Cognitive-behavioral therapy (CBT) is one of the top recommended treatments for children who are struggling with anxiety, depression, or challenging behavior problems. (CBT works great for grown-ups, too.)
What is CBT? Let’s use a picture to show how it works:
As you can see, what we have here is a loop, with no clear beginning or end. What this means is that we can choose where to start: with changing our thoughts, addressing our feelings, or adjusting our actions.
For kids, we usually start by reinforcing for them the relationship between FEELINGS and ACTIONS. What we do affects how we feel. If we’re feeling down, we can do something to help give our mood a boost. When we’re feeling worried, we can do something to calm ourselves down. Kids can make their own list of activities that make them feel good, or better, or calmer when inside they’re feeling down or anxious. We pay special attention to those positive mood-boosting or calming actions that kids put on their list, like listening to or playing music; doing something outside; using our bodies in some way (this is a GREAT one); or talking with someone we trust. The idea is to help kids see the control they have to change their mood: what they do affects how they feel. Of course, this same approach applies to grown-ups. They have their own list of things that make them feel better or make them feel calmer. And just like with kids, we try to keep our eye on positive actions, like getting coffee with a friend, going for a run (or even a brisk walk), listening to music (extra points for dancing!), or anything creative at all, like baking, writing, cooking, drawing, or coloring with a child.
Once we’ve made the point about the two-way connection between feelings and actions we can start to bring THOUGHTS into the conversation. What we do not only affects how we feel, but it can also affect what we think. When you’re in the middle of an anxious spiral, just a 15-minute walk outside can help you turn down the volume in your head so you can start to see a troubling situation more clearly. What you did (take a walk) had an impact on what you thought (the threat-level felt high and out of control, and then after the walk you still felt anxious, but the threat-level was downgraded to where you could start to apply good decision-making).
At this point you probably know what’s next: what we feel not only affects what we do, but what we think, too. When we feel sad and hopeless, or when we feel really worried and anxious, it can sometimes have the effect of giving us tunnel vision, where all we see is what’s wrong or what’s scary. We don’t see the bigger picture – the things around us that are actually working okay or are there to protect us. That same process works in reverse, too. When our thoughts focus only on what’s wrong or what’s scary, if that’s all we see, then of course our feelings will follow in suit. We’ll feel helpless or hopeless, we’ll feel worried and anxious.
Cognitive-behavioral therapy shines a bright light on the connections between thoughts, feelings, and actions. When we see these patterns for what they are, when we see how they are operating in our lives, we have the power to intervene: to dismantle what’s not working and put in place healthier patterns of thinking, feeling, and being in the world.
Photo credit: https://www.clinical-partners.co.uk/child-adolescents/cbt