What Are the Pros And Cons of CBT (Cognitive Behavioural Therapy)?

April 24, 2021 The Ed Psych Practice No Comments Referrals Anxiety, CBT, Children, Depression, Evidence Based, Mental Health, Present Focus, Short Term Therapy, Talking Therapy

Takeaway: CBT is a form of talk therapy that helps us change the way we think, which in turn changes the way we react to challenges. It can help your child through tough times, but make sure you find a skilled therapist who has experience working with children.

Cognitive behavioural therapy (CBT) is a type of talk therapy that’s become especially popular over the last few decades.

CBT was developed in the 1960s by University of Pennsylvania psychiatrist Dr Aaron T Beck to treat depression. But over the following years, it was applied to a range of other concerns like anxiety, drug addiction, eating disorders, mental illness, and more. And nowadays, it’s a key part of most psychologists’ toolkit.

CBT helps people by taking the focus off the problems they face and redirecting it to how they respond to the problems.

At the heart of CBT is the idea that when we’re overwhelmed, anxious, or upset by something, it’s our thoughts and feelings about the event that’s causing us problems — not the event itself. So, if your child is made fun of at school, it’s not the teasing that makes her unhappy. Rather, It’s her thoughts — for example, ‘I’m not good enough’ or ‘Nobody likes me’. These inaccurate thoughts trigger negative emotions (e.g., sadness or loneliness) which in turn reinforce the thoughts. Soon, your child is stuck in a vicious cycle of negativity.

CBT breaks the downward spiral of distorted, negative thinking.

As she works with a therapist, your child will learn to recognise negative, inaccurate thoughts and replace them with more balanced, accurate ones. For example, ‘Nobody likes me’ is an overgeneralisation, and a more accurate thought is, ‘On Tuesday, 3 of my friends didn’t like the clothes I was wearing’. By redirecting and refining her thinking, she’ll learn to explore problems more constructively. Note: This is not about positive, wishful thinking. It’s about being more objective, precise, and deliberate in how we approach life.

So, why is CBT for children so popular? Here are some of the main reasons.

The principles of CBT stay the same whether we’re applying them to an adult or a child. The only differences are the exercises we use and how we teach children to apply these abstract concepts. Here’s why CBT for children is so popular.

1. It’s evidence-based, so we have proof that it works.

CBT theory and practice have been rigorously tested in real-life situations. So, they’re not just a medley of ideas that make sense. When psychologists talk about, say, how effective CBT is in helping anxious children, it’s based on trials with hard data backing their claims. For example, one trial took 37 anxious children aged 3-7 years old and looked at how bad their symptoms were before and after CBT. And after just 8 sessions, on average, most of them had become much less anxious — based on reputed ratings scales and questionnaires. These findings have been replicated in other studies, too. And this is the sort of scientific evidence on which CBT is built.

2. It’s goal-oriented, so it’s simple to track your child’s progress.

After an initial assessment, the therapist will develop a clear plan of action for your child. There’ll be specific goals, subgoals, and a timeline for reaching them. Also, each session is carefully designed, lasting about 30-60 minutes with about one session a week. Often, you’ll see results after as few as 8 sessions — although, sometimes a CBT course could go on for up to 20 sessions. As a parent, you’ll love this approach because it makes it easy to track your child’s progress.

3. It’s largely standardised, so quality-control is easy.

While most goals will be specific to your child, CBT’s general approach remains the same. And this makes it easier for therapists from different backgrounds to get the same results. Here’s roughly what’s involved:

Learning what ‘thoughts’ and ‘feelings’ are. The therapist might start by explaining that thoughts are ‘words we say to ourselves’ and they happen all the time without us realising it. Next, she might check your child’s ‘feelings vocabulary’. Does your child understand basic feelings like ‘angry’, ‘happy’, and ‘sad’? If so, she can start learning more advanced ones like ‘frustrated’, ‘excited’, and ‘depressed’.
Separating thoughts from feelings. This is where your child will learn there’s a difference between thinking a thought (e.g., ‘My friends don’t like me’) and feeling an emotion (e.g., loneliness). Once she realises this, she won’t be a victim of her feelings. She’ll be able to negotiate with them by examining the underlying thoughts.
Practising how to apply these ideas. Now your child will need to practise what she’s learned. A common exercise is to go through cue cards each listing a thought or a feeling, and sort them into one of two trays — a ‘feelings’ tray and a ‘thoughts’ tray. Or, the therapist could use storytelling as a tool — asking your child to differentiate between the thoughts and feelings her favourite characters experience.

4. It’s empowering, so it can help all children (not just those with a specific challenge to overcome).

The beauty of CBT is that it’s not just for children struggling with challenges. Instead, it can help empower all children with a new way of approaching life. First, it teaches them to focus on the things they can control — i.e., their reaction to events. Then, it helps them become more self-aware — able to separate fact from feelings and irrational thoughts. And this in turn lets them challenge their limiting assumptions about life, situations, and people. Take, for example, the teased child from earlier. CBT would train her to challenge her faulty assumptions, so she’ll see that her friends don’t necessarily mean her harm. Now, she’s more likely to explore the problem rather than shying away and isolating herself further. And this habit of exploring will give her to confidence to face whatever life throws at her.

5. It’s cost-effective, so it can fit most budgets.

CBT emphasises the here and now. So, rather than delving into the past and trying to give those events meaning, it deals with your child’s current thinking and behaviour patterns. Plus, as we saw earlier, it’s structured and goal-oriented. Both these characteristics mean that CBT can accomplish a lot in relatively short bursts, as opposed to open-ended, long-term therapy. This short lifespan of CBT makes it very affordable.

You’ll need a skilled therapist, though, who has lots of experience with children.

CBT does have some limitations. Because it only focuses on the present and your child’s reactions to events, it doesn’t consider other factors that can affect her behaviour. For example, she might have genetic triggers for depression. If so, addressing her faulty thinking alone might not be enough. And it’ll take a skilled therapist to recognise this and switch to a more eclectic approach.

Do you feel your child might benefit from CBT? Consider consulting a specialist.

The Ed Psych Practice offers online assessments, consultation, advice, and problem-solving strategies for parents, nurseries, schools, and colleges in London. We have psychologists and therapists who can help assess your child and offer guidance and support.

Phone: +44 (0) 78 3344 7356
E-mail: Office@TheEdPsych.com