Cognitive Behavioral Therapy is a present oriented, problem-focused approach to treatment. Attention is given to the interplay between thoughts, feelings and behaviors. In CBT, kids, with the help of the therapist, develop the skills to identify and evaluate thoughts on the basis of helpfulness and accuracy. This puts the child in the position to decide what ways of thinking are problematic (i.e., make a bad feeling stronger or last longer; lead to avoidance, acting out or giving up) or helpful (i.e., encourage coping and proactive behavior). Child and therapist come up with ways for the child to try out new skills, thoughts and behaviors each week outside of session.

As an example, imagine there’s a child who worries a lot. A closer look is likely to uncover a pattern of thinking that overestimates the likelihood of the “bad thing” happening, makes the “bad thing” or problem out to be catastrophic and underestimates his or her ability to cope. The child can begin to evaluate these thoughts by asking, “what is my worry saying? Is the bad thing likely or unlikely to happen? How do I know? If likely, what can I do to help myself?” Having developed a more realistic and helpful interpretation of things, the child experiences less worry and a new behavioral response. By doing things differently, the child is able to further test assumptions and gain mastery of problem solving and coping skills.