Adapting cognitive behaviour therapy for children and adolescents

Cognitive behaviour therapy Cognitive behaviour therapy (CBT) is a generic term used to describe therapeutic interventions based upon cognitive, behavioural and problem-solving approaches. This integrated approach builds upon the efficacy of behavioural techniques by considering the meanings and interpretations that are made about the events that occur. These are assumed to be important since dysfunctional cognitions and processing are associated with psychological problems. Cognitive behaviour therapy therefore involves the assessment and identification of biased or selective cognitions and processing. These are then subject to objective evaluation which leads to the development of more functional and balanced thoughts, assumptions and beliefs. Behavioural and cognitive skills are developed through problem-solving approaches where skills and frameworks for coping with challenges are developed. This occurs within a systemic framework where the role of the family and other systemic factors that may contribute to the onset and maintenance of the child’s difficulties are recognised and addressed (Dummett, 2010). Cognitive behaviour therapy therefore helps the child and their family to develop more functional skills and to identify, challenge and develop alternative cognitions to counter and replace the cognitive deficits and distortions assumed to underpin emotional and behavioural problems. Cognitive behaviour therapy techniques Cognitive behaviour therapy is ‘an umbrella term for a non-standardised package of different treatment techniques that can be offered in many different sequences and permutations’ (Durlak et al., 1991). Cognitive behaviour therapy is not therefore a unitary approach but a collection of behavioural, cognitive and problem-solving approaches which can be used in different combinations depending upon the individual’s needs. Cognitive behaviour therapy therefore offers the clinician a toolbox of techniques that can be drawn upon to facilitate the development of more functional cognitive, emotional and behavioural skills. The selection of specific techniques will be informed by the case formulation and will be adapted to account for the child’s development.