How Does Cognitive Behavioral Therapy Work for Children? | Conditions In Children Where Cognitive Behavioral Therapy May Help

Cognitive-behavioral therapy (CBT) is a type of treatment technique that helps you to recognize negative and unhelpful behavior and thought patterns. Most experts consider cognitive behavioral therapy to be the ‘gold standard’ of psychotherapy. This type of talk therapy is recommended for people of all ages, even younger children and teenagers. Cognitive-behavioral therapy helps a person or child focus on how emotions and thoughts affect their behavior. Many parents often have doubts and questions regarding how this form of psychotherapy can help their child. Read on to find out how cognitive behavioral therapy works for children and how it can help.

What is Cognitive Behavioral Therapy and How Can It Help Children?

Cognitive-behavioral therapy that is a type of talk therapy designed to help people of all ages to recognize negative and unhelpful thoughts and behaviors and helps them learn how to change such behavior patterns.(1,2,3,4) This type of therapy focuses both on the present and the future instead of focusing on the past like other traditional talk therapies. Experts consider cognitive behavioral therapy to be the ‘gold standard’ of psychotherapy.(5)

Cognitive-behavioral therapy helps you identify and explore the various ways your thoughts and emotions have an impact on your actions. Once you notice and understand these patterns, you can then begin to learn how to reframe your thoughts in a more positive and helpful way. As stated above, unlike most other therapy approaches, cognitive behavioral therapy does not focus on your past.

It is essential to realize that cognitive-behavioral therapy is not designed to cure conditions like attention deficit hyperactivity disorder (ADHD), but it can be used to complement the other treatments that are being used to treat the condition and help improve certain symptoms.(6,7)

Cognitive-behavioral therapy for children has its own set of practical everyday applications. This type of therapy can help your child better understand the negativity of their thought patterns. It also helps them learn how to replace the negative thought pattern with more positive ones. Cognitive-behavioral therapy can help your child discover new ways of looking at things that can help him/her learn how to respond differently and improve instead of worsening any stressful situations.

Such type of therapy can provide your child with realistic strategies to help improve their lives in the present. And once these strategies become a habit, these new skills will stay with them for the rest of their lives.(8)

Cognitive-behavioral therapy can help children learn how to control the following:(9)

  • Defiance
  • Tantrums
  • Self-defeating and self-deprecating thoughts
  • Impulsivity

At the same time, cognitive-behavioral therapy replaces the negative thought patterns with:

  • More self-control
  • Improved self-image
  • Problem-solving skills
  • New stress coping mechanisms.

How Does Cognitive Behavioral Therapy Work For Children?

Typically, a parent or primary caregiver and the child will discuss the goals and come up with a treatment plan with a therapist. Cognitive-behavioral therapy follows a structured approach towards problem-solving within a specific number of sessions. These sessions can be as few as six or as many as 20 or more, depending on the particular goals and the child.(10)

Cognitive-behavioral therapy is also a type of talk therapy, but it is much more than just talking. The therapist will work together with your child to provide him/her with some tangible ways to take better control and empower themselves. The therapist will teach them skills that can be put into practice right away.

Your child might benefit from having cognitive behavioral therapy alone or along with medications or other treatments that may be required. Their treatment plan will be adapted and changed accordingly to meet regional or cultural differences as well.(11)

What are the Techniques Used in Cognitive Behavioral Therapy for Children?

Here are the various therapy techniques used with children:

  • Play Therapy: The most commonly used cognitive behavioral therapy technique in children is play therapy. This involves dolls and puppets, arts and crafts, or role-playing games to help children address their problems and find out solutions. This is also a great way to keep younger children engaged.(12,13)
  • Modeling: In this form of cognitive-behavioral therapy, the therapist may act out examples of the desired behaviors. Examples may include how to respond to a bully, how to control their anger, etc. They will then ask the child to do the same. Other examples may also be demonstrated, depending on the specific situations the child is dealing with.
  • Trauma-focused Cognitive Behavioral Therapy: This technique is used for treating children who are affected by traumatic events, including natural disasters, wars, accidents, and others. In this technique, the therapist will focus on cognitive and behavioral issues that are directly related to the traumatic incident the child has experienced. (14)
  • Restructuring: This technique of cognitive-behavioral therapy focuses on a way for a child to learn to take a negative thought process and change it into a positive one. For example, if a child says they stink at soccer and feel like they are a loser, the therapist will focus on changing this thought process towards ‘I am not the best soccer player, but I am good at many other things.’
  • Exposure: In this type of therapy, the therapist will slowly expose the child to the things that are known to trigger their anxiety. They will then proceed to help them understand ways to deal with these triggers.

Regardless of whichever technique is being used, cognitive behavioral therapy can be conducted in a variety of ways, including:

  • Individual: In this type of therapy, the sessions only involve the child and the therapist.
  • Parent-Child: The therapist will work together with the child and the parents. They will also be teaching certain parenting skills to the parents so that the children are able to benefit the most from taking this type of therapy.
  • Family-based: In this type of cognitive-behavioral therapy, the sessions can involve the entire family – parents, siblings, or others like grandparents who are close to the child.(15)
  • Group: In group sessions, along with the child and therapist, there are other children also present who are dealing with similar or identical problems.

Conditions In Children Where Cognitive Behavioral Therapy May Help

It is important for parents to know that it is not necessary for their child to have been diagnosed with a mental health condition in order to benefit from cognitive behavioral therapy. However, if your child has been diagnosed with a specific condition, then cognitive behavioral therapy can be extremely effective in dealing with certain conditions.

These include:

Attention Deficit Hyperactivity Disorder (ADHD)

Children who have been diagnosed with attention deficit hyperactivity disorder have a difficult time sitting still and are prone to engage in impulsive behaviors. They often face multiple issues at school and home. While there are several medications used for treating this disorder, but doctors still prefer to recommend cognitive behavioral therapy as a course of treatment.

Even with medications, though, some children may continue to experience persistent symptoms of attention deficit hyperactivity disorder. Studies show that for teenagers, adding cognitive behavioral therapy to the treatment plan works better than using medication alone.(16)

Anxiety with Autism Spectrum Disorder

Many adolescents who have been diagnosed with high functioning autism spectrum disorder are known to also have anxiety. In 2015, a study designed a cognitive behavioral therapy program for preteens who had autism spectrum disorder along with clinical anxiety.(17) The focus of this program included:

  • Challenging irrational beliefs associated with anxiety and autism spectrum disorder
  • Ensuring that proper behavioral support provided by caregivers
  • Exposure
  • Treatment elements specifically related to autism spectrum disorder.

This was a small study that included only 33 children in the range of 11 to 15 years old. After the study, parents reported witnessing a positive impact of cognitive-behavioral therapy on the severity of the anxiety symptoms.

In many other studies also, cognitive behavioral therapy has been found to be effective in lowering the severity of anxiety symptoms and helping children manage their autism more effectively.(18)

Mood Disorders and Anxiety

Cognitive-behavioral therapy has been found to be an effective treatment for adolescents and children who have mood disorders and anxiety. A review conducted in 2015 found significant support for cognitive behavioral therapy as being an effective first line of treatment for treating children with anxiety disorders.(19)

However, it is believed that parents also have a big role to play. In 2010, a research study discovered that cognitive-behavioral therapy that included active parent involvement showed better promise as an effective therapy for children between 3 to 7 years who had anxiety. The study, however, was a small one and only had 37 children, but it showed substantial improvement in a child within an average of 8.3 treatment sessions.(20)

Post-Traumatic Stress Disorder (PTSD) and trauma

Cognitive-behavioral therapy is a common first-line treatment for treating children and adolescents with post-traumatic stress disorder. It has been shown to have both short-term and long-term benefits for children struggling with PTSD.(21)

A 2011 review of studies found that there was a dramatic improvement at an 18-month follow-up and a four-year follow-up, and cognitive behavioral therapy was found to be highly effective for chronic and acute post-traumatic stress disorder in children who have gone through a range of traumatic experiences. The same held true even for younger children.(22)

Cognitive-behavioral therapy was also found to be helpful in treating the following:

How Effective is Cognitive Behavioral Therapy for Children?

There is a lot of evidence to show that cognitive-behavioral therapy is effective in treating various conditions and issues in children.

Meta-analyses show that nearly 60% of youths treated with cognitive behavioral therapy for anxiety disorders recovered and had a dramatic reduction in symptoms after treatment.(23) Follow-up studies of children who were treated in community mental health clinics showed that these recovery rates were likely to continue for up to four years post-treatment with cognitive behavioral therapy.

Studies have also shown that many adolescents with attention deficit hyperactivity disorder who underwent cognitive behavioral therapy experienced a substantial reduction in the severity of their symptoms.(24)

In children with post-traumatic stress disorder who received individual trauma-focused cognitive behavioral therapy, there was a greater improvement in symptoms of depression, anxiety, and PTSD. In fact, one study found that 92% of children treated with cognitive behavioral therapy no longer met the criteria for post-traumatic stress disorder. This gain was consistent even at the six-month follow-up.(25)

Conclusion

Cognitive-behavioral therapy can be very helpful in helping children understand how their emotions and thoughts affect their behavior and how positively changing their emotions and thoughts can change their behavior as well as the way they feel. Cognitive-behavioral therapy is a safe and effective therapy that can help children deal with a wide range of issues and conditions, from attention deficit hyperactivity disorder to post-traumatic stress disorder.

References:

  1. Rothbaum, B.O., Meadows, E.A., Resick, P. and Foy, D.W., 2000. Cognitive-behavioral therapy.
  2. Craske, M.G., 2010. Cognitive–behavioral therapy. American Psychological Association.
  3. Bieling, P.J., McCabe, R.E. and Antony, M.M., 2009. Cognitive-behavioral therapy in groups. Guilford press.
  4. Cahill, S.P., Rothbaum, B.O., Resick, P.A. and Follette, V.M., 2009. Cognitive-behavioral therapy for adults.
  5. David, D., Cristea, I. and Hofmann, S.G., 2018. Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in psychiatry, 9, p.4.
  6. Weiss, M., Murray, C., Wasdell, M., Greenfield, B., Giles, L. and Hechtman, L., 2012. A randomized controlled trial of CBT therapy for adults with ADHD with and without medication. BMC psychiatry, 12(1), pp.1-8.
  7. Ramsay, J.R. and Rostain, A.L., 2011. CBT without medications for adult ADHD: An open pilot study of five patients. Journal of Cognitive Psychotherapy, 25(4), pp.277-286.
  8. Stallard, P., 2005. A clinician’s guide to think good-feel good: Using CBT with children and young people. John Wiley & Sons.
  9. Fuggle, P., Dunsmuir, S. and Curry, V., 2012. CBT with children, young people and families. Sage.
  10. Tang, T.Z. and DeRubeis, R.J., 1999. Sudden gains and critical sessions in cognitive-behavioral therapy for depression. Journal of consulting and clinical psychology, 67(6), p.894.
  11. Hays, P.A. and Iwamasa, G.Y., 2006. Culturally responsive cognitive-behavioral therapy: Assessment, practice, and supervision. American Psychological Association.
  12. Knell, S.M., 1999. Cognitive-behavioral play therapy. In Handbook of psychotherapies with children and families (pp. 385-404). Springer, Boston, MA.
  13. Knell, S.M., 1993. Cognitive-behavioral play therapy. Rowman & Littlefield.
  14. Deblinger, E., Mannarino, A.P., Cohen, J.A., Runyon, M.K. and Steer, R.A., 2011. Trauma‐focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length. Depression and anxiety, 28(1), pp.67-75.
  15. Storch, E.A., Geffken, G.R., Merlo, L.J., Mann, G., Duke, D., Munson, M., Adkins, J., Grabill, K.M., Murphy, T.K. and Goodman, W.K., 2007. Family-based cognitive-behavioral therapy for pediatric obsessive-compulsive disorder: Comparison of intensive and weekly approaches. Journal of the American Academy of Child & Adolescent Psychiatry, 46(4), pp.469-478.
  16. Sprich, S.E., Safren, S.A., Finkelstein, D., Remmert, J.E. and Hammerness, P., 2016. A randomized controlled trial of cognitive behavioral therapy for ADHD in medication‐treated adolescents. Journal of Child Psychology and Psychiatry, 57(11), pp.1218-1226.
  17. Wood, J.J., Ehrenreich-May, J., Alessandri, M., Fujii, C., Renno, P., Laugeson, E., Piacentini, J.C., De Nadai, A.S., Arnold, E., Lewin, A.B. and Murphy, T.K., 2015. Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: A randomized, controlled trial. Behavior therapy, 46(1), pp.7-19.
  18. Rotheram‐Fuller, E. and MacMullen, L., 2011. Cognitive‐behavioral therapy for children with autism spectrum disorders. Psychology in the Schools, 48(3), pp.263-271.
  19. Higa-McMillan, C.K., Francis, S.E., Rith-Najarian, L. and Chorpita, B.F., 2016. Evidence base update: 50 years of research on treatment for child and adolescent anxiety.
  20. Journal of Clinical Child & Adolescent Psychology, 45(2), pp.91-113.
  21. Minde, K., Roy, J., Bezonsky, R. and Hashemi, A., 2010. The effectiveness of CBT in 3–7 year old anxious children: Preliminary data. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(2), p.109.
  22. Smith, P., Yule, W., Perrin, S., Tranah, T., Dalgleish, T.I.M. and Clark, D.M., 2007. Cognitive-behavioral therapy for PTSD in children and adolescents: a preliminary randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 46(8), pp.1051-1061.
  23. Kar, N., 2011. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review. Neuropsychiatric disease and treatment.
  24. Kodal, A., Fjermestad, K., Bjelland, I., Gjestad, R., Öst, L.G., Bjaastad, J.F., Haugland, B.S., Havik, O.E., Heiervang, E. and Wergeland, G.J., 2018. Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. Journal of anxiety disorders, 53, pp.58-67.
  25. Sprich, S.E., Safren, S.A., Finkelstein, D., Remmert, J.E. and Hammerness, P., 2016. A randomized controlled trial of cognitive behavioral therapy for ADHD in medication‐treated adolescents. Journal of Child Psychology and Psychiatry, 57(11), pp.1218-1226.
  26. Kar, N., 2011. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review. Neuropsychiatric disease and treatment.

Also Read:

Was this article helpful?

Yes No
×

Suggestions to Improve the Article

This article contains incorrect information.

This article does not have the information I am looking for.


I Have a Medical Question.

Ask A Doctor Now

If you are facing a medical emergency, call your local emergency services immediately, or visit the nearest ER or urgent care facility
×

Suggestions to Improve the Article

×

How Did This Article Help?

This Article Did Change My Life!


I Have a Medical Question.

Ask A Doctor Now

If you are facing a medical emergency, call your local emergency services immediately, or visit the nearest ER or urgent care facility
×

Thank you for your feedback.