Ever consider how your thoughts, emotions, and behaviors are interrelated? For example, if you frequently think “I’m no good,” your self-esteem is likely to plummet. If you can’t control your anger, you’re more likely to act it out in inappropriate ways.
Cognitive behavioral therapy (CBT) explores such connections to help teens understand them and achieve positive changes. It’s a therapeutic approach based on the idea that an individual’s thoughts drive both their feelings and behavior.
What is CBT for teens?
CBT is based on the pioneering work of Aaron Beck, a psychiatrist who discovered that certain types of thinking contribute to psychological difficulties. Beck called these patterns “automatic negative thoughts.”
The theory behind teen CBT is that thoughts give rise to emotions. If a teen is suffering because of negative feelings, therefore, they can alleviate their distress by applying CBT principles. According to CBT, much psychological suffering is caused by one’s interpretation of events, so changing our interpretation of a particular event can change how we feel about it.
For example, a teen who hears classmates laughing might think others are making fun of them behind their back. If this teen analyzes this automatic thought, however, they might see that these chuckling students aren’t necessarily laughing at them. This recognition can stop any mental torture about being ridiculed.
Here’s another example: some adolescents see others’ social media highlight reels and think their lives can’t possibly measure up, causing them to develop a poor self-image. CBT can help such teens challenge this negative self-talk and establish healthier ways of thinking.
A CBT therapist begins by helping a patient identify flawed thought patterns that cause them to see themselves and the world in overly negative ways. Such errors in thinking are called cognitive distortions. Once they gain this insight, patients can work on cultivating more positive and empowering ways of looking at themselves and the world.
Common cognitive distortions
- Black-and-white thinking: This faulty thought pattern causes people to see the world in terms of extremes. For example, one may think, “If I don’t get straight As, I’m a total failure who’ll end up homeless.”
- Jumping to conclusions: This is where someone makes an unfounded assumption based on limited information. For instance, a teen may see a classmate walking by with an expression of disgust and immediately conclude that this student hates their guts. However, their classmate may have only been thinking about an upcoming dreaded chemistry test.
- Magnification: Also known as “making a mountain out of a molehill,” this cognitive distortion causes people to blow things out of proportion. For instance, a teen believes that not making the football team isn’t a momentary setback but a disaster of epic proportions.
- Overgeneralizing: This is where someone makes a broad assumption based on a single experience. For example, a teen who fails their driving test may believe that they’ll fail at everything.
- Emotional reasoning: In this cognitive distortion, a person believes something is true based on feelings. For instance, “I feel anxious, so something bad must be about to happen.”
Behavioral issues
CBT for adolescents has been found to be particularly helpful for those struggling with behavioral issues because these types of problems often arise from an inability to regulate emotions.
When their anger gets out of control, for example, teens sometimes have an overwhelming urge to act on this feeling, prompting destructive behavior. CBT helps to extinguish the negative emotions that fuel this troubling behavior.
CBT activities for teens
Cognitive restructuring
In this approach, a therapist examines the errors in a teen’s thinking and helps replace them with rational alternatives. For example, they may help an adolescent reframe the thought “I only won that award because they felt sorry for me” to “That award is given for merit, and I deserved to win it.”
Guided discovery
This approach involves asking questions that make a teen consider why they think the way they do. When the counselor sees that the teen is making assumptions, for example, they’ll ask them to provide evidence that both supports and contradicts these claims. This process can lead to healthier, more empowering thought patterns.
Journaling
Between therapy sessions, teens can work on overcoming self-sabotaging thoughts by journaling. In a CBT journal, they can log the following aspects of negative thoughts they experience to help them recognize and challenge their thought patterns:
- The situation that triggered the thought
- A ranking (1 to 100) of the resulting emotion
- The physical sensations that accompanied the thought
- How strongly they believe the thought
They can also use their journal to envision likely outcomes. When we worry about something, we often think about worst-case scenarios, even if they’re unlikely. To prevent such needless catastrophizing, an adolescent can challenge their anxiety by asking themselves the following questions:
- What am I worried about?
- How likely is it to happen on a scale from 1 to 10?
- What will likely happen instead?
- If my fear becomes real, how will I handle it?
- Will I be okay no matter what happens?
Self-soothing techniques
Cognitive distortions often prompt negative emotional reactions because thoughts fuel feelings. That’s why reframing is usually accompanied by self-soothing techniques. An example is progressive muscle relaxation, in which one slowly relaxes their body, starting with the toes and ending with the head, until they’re completely relaxed.
Another technique is breath awareness, which can be used after a negative thought triggers an unpleasant emotion, such as panic. When one puts all their attention on their breath, it’s impossible to think. Practicing this technique not only provides temporary respite from the troublesome thought but also allows one to step back and see how it creates suffering.
How effective is CBT for teens?
CBT for teens has proven highly effective. For example, a 2004 study compared the effectiveness of CBT and medication in treating depression in adolescents. CBT reduced depressive symptoms as much as medication.
Another study found that two-thirds of teens responded favorably to CBT treatment for anxiety. Studies have also shown that CBT is the most effective evidence-based treatment for eating disorders.
CBT for adolescents has also proven highly effective at treating a range of other mental health conditions, including the following:
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Substance use disorder
- Panic attacks
- Bipolar disorder
- Phobias
- Panic disorder
How long does CBT for teens take?
Most people learn the basics of CBT within 15 sessions. Some adolescents may see improvements within a week or two of implementing CBT strategies. For others, it might take several months.
Importantly, teens who learn CBT techniques acquire skills that can benefit them for the rest of their lives. Because the approach is interactive and involves continual introspection, it tends to keep teens interested and engaged. They continually reinforce the skills they’re learning by doing homework outside of sessions.
CBT for teenagers: Final thoughts
If your teen is suffering a mental health condition, such as depression or anxiety, CBT can help them manage symptoms. At Avery’s House in both Phoenix and Boise, we have experienced mental health counselors who specialize in treating adolescent issues and skillfully employ CBT and other evidence-based therapies to help teens recover, grow, and forge happy and successful futures.
Contact us today to learn more!