. When they can choose the therapist, they may be more likely to engage in the treatment. Of course, if you have any questions about how to engage your child in therapy and/or want to get a sense of whether the therapist feels like a good fit, it is okay to do a parent-only meeting first and then schedule a session with the therapist and your child.