About Cognitive Behavioral Therapy (CBT)

CBT, or Cognitive Behavioral Therapy, is a practical, goal-oriented approach to helping children and adolescents manage and change unhelpful patterns of thinking, behavior, and emotional responses. It focuses on the connection between thoughts, feelings, and actions, teaching children that while they can’t always control the things that happen, they can learn strategies to influence how they respond.

Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life across all ages. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.

Ms. Josie blends CBT with other modalities, such as play therapy and mindfulness to help kiddos learn and practice concepts and techniques in ways that are more accessible, engaging, and non-threatening. For example, we might use stories, games, music, and other playful ways to assess, learn, process, and explore more abstract, complicated topics.

CBT focuses on developing insight and awareness into thoughts, feelings, and behavior, as well as skill-building in sessions and at home. Through guided activities, therapists teach children how to recognize negative thought patterns that contribute to anxiety, depression, and other difficulties and replace them with more balanced, positive ones. Techniques like identifying and reframing thoughts, relaxation exercises, and practicing new behaviors are often used. Caregivers often play a key role, reinforcing skills learned in therapy through regular practice at home.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a structured, evidence-based treatment specifically designed to help children and adolescents recover from trauma. This therapy combines cognitive-behavioral techniques with trauma-sensitive interventions, providing children with skills to process and manage the impact of traumatic experiences. Here’s an overview for parents considering TF-CBT for their child:

• TF-CBT prioritizes creating a trusting, supportive environment where the child feels safe to discuss challenging experiences.
• The therapist will work with both the child and family to establish a secure foundation, helping the child feel comfortable and understood before trauma processing begins.

• TF-CBT is organized into specific phases, each designed to gradually build coping skills, address trauma, and create a positive framework for recovery.
• This structured approach ensures that the child doesn’t feel overwhelmed by trauma memories and has tools to manage distress.

• Psychoeducation: Parents and children learn about trauma and its effects on thoughts, feelings, and behavior. This helps normalize the child’s experience and provides context for their reactions.
• Parenting Skills: Parents are equipped with techniques to support their child’s emotional well-being, manage behavior, and promote positive communication.
• Relaxation Techniques: The child learns relaxation methods like deep breathing, visualization, and progressive muscle relaxation to manage anxiety and physical responses to trauma.
• Affective Expression and Regulation: The therapist teaches the child to identify and express emotions safely, helping them understand and manage intense feelings.
• Cognitive Coping: Children learn to identify and reframe negative or unhelpful thoughts related to the trauma, such as guilt, shame, or fear, replacing them with balanced, realistic ones.
• Trauma Narrative Development: The child creates a trauma narrative, or story, about their experiences, which helps them process and make sense of what happened in a safe, supported way. This narrative work is gradual, allowing the child to share and reframe memories without feeling overwhelmed.
• In Vivo Exposure: This involves gradually facing reminders of the trauma in a safe, controlled manner, reducing fear or avoidance behaviors.
• Conjoint Parent-Child Sessions: Parents and children come together to share and reinforce learning, build trust, and communicate about the trauma in healthy ways.
• Enhancing Future Safety and Development: The final phase focuses on reinforcing the child’s growth and resilience, equipping them with skills to handle future challenges and supporting a positive, hopeful outlook.

• TF-CBT recognizes the importance of parents as allies in their child’s recovery. Parents are closely involved in learning skills, supporting their child’s trauma narrative, and reinforcing coping techniques.
• The therapist works with parents to foster a calm, supportive home environment, helping to sustain therapeutic progress outside of sessions.

• TF-CBT is usually short-term (about 12-16 sessions), though it can be adapted based on the child’s needs. Those with more complex, chronic, or developmental (pre-verbal or very early childhood) trauma may need more sessions, such as 20+. Its effectiveness is well-supported by research, with children often showing significant improvement in symptoms like anxiety, depression, and post-traumatic stress.
• Children also gain long-term tools that help them manage emotions, face fears, and build resilience, fostering positive mental health even after therapy ends.