Using the Child Behavior Checklist (CBCL) to Assess Depression

African American mother consoling her sad girl at home.
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The Child Behavior Checklist (CBCL) is a common tool for assessing depression in children, as well as other emotional and behavioral problems. The CBCL is one of the most widely used measures for assessing emotional and maladaptive behaviors in children. It is used in a variety of settings such as pediatricians' offices, schools, mental health facilities, private practices, hospitals, and research.

What the CBCL Measures

The CBCL is used to assess a wide variety of behaviors and emotions in children, including depression. It's particularly useful when it is unclear what might be causing a child's problem behaviors or symptoms.

Psychologist Thomas M. Achenbach, PhD, developed the CBCL in 1966. He studied common problematic behaviors in children and used his findings to create a questionnaire that describes and detects those behaviors. These behaviors are meant to be easily identifiable by parents, caregivers, teachers, and others.

The questions are grouped into eight categories, or subscales, which focus on different aspects of behavior:

  1. Social withdrawal (e.g., not wanting to play with friends anymore)
  2. Somatic complaints (e.g., unexplained stomachaches)
  3. Anxiety/depression
  4. Social problems
  5. Thought problems
  6. Attention problems
  7. Delinquent behavior
  8. Aggressive behavior

There are also two broad scales made up of these syndrome scales. The internalizing behaviors scale includes the anxious/depressive, social withdrawal, and somatic complaints scores. The externalizing behaviors scale includes the delinquent behavior, social behavior, and social problems scores.

Who Uses CBCL

The CBCL is used by a qualified mental health professional to assess the behaviors and symptoms of the child.

There are two additional related versions of CBCL for the child and their teacher to complete: the Youth Self-Report Form (YSF) and the Teacher Report Form (TRF). The TRF is especially useful when the concern is stemming from classroom behavior.

Only one form of the survey is required for scoring, but completion of all three versions allows for different perspectives and cross-referencing.

There are two versions of the CBCL: one for preschoolers, and one for youth ages 6 to 18.

What to Expect

The CBCL is a survey completed independently with a paper and pencil. If there are concerns about reading level or comprehension, the survey can be administered orally by an interviewer. There are more than 100 items on this survey, so it may take between 30 minutes and one hour to complete.

For each question, the survey-taker must select the answer that best describes the frequency of the behavior. Additionally, there are several items in which an explanation of the behavior is required. Once the survey is complete, the qualified mental health professional will quickly review it to make sure all of the questions were answered.

Results

A trained professional needs to interpret the results. The raw score on its own is essentially meaningless. The mental health counselor who interprets the results should review and discuss findings.

All of the versions of the CBCL have been studied to ensure that it is a valid and reliable measure of a child's behaviors and emotions.

How to Prepare

Generally, there is no preparation needed for the CBCL. However, if you know that you will be taking the parent version of the survey, you may want to think about the specific behaviors in your child that are of concern to you.

Be sure to answer honestly. Indicating that your child may have some negative behaviors or feelings does not mean that you did anything to cause them.

Getting an accurate diagnosis for your child is extremely important for their treatment and recovery.

If your child will be taking the survey themselves, you can explain to the child that there are no right or wrong answers and that they will not be graded. A child may worry about how the results will affect him or her and the family. Encourage your child to be as honest as possible and be sure to reiterate that the child will not get in trouble for any answer.

You may consider rewarding or praising your child for completing the survey, as it takes a lot of courage, especially for a child, to answer questions honestly about feelings.

A Word From Verywell

If your child is depressed, or you are concerned about any behaviors or feelings, speak to your child's pediatrician or another healthcare provider. The health professional can accurately diagnose your child's symptoms and suggest appropriate treatment.

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