Cognitive behavioral therapy, often referred to as CBT, is a type of psychotherapy that focuses on making connections between thoughts, feelings and actions, based on the belief that when negative thought patterns are identified, positive changes in feelings and behavior can take place. Currently CBT techniques are being used to treat a wide range of problems in troubled teens including eating disorders, substance abuse, anxiety and depression.
The Basic Principles of CBT
The term CBT refers to several types of therapy with a similar approach - changing behavior by identifying negative and distorted thinking patterns. All CBT approaches emphasize the link between thoughts, feelings and behavior; identifying the ways certain thought patterns contribute to problems and how changing one's thoughts can result in acting and feeling differently.
CBT is a problem focused, goal directed approach that helps teens identify the ways their thoughts influence how they feel and behave. Connections are made through the therapeutic process of monitoring individual reactions to daily events, usually by keeping a journal, and discussing them in each session.
For example: a teen may think 'I'm worthless,' in response to forgetting to set the table. The cognitive therapy process will explore the distorted nature of these beliefs, how these thoughts make the teen feel and the behaviors that emerge and perpetuate this negative cycle.
How CBT Works
Troubled teens develop distorted thinking for several reasons including:
- Feeling an increased sense of control
- Justifying their behavior or choices to others
- Not knowing other ways to cope
The techniques used in CBT confront and attempt to modify these distortions through a process that:
- Tests out beliefs
- Identifies thought patterns that cause distress
- Focuses on realistic interpretations of events
- Teaches problem solving and coping skills
- Changes unwanted reactions and patterns
- Shows how internal thoughts lead to actions more than external influences
- Provides teens with experience articulating their thoughts
In early sessions the therapist asks numerous questions in order to help the teen identify needed changes and to begin exploring thought patterns that are working and those that aren't. 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 seems to work by helping teens learn how to interpret their environment differently. Compared to certain other therapeutic approaches it is more short term and very problem focused, dealing with issues in the present. It teaches ways to identify distortions in thinking and how to make changes by dealing with these distortions in more positive ways.
This type of therapy can provide the following potential benefits:
- Improve communication with others
- Help in dealing with fears
- Interrupt thoughts that lead to addictive or other self-destructive behaviors
- Improve self-esteem
- Identify positive responses to stress
- Change negative thought patterns
The CBT approach is likely to be most effective for teens struggling with issues related to distorted thinking who have the interest and cognitive ability to make connections between what they think and how they act. Cognitive behavioral therapy is increasingly being used to treat teens struggling with emotional or behavioral disorders, and is offered in both individual therapy and group therapy sessions.
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