CBT for children and adolescents

CBT is a time-limited and present focussed talking therapy. It is adaptable and can be applied very flexibly, making it great for working with children and young people of all ages, either face-to-face or online.

What is CBT?

CBT (Cognitive Behaviour Therapy) is a talking therapy which can work very effectively for children and adolescents to help them overcome conditions such as anxiety, depression, OCD and anger management

Children with ADHD and ASD can also benefit from CBT as it helps them manage some of their experiences in a positive and healthy way.

The aim of CBT is to challenge unhelpful patterns in thought processes and behaviour and to replace them with more positive patterns and responses.

CBT for children has grown in popularity in the last few years. There is a large evidence base showing it to be highly effective, and more effective than many medications alone. Given that CBT teaches lifelong skills and coping strategies that can be applied across a situation, it can have different long-term benefits for the child or teenager.

What conditions can CBT help children with?

CBT can be useful for many different conditions as it helps form healthy responses to challenging situations and research has shown particular benefits for the following conditions:

• Anxiety Disorders, including Post-Traumatic Stress Disorder
• Low mood and Depression
• Stress
• Obsessive Compulsive Disorder
• Phobias
• Bullying
• Behavioural Problems

CBT works with the relationship between thoughts, feelings and behaviours.

CBT is based on the theory that it is our thoughts about an event or situation, and not the event itself, which determine our response to it.

It is very common for people to develop unhelpful and negative patterns in their thinking and, in turn, this affects our behaviour. As our behaviours reinforce our thoughts, a negative cycle starts; as described above, our thoughts, emotions and behaviours are all interlinked.

For instance, a child who thinks ‘Everyone thinks I am stupid’ because they were laughed at once, may then go on to develop a fear of answering questions in class.

As a result, the child may stop putting their hand up in class and become increasingly quiet. They may stay off school more, lose friendships and grow increasingly fearful about going to school at all.

All of these behavioural responses further feed into the unfounded thought ‘Everyone thinks I am stupid’.

CBT works by ‘reprogramming’ some of the negative assumptions that the child or teenager has. During therapy, the young person and therapist will work together to understand what negative cycles in thoughts, feelings and behaviours are contributing to their current difficulties.

They will then work together to change these patterns; during this process, they will develop different behavioural and cognitive strategies that can be applied across situations.

CBT helps the child or teenager gain control of their thoughts, by challenging assumptions, encouraging healthy ‘self-talk’, finding effective coping strategies and, where suitable, facing the feared situation to show that things are in fact OK.

What to expect from CBT

With so many therapy options available, it can be hard for parents to know which one is best suited for their child or teenager.

1. CBT can be used effectively with children as young as three; a study showed that following just 8 sessions of a modified CBT course, in which parents were involved, the young children experienced lower levels of anxiety and their home lives were happier and more settled.
2. CBT typically lasts for 8-12 sessions and is mainly focussed on the ‘here and now’ as opposed to past experiences.
3. CBT requires children to complete work in between sessions; this ensures that different skills and strategies are being practised and consolidated in real-world scenarios. Whilst some young people can find this difficult to begin with, your therapist will work hard to ensure that any specific concerns or barriers regarding this are overcome.
4. Often, CBT is sufficient to support children and young people to overcome and manage their difficulties. Some children, for example those who are very depressed, may however benefit from medication before therapy can begin. Your psychiatrist or psychologist can help advise on this.

In my experience, CBT is often a really great fit when working with children and young people. It is inherently collaborative, and there are loads of fun and engaging ways to ensure that the young person is an active participant throughout. It is really great to work alongside clients as they become more familiar with patterns in their thoughts, feelings and behaviour, and develop new strategies that help them work towards their goals. CBT is a brief, time-limited therapy but so much can be achieved during 8-12 sessions.

Dr Clare Holt

DClinPsy, MSc

Psychologist

Birmingham

Dr Holt is an experienced Clinical Psychologist, currently working for Central & North West London NHS Foundation Trust in a multi-disciplinary Child & Adolescent Mental Health Service (CAMHS). Clare has a Doctorate in Clinical Psychology, an...