How can CBT be utilized for children?

In this article we will explain how CBT can be utilized for children and if it is different from the CBT used for adults. We will also see the various mental health disorders in children that can be treated with CBT. 

How can CBT be utilized for children?

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When CBT is used for children usually the parent and caregiver are also involved in the process. The therapy is not carried out without their consent. The therapist discusses all the goals and objectives to be achieved through the therapy with the child and their caregiver before starting the therapy. The main goal of CBT for children is to equip them with the necessary skills with the help of various strategies and techniques so that they become adept at tackling the problems they face outside. When it comes to children gaining their trust and attention is more difficult than for adults. Therefore CBT modified many of its techniques in such a way that they resemble play activities rather than techniques or strategies. 

CBT with Children

CBT is a structured and systematic process that is highly effective in meeting its goals. But since it is designed so meticulously and requires a lot of focus, effort, and cognitive inputs from the client’s side as well it can be a bit difficult for children in its original form. Therefore some changes and additions are made to the therapy to make it children friendly. 

To gain the trust of the kids and to help them be comfortable play activities are introduced in CBT. In fact, many intervention techniques are employed in the guise of play activities.  

CBT techniques

Play therapy.

In this type of treatment method, the therapist may utilize things such as dolls, toy cars, coloring paper, crayons, or even puppet shows to open up the child and help them address their problems in a comfortable environment. Children feel safe and comfortable when they are surrounded by things they can play with and sometimes even the therapist can join in the play.   

Trauma-focused CBT. 

Trauma-focused CBT helps to treat children who have undergone traumatic events such as the death of a loved one, accidents, or even natural disasters. The motive of this approach is to treat the behavioral and cognitive issues that are directly related to trauma the child has experienced.

Modeling. 

Modeling is like setting an example of appropriate or expected behavior. In modeling, the therapist can act out an example of the desired behavior so that the child can learn the desired and appropriate behavior in which they should respond during a troubling event. For example, the therapist may act on how to respond to a stressful situation at school or on the playground.  Then the child can do the same or act out some other scenarios and learn from this technique. 

Restructuring. 

Restructuring refers to reconstructing our thinking pattern by eliminating negative thoughts and replacing them with positive and productive thought patterns. So it could be changing their negative thoughts of, “I cannot make friends easily so I must be unlikeable.” to a positive outlook of, “I may not be able to make friends quickly but the bonds I share with my existing friends are very strong”.  

Exposure.

In exposure therapy, the child is slowly exposed to things, situations, or objects that trigger anxiety within them in order to increase their tolerance towards them. This approach is very effective for dealing with anxiety in adults as well.  

How is CBT for Children Conducted?

CBT is conducted in the following ways

  • Individual. In the individual method, only the therapist and the client (child) are involved in the session. 
  • Parent-child. The parents/ caregiver, child, and therapist work together as a unit in this type of therapy conduction. The parents are given psychoeducation and provided with essential parenting skills and techniques to make them capable of helping their child.  
  • Family-based. In such sessions, the whole family that is the parents along with siblings and any relative close to the child such as their grandparents are involved,  
  • Group. Includes the child, therapist, and other children who are dealing with the same or similar problems.

Conditions in children that can be helped with CBT

 

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 show symptoms such as impulsiveness, inattention, and hyperactivity. They have a very hard time completing their tasks due to the onslaught of information they are subjected to due to their condition. They cannot sit still in one place and engage in erratic behavior. While medications are available for this disorder it is not the most sought-after treatment option by both the parents and the therapists. Therefore CBT is often utilized to treat ADHD as it has been proven effective in bringing about positive changes in their behavior by alleviating some of their symptoms

Anxiety and mood disorders

CBT is an effective treatment for children and adolescents with anxiety and mood disorders. Techniques such as exposure therapy work very well in increasing the tolerance towards their feared or triggering stimuli. Mood disorders can also be treated with help of various CBT techniques such as cognitive restructuring and help the children in leading a normal life. 

Anxiety with autism spectrum disorder

It has been observed that anxiety is a  co-morbid symptom with a high functioning autism spectrum disorder. In such cases, CBT can help alleviate the symptoms as well as provide the children with the necessary tools to maneuver the obstacles in their daily lives that arise due to their conditions. The CBT techniques that are specifically utilized are exposure techniques and challenging of irrational beliefs

Trauma and PTSD

For CBT  post-traumatic stress disorder (PTSD) in children, CBT is the primary treatment option. CBT has a specially developed approach that focuses on related disorders and issues called trauma-focused CBT. Teens and children who have undergone ghastly events greatly benefit due to CBT and it also has both short-term and long-term benefits.   

Eating Disorders

Eating disorders such as anorexia, bulimia, or binge eating are commonly found disorders in adolescents. These disorders arise mainly due to self-image issues and emotional instability. Girls are more likely to be affected by this disorder than boys. CBt helps with this disorder by tackling the self-esteem issues and treating the distorted thinking process that leads them on this path. 

Oppositional Defiant Disorder

In this type of developmental disorder, children display rebellious behavior and challenge figures of authority in their life. They show symptoms such as aggression, hostility, defiance, resentment, etc., They are prone to outbursts of anger and violent behavior. They might even engage in illicit and dangerous behavior and also put others in danger. Sometimes children diagnosed with oppositional defiant disorder go on to be diagnosed with antisocial behavior in their adulthood. CBT can reduce the destructive symptoms to a significant degree and also aids the child in communicating their thoughts and views in a controlled manner.

Deliberate Self-Harm

Adolescents often go through turbulent times during puberty or sometimes even due to peer pressure can engage in dangerous activities such as self-harm. Sometimes a traumatic or abusive environment at home or school can also lead them to take this dangerous step. Cognitive-behavioral therapy or more accurately dialectical behavior therapy (DBT) is a modified form of CBT that focuses on skills like mindfulness, regulating emotions, and tolerating distress; is very effective for this issue. 

Low Self-Esteem

Low self-esteem can lead to the development and manifestation of many types of mental health disorders such as depression, obsessive-compulsive disorder, eating disorders, self-harm, and substance abuse. According to various studies as compared to other therapies such as interpersonal therapy CBT is more effective for low self-esteem issues. 

Bedwetting/Enuresis

Bedwetting clinically known as Nocturnal Enuresis can be a source of embarrassment and self-esteem issues in many children. This can further lead to the development of other types of emotional and behavioral disorders. CBT is a behavioral approach and aims to bring about changes in maladaptive behaviors ad hence works very well for treating enuresis in children.

Other types of issues such as bullying and substance misuse are also helped with CBT. Bullying can be experienced at all ages but be particularly affecting the mental development of children and young adults. It can lead to self-esteem issues as well as poor self-image. They can even become bullies themselves because of the trauma afflicted on them. They can start engaging in destructive behaviors such as substance misuse which is hazardous for their health. Therefore CBT is utilized to combat these issues. 

Conclusion

We understood how CBT helps children with their mental health problems and also how CBT for children differs slightly from CBT for adults. 

Frequently asked questions

What does CBT treat in children?

CBT has been very effective for treating mental health disorders in kids. The reason is that CBT provides the children with the necessary tools to help combat any kind of issues they face in the outside world. 

At what age does CBT work?

CBT is used to help children learn to manage their emotions and behavioral responses. As it is an interactive treatment method it requires active participation from the child’s side as well. They need to learn to identify their thought patterns. Usually, kids learn to understand their thought patterns by the age of six or seven. But some kids might take some more time. 

Is play therapy a CBT?

Traditional play therapy uses play as an intervention method in the therapy, whereas in CBT, play is utilized to engage the child in the tasks and goals of the therapy. Play is an integral part of all phases of CBT. It is present right from assessment and psychoeducation, to intervention strategies, such as exposure tasks and relapse prevention. So though the play is a common aspect in both the treatment options they are still distinctively different from each other. 

Does play therapy help with ADHD?

Play therapy is a treatment method that helps children deal with their problems while making use of play activities. Research has shown that Play therapy can significantly reduce the symptoms of ADHD. As children can be put off by the traditional methods of therapy it is a very wise decision to opt for play therapy when dealing with kids. 

How can CBT assist teachers?

CBT is based on changing thoughts and beliefs in order to bring about changes in our behavior and emotions. The interventions utilized in CBT come with instructional techniques such as explicit teaching and use of modeling, role-playing, feedback, reinforcement, and cognitive components that include cognitive modeling. Thus, they are very easy to understand and follow for teachers to help a student in need. 

References

Watt, A. (2021, June 22). Treating bipolar disorder with cognitive behavioral therapy. Healthline. Retrieved January 19, 2022, from https://www.healthline.com/health/bipolar-disorder/cognitive-behavioral-therapy 

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