What is CBT (Cognitive Behavioral Therapy) and why it is effective with adolescents?

CBT: An effective psychotherapeutic approach for adolescents

The effectiveness of CBT for various psychological problems has been researched more extensively than any other psychotherapeutic approach.  Several studies reveal that CBT is more effective than medication alone for the treatment of anxiety and depression.  I find CBT to often be a match for my adolescent clients because there is usually some faulty thinking going on to some extent, such as catastrophizing or mental filtering, for example.  And due to this faulty thinking, the client, let’s just say, is not feeling optimal.  CBT offers a very concrete format that usually resonates with adolescents, who strive off of a more structured approach that is under their control.

When presenting CBT to a client initially, I think it’s most important to discuss the efficacy of it for the client to buy in and then introduce the basic principles of the modality. “You think how you  feel” is a good way of summing up CBT.  Often, individuals have common thinking errors but there are ways to counteract skewed thinking.  Even when circumstances and other people in one’s life are unlikely to change for the better, the client can still make positive changes.  This offers the adolescent some real hope.

After discussing the basic themes of CBT, it’s important to the chart the course or define problems and set goals with the adolescent.  This allows the client to see where their problems are springing from and develop specific and attainable goals for their emotional future.  Perhaps an adolescent had made the attempt to deal with worries and ideas about themselves on a frequent basis before, but it actually ended up being counterproductive in the long term.  CBT gives more alternative strategies to produce long term benefits.

Actions, of course, speak louder than words.  While correcting one’s thinking is an important endeavor and the “meat and potatoes” of CBT, all of one’s efforts to think in a healthy way could fall apart at the seams unless one can translate new beliefs into new actions. A lot of this involves manageable exposure, where one can successfully experience facing one’s fears and mastering them and taking it step by step.  Let’s assume anxiety is a symptom with client, for example. Clients can rate their experiences in terms of how fearful they are of them, and eventually override these anxieties through a step-by-step approach in which they continue to put themselves in more challenging situations that trigger anxiety, as they progress.  By exposing themselves to new situations, clients will often realize that the actual event wasn’t as bad as their mind pictured it to be.

You often hear that CBT ignores the past, which is actually a myth. CBT concentrates on how your current thinking and behavior cause your current difficulties.  This part aids you in recognizing experiences from your past that may have lead you to form certain types of beliefs about yourself, other people, and the world around you.  Assigning updated and more accurate meanings to past events really can make a difference to the way an adolescent can experience life today.  So, the past shouldn’t be ignored!

CBT is a very effective tool for adolescents in promoting positive change and a life full of new perspectives and meaning.  While I believe it is not the end all be all to solving issues, usually some benefit can be seen if effectively delivered and appropriately incorporated into therapy sessions.

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Ryan Long, MSW, LICSW



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