What is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy, often referred to as CBT, is a type of psychotherapy that focuses on making connections between thoughts, behavior, and feelings. Psychotherapists who use CBT help people identify and change dysfunctional patterns.

CBT is often used with adolescents. It can be effective in treating a wide range of issues including eating disorders, substance abuse, anxiety, and depression.

The Basic Principles of CBT

CBT is based on the idea that there is a clear link between thoughts, behavior, and feelings. Here's an example:

• Thought: I'm socially awkward
• Feeling: Anxious
• Behavior: Teen sits in the corner alone while at a party

A teen who thinks she is awkward might avoid eye contact and shy away from conversation. Then, when she doesn't have positive social interactions, her belief that she's socially awkward is reinforced.

CBT aims to break that cycle by changing the way a teen thinks or behaviors. 

A psychotherapist may help the teen challenge negative assumptions with a behavioral experiment. For example, the teen who thinks she is socially awkward might challenge herself to strike up a conversation with five new people. If she experiences some success, her belief that she is socially awkward might not be as strong. 

Additionally, the therapist may help her change her thoughts.

When she tells herself, "People think I'm weird," she might remind herself, "Everyone is different and that's OK." Changing her thoughts can reduce the anxiety she experiences. 

How CBT Works

Teens often develop distorted core beliefs about themselves. CBT helps confront and modify those distortions.

A teen who believes she's unworthy, may always look for evidence that reinforces this belief. For example, if she gets a bad grade on a test, she may think it's because she's stupid. And if a friend doesn't call her back, she may assume it's because her friend doesn't like her anymore.

A psychotherapist using CBT would help the patient identify those unhealthy thought patterns that contribute to mental health problems. A therapist may ask a series of questions and ask a patient to keep a thought record to help identify dysfunctional thoughts.

In later sessions, specific techniques are utilized that teach new ways to think about maladaptive thought patterns and behaviors and may lead to more effective ways of getting one's needs met. For example, CBT can be effective in treating a teen with bulimia by exploring and helping change thoughts, attitudes and feeling patterns about their body and food that lead to purging behaviors.

The Benefits of CBT

CBT helps teens learn how to interpret their environment differently. Compared to other therapeutic approaches CBT is short-term. Sometimes, only a handful of sessions are needed.

It is also very problem-focused which means it deals with issues in the present.

Treatment providers aren't likely to rehash a teen's childhood or look for hidden meaning in their behavior. Instead, sessions focus on helping the teen with problems going on now. 

This type of therapy can provide benefits such as:

• Improve communication with others
• Reduce fears and phobias
• Interrupt thoughts that lead to addictive or other self-destructive behaviors
• Improve self-esteem
• Identify positive responses to stress
• Change negative thought patterns

How to Find a Cognitive Behavioral Therapist

If your teen is struggling with a mental health problem or a behavioral issue, talk to his physician. A physician can rule out any possible medical issues contributing to the issue can refer you to a cognitive behavioral therapist.

A cognitive behavioral therapist will likely want to interview you and your teen to gain a better understanding of the current issue. Then, sessions may include your teen only or the therapist may want you or other family members to attend.

CBT often involves homework assignments. Getting parents involved in supporting a teen's efforts to complete the homework can be key to getting better. Be sure to talk to the therapist about how you can best support your teen's treatment.

Sources

Flink IK, Sfyrkou C, Persson B. Customized CBT via internet for adolescents with pain and emotional distress: A pilot study. Internet Interventions. 2016;4:43-50.

Spirito A, Esposito-Smythers C, Wolff J, Uhl K. Cognitive-Behavioral Therapy for Adolescent Depression and Suicidality. Child and Adolescent Psychiatric Clinics of North America. 2011;20(2):191-204.