All children and adolescents feel anxiety, fear or sadness at one time or another. These emotional responses help them cope with danger, threats and loss. However, when symptoms persist or adversely affect their daily living, they may represent a more serious condition, such as an anxiety disorder or depression.
How Cognitive Behavioral Therapy (CBT) Works
A form of psychotherapy, CBT is a problem-focused, skills-based treatment that teaches clients how to identify and modify unhelpful behavior patterns and thinking patterns that may cause or increase anxiety and distress. CBT typically focuses on difficulties in the moment, and relies on the therapist and client to develop a shared view of the client's problem. CBT with children and adolescents will always involve the family, who are a key resource to support change.
Conditions CBT Can Treat in Children & Adolescents
- Agoraphobia: persistent avoidance of situations that could trigger panic attacks. Common examples for children and adolescents include a fear of being trapped in situations or places without an escape or without help.
- Body Dysmorphic Disorder: a preoccupation with one or more perceived defects or flaws in physical appearance. Although others don't notice these perceived flaws, the individual feels driven to perform excessive, repetitive behaviors or mental acts in response to appearance concerns.
- Child Abuse: verbal or physical maltreatment or sexual molestation of a child.
- Depression: persistent depression can interfere significantly with an individual's ability to function. Depression in children and adolescents often looks different than it does in an adult. A professional opinion will help to provide the correct diagnosis.
- Generalized Anxiety Disorder: excessive worrying. Other symptoms include muscle tension, restlessness, irritability, difficulty concentrating and the feeling of being keyed up or on edge.
- Hair-pulling/Trichotillomania: recurrent pulling out of hair, resulting in noticeable bald patches.
- Health Anxiety: excessive preoccupation with having or acquiring a serious illness. Although somatic symptoms are not present or are mild, the child or adolescent experiences anxiety about health and repeatedly checks for signs of illness, or exhibits maladaptive avoidance.
- Obsessive-Compulsive Disorder: recurrent, distressing thoughts or ritualized behavior, such as excessive hand washing.
- Panic Attack: a sudden rush of intense fear or anxiety. Physical symptoms include rapid heartbeat, dizziness, difficulty breathing and/or sweating.
- Panic Disorder: frequent occurrence of unexpected panic attacks and excessive worry about having panic attacks.
- School Refusal: when the school environment triggers emotional distress – whether due to abuse, bullying or other causes – children may develop warning behaviors, such as not wanting to go to school, calling home from school or refusing to get out of bed on school days.
- Skin-picking/Excoriation: recurrent skin picking that results in skin lesions.
- Social Phobia: excessive fear of being observed by, criticized or embarrassed in front of others. Children or adolescents with social phobias exhibit excessive dread and try to avoid situations such as public speaking, eating in front of others and going to parties.
- Specific Phobia: the exaggerated fear of a specific situation or objects. Even though a child or adolescent may recognize that the fear is excessive, they still avoid the situation or object.
How Long CBT Takes
Effective CBT treatment requires that each client have a highly individualized plan for treatment, follow-up and aftercare. Because every client differs, the number of treatment sessions varies, but many problems can be treated in 12- to 20-week individual therapy sessions.
The Role of Parents During CBT for Children & Adolescents
Parents will be supported in becoming "emotion coaches" for their children in a developmentally appropriate way that aims to promote their child's independent, effective use of coping skills.
How to Get Your Child Started with CBT
First, we will need a complete assessment of the problem. Clients participate in a detailed, comprehensive interview about past and present problems with depression, anxiety, panic and related conditions. We ask each child or adolescent to fill out questionnaires to determine exactly what triggers the problem and identify the severity of symptoms.
This results in an explicit, understandable and flexible treatment plan that accurately reflects the adolescent's individual needs and how the family can help. We also encourage each child or adolescent to undergo a physical examination with their medical doctor.