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ToggleWhen teen’s mental or behavioral issues get worse, it often comes down to how they think and act. One way to work through this is Teen CBT or Cognitive Behavioral Therapy. It’s a popular method that helps teens deal with mental health and substance abuse problems by changing negative thinking and behavior patterns.
Since 2015, we have offered Cognitive Behavioral Therapy for teens within our teen treatment programs at Key Healthcare. Adolescents engage in both individual and group therapy sessions tailored to address mental health issues and substance abuse with dual diagnosis. For further details about our comprehensive care options, including intensive outpatient, partial hospitalization, and residential treatments for teens, feel free to reach out to us.
Our experts here try to answer all common questions, providing a comprehensive guide on cognitive behavioral therapy techniques to let you know all there is to know about it.
What is Cognitive Behavioral Therapy (CBT)?
Cognitive behavioral therapy is a structured, goal-oriented psychotherapy focused on changing maladaptive thoughts and behaviors that result in negative outcomes. This therapy technique is one of the most studied and scientifically proven to lead to a notable improvement in functioning and quality of life.
The Benefits of CBT for Teens
- It is a well-researched and established form of therapy that effectively treats various mental health problems. It may be helpful in situations where medication alone has not been effective.
- CBT can treat numerous mental health and emotional issues.
- CBT can be completed relatively quickly compared to DBT or ACT.
- CBT helps your teen develop and retain positive thoughts and beliefs and alters behaviors to change their feelings positively.
- CBT offers long-lasting benefits to teens’ anxiety and mental health since they can use the skills learned throughout their lives.
- It empowers teens to learn skills and strategies for managing their mental health by themselves, giving them more control over their lives.
- CBT is holistic as it considers your teen’s broader context and experiences.
Conditions Treated by Cognitive Behavioral Therapy (CBT)
CBT can treat and manage various mental health conditions and emotional changes in people of all ages.
Mental health conditions managed and treated by CBT include;
- Anxiety
- Phobias
- Depression
- Personality disorders
- Obsessive-compulsive disorder (OCD),
- Post-traumatic stress disorder (PTSD),
- Attention-deficit/hyperactivity disorder (ADHD),
- Substance use disorder and alcohol use disorder
- Eating disorders, including binge eating disorder and bulimia
- Combined with medication, it can help treat bipolar disorder and schizophrenia.
Nonpsychological medical conditions that CBT can assist in managing include;
- Insomnia
- Migraines
- Irritable bowel syndrome
- Chronic fatigue syndrome
- Fibromyalgia and other chronic pain causes.
CBT can also help deal with daily life challenges such;
- Grief
- Relationship issues
- Problems at work
- Divorce
- Stress and coping difficulties.
The Principles of CBT for Behavioral Issues
CBT is based on four core principles, which help to identify the root cause and treatment of behavioral issues among teens. The core reasons for teen behavioral issues are
- Wrong or unhelpful ways of thinking.
- Learned patterns of unhelpful behavior.
- Problematic core beliefs include central ideas about the world and yourself.
- People who suffer from psychological problems can learn better ways of coping with them, thereby helping to relieve their symptoms and improve their mental and emotional health.
The Structure of CBT Sessions
CBT sessions are structured and goal-oriented. They are geared toward helping you identify and change negative thought patterns and behavior that lead to psychological and emotional problems.
Typically, CBT involves three types of sessions;
- The evaluation session aims to develop a collaborative and individualized treatment plan to help you achieve your goals and improve your mental health.
- The first therapy session is in which the treatment and problem-solving begin.
- The therapy sessions afterward, in which treatment continues as you progress toward self-sufficiency.
How Does the CBT Session Work?
The typical structural format of all CBT sessions includes the following components;
- Agenda setting: At the beginning of every session, you and the therapist collaboratively set the session’s agenda, which involves identifying the issues you want to focus on during the session.
- Review of Homework: In case you were assigned homework in the previous session, the therapist will review it with you to assess your progress and tackle challenges you might have faced.
- Discussion and Analysis of Thoughts and Behaviors: This is the central part of the session, which involves you and the therapist collaboratively working to identify and analyze the thoughts and behaviors contributing to your difficulties.
- Homework Assignment: The therapist typically assigns homework for you to complete between sessions. The homework will help you practice new skills and reinforce what you learned during the session.
- Review and Feedback: At the end of the session, you and the therapist review what was covered and provide feedback to each other to help ensure that you are progressing and that the therapy meets your needs.
The Role of the Therapist in CBT
A cognitive behavioral therapist works one-on-one with you to explore thoughts, beliefs, and behaviors and determine how each affects your life.
The main work of the therapist is to talk to you. As they do, they help you set goals for each session, keep you on track, reflect on your progress and regression, design healthier behaviors, and assist you in getting rid of negative thoughts, beliefs, and behaviors.
The roles of the therapist in CBT may also include the following;
- Teaching you mindfulness and relaxation
- Assigning you homework that may consist of journaling or reading assignments
- Giving you thought exercises.
- Coaching you to reduce the results of fear
- Creating treatment plans
- Openly challenge beliefs and thoughts.
- At the end of CBT, the therapist should have helped you be self-sufficient.
CBT Techniques for Teens
Three main CBT techniques can be used to treat or manage teens’ mental health and emotional issues.
Behavioral Activation
Behavioral activation involves using behaviors to influence your emotional state. It is based on the idea that deliberate practice of certain behaviors can activate a positive emotional state. For instance, engaging in fulfilling or healthy activities makes teens feel good, making them more likely to continue participating.
However, the reverse of this idea is also true. When teens engage in activities or behaviors that make them feel bad, they activate unpleasant feelings, which may create a vicious cycle.
Behavioral activation is mostly used for treating depression and encouraging teens to participate in antidepressant behaviors. It may also help with overcoming substance misuse and addictions.
Cognitive Restructuring
This technique aims to reduce the impact of negative and unhelpful thinking on a teen’s well-being by changing the teen’s beliefs and thinking patterns. It involves slowly replacing an unhelpful belief or thinking style with a more positive, accurate, and helpful one.
Cognitive restructuring may help a teen deal with anxiety, stress, depression, relationship problems, low self-esteem, and insomnia.
Exposure Therapy
Exposure therapy aims at helping teens overcome their fear by gradually exposing them to their fear and anxiety triggers. The teen is exposed to all the causes of their behavior in the presence of the professional. The therapist then guides them on handling objects, thoughts, or situations.
The therapist regulates the frequency and period for which the teen is exposed to the triggers until such a time that the teen is capable of moving on to a more complex situation. By the end, the teen will have tackled all the situations, objects, or thoughts they ought to and will be better equipped to manage their anxiety.
This technique effectively treats anxiety disorders such as phobias, PTSD, OCD, and generalized anxiety disorder.
How to Prepare Your Teen for CBT
Before taking your teen for CBT, you must prepare them so that they open up and actively engage in the therapy process.
When explaining CBT, use simple and understandable terms to acquaint your teen with what CBT is, what it involves, its benefits, what to expect, and the therapist’s role in the process. Ensure that you explain to them the main purpose: to help them manage their thoughts and emotions and make them positively change their lives.
Secondly, set reasonable goals for the therapy. Lastly, emphasize the goal of the treatment and that the therapist is there to help them achieve their goals.
What to Expect During CBT Sessions
During CBT, your teen and the therapist work together to identify and tackle negative thoughts, patterns, and behaviors contributing to your problems. CBT sessions involve:
- Discussing the goals of the therapy.
- Identifying and challenging negative thought patterns.
- Learning coping skills.
- Homework assignments.
- Review progress.
The Role of Medication in CBT for Teens
Combining CBT and medication for treating mental health issues may be advantageous over using either treatment alone. However, the combination may not be necessary at all times.
When Medication May Be Necessary
Medication in CBT may be necessary when your teen is dealing with chronic or severe recurrent mental health issues or when hospitalized. The therapist may also recommend whether medication is needed based on their assessment of your teen’s problem.
Types of Medication Used in Conjunction with CBT
Common medications used with CBT include;
- Antidepressants – Commonly used in treating depression and anxiety disorders. For depression, a combination of antidepressants and CBT is more effective than either treatment alone. On the other hand, CBT is more effective than medication for the treatment of anxiety disorders.
- Mood stabilizers – These are used to treat mood disorders such as bipolar. They regulate neurotransmitters in the brain to help stabilize mood and reduce mania and depression symptoms.
- Antipsychotics – Medications used in treating psychotic disorders such as schizophrenia and bipolar. They block dopamine receptors to reduce delusions, hallucinations, and other psychotic symptoms.
- Benzodiazepines – Medications used to treat sleep and anxiety disorders. They work by raising the activity of GABA, which can reduce anxiety, thereby relaxing your teen. They are, however, not suitable for long-term use.
Finding a CBT Therapist for Your Teen
You must choose the right therapist for your teen to ensure the effectiveness of the treatment.
How to Assess a Therapist’s Qualifications
To assess a therapist’s qualifications, check the following;
- Credentials – A licensed or certified therapist is an indication of qualification. Look for a therapist who has specialized in working with teens, as they may be well-equipped to handle teen matters.
- Reviews or testimonials – You can check the therapist’s reviews or ask their past clients for testimonials. These tend to give an idea of the therapist’s effectiveness and the quality of service they provide.
- Their education and training – These indicate the therapist’s area of specialization.
- Additionally, you may assess a therapist by relying on your gut feeling to determine whether they fit your teen.
- Therapist availability – You should consider the therapist’s availability, schedule, and location. The therapist’s schedule must align with that of your teen. The therapist’s location should also be convenient for your teen to access.
Questions to Ask During an Initial Consultation
An initial consultation is your opportunity to learn about the therapist’s credentials, cost, and approach to therapy. It may be uncomfortable to ask a therapist about their qualifications and cost. However, this information is necessary if you are to end up with a therapist that suits your teen’s needs.
Examples of questions you may ask include;
- How long have you practiced?
- What certifications and licenses do you have?
- Are you registered with a professional organization?
- What are your charges, and do you accept insurance?
- What approaches do you use in therapy?
- Have you had clients with similar issues to my teen? How many?
- Can you describe your ideal patient?
You can ask other questions to get answers to every other information you may consider necessary, such as privacy issues, appointment times, and length of sessions.
The Limitations of CBT for Teens
When CBT may not be Effective for Your Teens
Situations when CBT is not effective for your teen include;
- When the therapist is inexperienced or lacks the skill for CBT.
- When the mental health issue cannot be effectively treated using CBT. For instance, severe depression and schizophrenia.
- When your teen is unwilling to undertake CBT treatment.
- When your teen is not comfortable with the CBT therapist.
- When your teen has cognitive limitations or developmental disabilities, CBT alone may not be effective. Other therapies, like teen ACT and DBT, may be more suitable.
The Importance of Ongoing Support after CBT
After your teen has completed CBT treatment, you must continue supporting them. This is for the following reasons;
- To prevent relapse.
- To maintain the gains of CBT.
- Ongoing support may help your teen address new challenges as they continue to apply the skills learned in CBT.
- Ongoing support may help teens improve their overall well-being by giving them space to express their concerns and receive guidance as they continue to practice self-care.
How to Address Relapse or Setbacks During CBT
Below are some ways of addressing relapse and setbacks;
- Identifying setback triggers and developing strategies to manage them.
- Reassessing treatment goals and modifying them based on the setback will help your teen remain motivated and focused on improving.
- The therapist can review the skills that your teen has learned during the CBT treatment to determine the ones that can help address the setback or to train them on other skills that can.
- With the aid of their therapist, your teen must challenge negative thoughts and develop positive and realistic beliefs to avoid setbacks.
- Modification of the treatment may be necessary if the setback is severe. Your teen may be introduced to additional treatment models, such as medication, to make the treatment effective.
Disadvantages of CBT
- Your teen needs to commit to the treatment; otherwise, it will not be effective. The therapist can only advise but cannot solve the teen’s problems alone.
- CBT depends on your teen’s ability to change themselves but fails to address familial or wider systemic problems that may impact mental health.
- For first-timers, CBT may initially cause increased anxiety or emotional discomfort.
- Regular sessions and additional work outside therapy are required for effective CBT treatment.
- CBT may not be effective in treating severe or complex mental health problems.
Other Treatment Modalities Used in Teen Residential Treatment
Dialectical Behavioral Therapy (DBT)
Teen Dialectical behavioral therapy is a talk therapy designed for people, including teenagers, who experience intense emotions.
Common DBT Techniques Used in Teen Residential Treatment
The common techniques used in DBT include;
- Mindfulness – The practice of paying attention purposefully to be aware and fully focused on the present instead of being concerned with the past or present.
- Distress tolerance involves understanding and managing teens’ thoughts and emotions in stressful or difficult situations without resorting to harmful behaviors.
- Emotion regulation in teens involves understanding, being more aware, and controlling emotions.
- Understanding how teens ask for what they want and require and setting boundaries as you maintain respect for yourself and others.
Eye Movement Desensitization and Reprocessing (EMDR)
Teen EMDR is a mental health treatment technique that involves moving your eyes in a particular way as you process traumatic memories to help you manage and heal from trauma and distressing life experiences.
How EMDR is Used to Treat Mental Health Issues in Teens
EMDR can be used on teens to treat mental health problems, including anxiety, depression, PTSD, and behavioral problems. It is especially effective in teens who have experienced traumatic events and have difficulty processing and managing their emotions. This therapy addresses the pain and suffering caused by traumatic life experiences without the need to talk about them.
How does EMDR work to treat trauma in teens?
EMDR works by making your teen process traumatic experiences in a safe and controlled environment. During an EMDR session, the therapist guides the teen through various rapid eye movements or alternative bilateral stimulation as the teen focuses on a distressing experience or memory. By doing so, the teen is desensitized to the traumatic event, allowing them to adapt and integrate the experience.
What Types of Trauma Can be Treated with EMDR?
EMDR can be used to treat numerous traumatic experiences such as physical or sexual abuse, accidents, natural disasters, experiencing or witnessing violence, and complex traumas related to attachment or development issues.
What is the Success Rate of EMDR in Teen Residential Treatment?
The success of EMDR may vary depending on the teen and the severity or complexity of their problem. Studies on EMDR have shown that it is very effective in the treatment of PTSD and trauma-related symptoms, with a reported success rate of up to 60.9% in the treatment of major depressive disorder in adolescents.
Art Therapy For Teens
Art therapy for teens involves using various forms of creativity, free expression, and integrative methods to promote personal expression, self-discovery, and emotional healing, especially where talk therapy might have failed.
Can Art Therapy Be a Standalone Treatment for Mental Health Issues in Teens?
Whether art therapy can be used as a standalone treatment for mental health issues in teens depends on the kind of mental issue, its nature, and its severity. Typically, art therapy is used together with medication or talk therapy for a more comprehensive and effective treatment.
What types of art are commonly used in art therapy?
The most common types of art used include drawing, painting, and molding. Other therapists may also use expressive techniques such as movement and sensory exploration.
How Does Art Therapy Help Teens Express Their Emotions?
Art therapy is particularly effective for teens who have a problem expressing themselves verbally. This therapy allows teens to tangibly explore their feelings and experiences and express their emotions as art provides a safe space for self-expression. Through art therapy, teens can gain insight into their thoughts and emotions, helping them gain self-acceptance and self-awareness. Finally, art is calming, helps teens manage their emotions, and reduces anxiety and stress.
Conclusion
Cognitive behavioral therapy is a well-established, well-structured, goal-oriented form of therapy that has proven effective in treating mental health issues. It helps teens identify negative thoughts, beliefs, and behaviors contributing to their problems. Through CBT at Key Healthcare, teens learn coping skills and strategies to improve their well-being.
Frequently Asked Questions (FAQs)
The length of CBT may vary depending on one’s needs and goals. Normally, CBT may last between 12-20 sessions. However, depending on the complexity of an individual’s problem and response to therapy, it may take a shorter or longer period.
Yes. CBT can be combined with medication to treat mental health disorders such as depression, PTSD, and anxiety. Combining CBT and medication is often considered better than either treatment alone.
As a preventive measure, CBT can be used for individuals at risk of developing mental health problems or those with a history of mental health problems. These individuals can learn coping mechanisms through CBT and be more positive, reducing their risk of developing mental health problems.
Yes, CBT can be done in a group setting. Teen Group therapy may provide a supportive environment for members to learn from each other. However, this approach may not be suitable for some individuals.
CBT suits mental health issues such as anxiety, depression, phobias, and trauma. It may also be used for other emotional issues. Your therapist may be able to determine whether CBT will be the right treatment for you after making their assessment.