Cognitive Behavioral Therapy (CBT) is one of the most effective psychological treatments when it comes to addressing a variety of emotional and behavioral concerns. Various research studies indicate CBT can lead to considerable progress in helping people reprogram unhelpful thought patterns and belief systems and improve quality of life. In numerous studies, CBT has proven to be effective time and time again and this is why it is considered an evidence-based treatment for a variety of conditions.
Several core tenets CBT is built on are:
A person's psychological problems are due to incorrect or unhelpful ways of thinking or processing.
A person's psychological problems are due to learned patterns of unhelpful behavior.
If a person is suffering from psychological problems, they learn more effective ways of coping with those problems, thus alleviating their symptoms and becoming more content in their lives.
Advances in CBT have been made based on both research and clinical practice. There is an abundance of scientific evidence supporting that CBT methods produce actual change in people. For those reasons, many counselors use CBT as their primary approach for helping their clients. And CBT has been successful in addressing issues from elementary to high school students. In my own practice, I tend to use an integrative approach and CBT is one aspect of that.
How can CBT be used with children?
CBT is centered around identifying thought and belief patterns and then challenging and reframing thoughts and beliefs that are deemed to be unhelpful and lead to uncomfortable feelings. For children, it can be helpful to look at it simply as first teaching them that their thoughts impact the way they feel and then helping them identify and change thoughts from unhelpful to more helpful! Thoughts control how we feel, which impacts how we act. So, if a child can change their thoughts, they can change their mood and actions too! This may seem like a complex concept, but I've worked with children 6 years old and up with this framework.
Changing Thoughts from Helpful to Unhelpful
A simple way to explain this to children is to say that helpful thoughts make you feel comfortable, while unhelpful thoughts make you feel uncomfortable. And then helping them identify what they think you mean by comfortable and uncomfortable feelings of course! It is vital to help them realize that thinking something does not necessarily make it true or accurate.
They can recognize and change or release unhelpful thoughts in favor of helpful ones. For example, a child can change the thought, "I am dumb because I made a mistake" to, "It's okay to make mistakes. Mistakes help me learn and grow. I learned from my mistake and now I know how to do this!" CBT techniques are extremely helpful for perfectionist children who worry about making mistakes.
When working through unhelpful thoughts, let children know that they should not get upset or judge themselves if they notice these thoughts. Everyone has unhelpful thoughts sometimes! And sometimes those unhelpful thoughts just keep coming. The important thing is to practice noticing them, challenging them, and replacing them with more helpful thoughts. It's immensely empowering to have the ability to control your thoughts!
Catch it, Check it, Change it: Helping Children Change Their Thoughts
We can make identifying, challenging, and changing thoughts a fun and interactive experience for kids!
Let's run CBT through a processing game I created called, Catch It, Check It, Change It. This is a tool to help children look at, sort through, and change their unhelpful thoughts into more helpful thoughts. It's got a fun football theme and I like to toss around the soft football when playing to add movement to it!
How the game works:
Catch it:
Have the child pay attention to their thoughts and "catch" any unhelpful thoughts. Explain to them that their feelings and sensations are clues. When you have big feelings, notice what you are thinking. Remind them that unhelpful thoughts usually make them feel lousy and helpful thoughts make them feel more comfortable.
Check it
"Check" your unhelpful thoughts: Is it true? Is it useful? Do you have proof to back it up? Would others see your thoughts in the same way?
Change it
“Change” your unhelpful thoughts into more helpful thoughts. Make sure the thought is genuine and realistic. Try to move away from all-or-nothing words like "always," "never," and "everyone." If you're stuck, try starting with the phrase "even though…" or ask for some help.
As children play this game, they will recognize what a helpful thought is. They will also learn what an unhelpful thought is and the difference between the two. I created this game with an American football aesthetic, so the symbolism of "catching" the thought would be more comprehensible and fun!
*When teaching about thoughts and how they are connected to feelings, it is important to let children know that just because you think a thought does not mean it is true. In addition, ALL feelings are okay, feelings come, and feelings go, and everyone feels ALL feelings. We use the terminology helpful and unhelpful, and avoid labeling thoughts as positive or negative. This helps children develop a more nonjudgmental and accepting attitude towards their thoughts and feelings.
If you are interested in incorporating this game into your counseling sessions or classroom, check out Catch It, Check It, Change here.
The Importance of Changing Thoughts
We can all agree that children have a lot to cipher through these days. The world in which we live now did not exist a few years ago. The rise of social media, advances in technology, and the way humans communicate have helped create layers of anxiety and self-doubt, not to mention the state of the world right now. Assisting children to become mindful of the ways their thoughts can affect their emotions and behavior is one of the most important lessons we can grant them right now.
CBT can help children reframe how they recognize, understand, and assess their emotional and behavioral responses to adverse events. Realizing that emotions and behaviors can be regulated and managed can be empowering and lead to improvements in self-regulation, self- control, coping skills, and emotional awareness during critical stages of development.
The Benefits of CBT with Children
With cognitive-behavioral therapy being implemented at scale, researchers have documented the many benefits the therapy can bring to clients.
Here is a list of some of the benefits.
CBT enhances self-control, perceptions of personal efficacy, analytical problem-solving skills, social skills, and participation in activities that bring a sense of fulfillment.
CBT can help reduce anxiety in children from 7-15, increase their coping skills and improve their emotional awareness.
CBT can focus on trauma and can help relieve some symptoms of PTSD.
When used in group therapy, CBT can improve children's expressions and social skills.
Helps to decrease social anxiety.
When applied to school programs such as PBIS, CBT affects positive thinking and reduces negative self-talk. Very adaptable to other school-based programs as well and can go hand-in-hand with growth mindset lessons.
Improves social problem-solving abilities and reduces anger, aggressive tendencies, and physicality.
CBT can help children with anxiety disorders such as OCD.
CBT can also help children who have trouble sleeping due to stress from school-related and family obligations.
Additional Issues Addressed by CBT
Cognitive-behavioral therapy challenges destructive thoughts and negative actions and helps to replace them with more rational thinking patterns and more adaptive coping techniques. These techniques can help to bring changes in the symptoms of numerous issues that children and adolescence face today.
Oppositional Defiant Disorder: Disruptive behaviors such as outbursts of anger and aggression are the most common reasons children receive mental health referrals. ODD is a consistent pattern of highly hostile, defiant, and sometimes violent behavior toward authority figures. CBT has been proven to produce substantial decreases in ODD as it introduces children to ways they can learn to resolve difficulties and communicate in a new manner.
Low Self-Esteem: Low self-esteem has been associated with several childhood behaviors that can affect their functioning in debilitating ways. This may come from being bullied or not feeling good enough to perform in school or even make friends. Research from CBT studies has shown successful results in helping children improve their self-esteem and even take on new challenges.
Bullying: Bullying is a widespread phenomenon among children and adolescents and has plagued the school and playgrounds for generations. Aggressive behavior and abuse of power cause children to suffer from anxiety, sleeplessness, and depression. CBT interventions have helped reduce the stress children experience due to bullying.
Don’t Forget Your Data Collection!
If you are working on CBT skills and techniques with kids, you'll want to set goals and progress monitor them. Ideally, you want to collect baseline data before writing your goals and objectives, so you can make sure they are realistic and achievable.
For example, if a child cannot currently identify any unhlpeful thoughts, you don’t want to say that they will be able to independently identify and change 25 unhlpeful thoughts, as this is unrealistic.
You want your objectives to be S.M.A.R.T. which means they are: (S)pecific, (M)easurable, (A)chievable, (R)ealistic and (T)ime limited.
If you want to accurately collect data, I have provided instructions along with the Catch It, Check It, Change it game with data collection sheets and I give examples of S.M.A.R.T treatment and IEP objectives.
Skills for Big Feelings
If you want a more comprehensive resource for teaching children to identify and change their thoughts and learn coping techniques in a FUN way, please check out my Super Ultimate Skills for Big Feelings Growing Bundle. You will receive the book (available in paperback or eBook formats) as well as my Coping Skills Craftivities book, digital interactive notebooks, printable poster pack, trauma-informed guided relaxations, presentation slides, editable documents, schedules, family handouts, coloring coping skills workbook, digital and print games (including this Jolly Jellybean Thought Hunt Game and this Butterfly Thought Changer Game) and so much MORE!
As more resources are added to this growing bundle, those who have already purchased will get access to the updates at no additional cost.
CBT Social Story Workbook
This 20-page digital and print cognitive behavioral therapy workbook helps children understand how their thoughts, feelings, and behavior are connected. It is an introduction to basic CBT concepts. It is a good precursor or companion to Skills for Big Feelings.
Kids will learn how helpful thoughts and unhelpful thoughts impact their emotions and discuss the connections between their thoughts, feelings, and choices.
Black and white and color versions are both available. The black and white ones are great so your kids can color the pages! There is also a foldable booklet version, and full-page version, as well as a Google Slides edition if you are doing distance, remote, telehealth, or hybrid learning.
The Social Story Workbook Reviews: ✅ What a thought is. and what a feeling is ✅ The connections between thoughts, feelings, and behavior ✅ How helpful thoughts and unhelpful thoughts make you feel
There are Pages To: ✅ Draw what helpful and unhelpful thoughts look like ✅ Identify what helpful and unhelpful thoughts you have ✅ Draw how powerful you feel when you take control of your thoughts
