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How is Cognitive Behavioral Counseling Therapy Used with Children?

Updated: Jul 6, 2022


this infographic defines cbt and how it is used with children

Cognitive behavioral therapy is one of the most widely studied and proven therapies for mental health. It is a powerful treatment method and has been used for decades. It was originally used for adults, but it has also been shown to be effective for children. However, the concepts can be complicated and difficult without some patience and help.


There are several models available for understanding how thoughts, feelings, and behaviors are interrelated. Some explain it as a triangle model with all three connected. The ABC model shows that an antecedent happens (a trigger). This leads to triggering a belief held by the person, which then leads to a consequence, or an action/behavior. Research indicates that if you can change either the thoughts, feelings, or behaviors the others will change as well.


There are many skills used in therapy to help children become aware of their self-talk and how to challenge their thoughts. Visualization helps children use their imaginations to calm down, stop intrusive thoughts, and envision success. Grounding techniques can calm the fight or flight response during a panic attack. Journaling is a great way to process emotions by putting words to the experience. A picture journal can be used for smaller children. An important aspect of CBT is confronting fears instead of avoiding them. It is systematically helping the client grow in skills and confidence to be able to confront their fears.


Coping skills are introduced to calm down when triggered to regain control of emotions. They are a good place to start, as they are pivotal to helping children process the deep issues of the heart. Rapport can be established while finding fun ways to learn skills before diving into deeper questions that can trigger strong emotional responses.


Sand tray is a staple in most play therapy offices. It is a blank slate where children can confront fears, past experiences, or role-play problems they are facing. It is hard to avoid the issue because the issues almost always come out when the sand tray is used. Even if it is just burying things in the sand. Maybe the kids are trying to keep emotions buried?


Other interventions include reading books, making art, and playing games. These are all ways to communicate about the problem but using a child's primary language: play. Sometimes kids just don't want to talk at all. Play can often be their way of talking it out. Maybe a child will have a T-rex attack the rest of the dinosaur family as a way to communicate frustration at being ignored at home. Or perhaps a child will nurture a baby doll in a way she wants to be nurtured. They may act out a conflict with a friend or draw pictures of a family member who has passed away.


Storytelling and role-playing can also be a way to verbally process situations. These are often included in CBT games, as they can be powerful and healing. They provide a back-door approach to addressing issues that a child may be defensive to confront head-on.


CBT is an amazing tool, but many are unsure how to use it with children. We hope to change that! Our resources are designed to take complicated CBT concepts and break them down into bite-sized pieces that even young children can understand.



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