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Do you know that approximately 31.9% of US teens suffer from chronic anxiety? Even worse, research has shown that adolescents with untreated anxiety disorders are at higher risk of poor academic performance and substance abuse. If you are a parent of one of these teens, you may be seeking ways to help your child.
The good news is that there are several effective treatments for anxiety disorders. One of the most powerful is cognitive behavioral therapy (CBT). One study found that 60% of young people who received a full dose of a CBT program called Coping Cat showed significant improvement. And when combined with an anti-anxiety medication like sertraline (Zoloft), the program’s success rate jumps to 80%.
What is cognitive behavioral therapy for teenagers?
Cognitive behavioral therapy for teens is talk therapy that helps youth understand how thoughts influence their feelings and actions. By using CBT to change negative thought patterns, adolescents can both feel better and improve their behavior.
In contrast to therapies that deeply examine past problems, CBT focuses on finding practical solutions to current issues. This makes it especially helpful for teens who want to see quick improvements in their mental health.
CBT is highly structured and goal oriented. In each session, your teen will work with their therapist on specific skills and strategies for tackling identified challenges. They’ll be given homework assignments to practice these skills in real-life situations.
CBT is typically a short-term therapeutic approach. While some therapies continue for years, CBT usually spans a few weeks to a few months, depending on the issue.
How CBT for children works
In a first session, your teen and their therapist will work together to identify negative thoughts. These may be automatic negative thoughts (ANTs) that pop up in response to triggers or cognitive distortions, which are irrational ways of thinking that make situations seem worse than they are. In other words, cognitive distortions are broad patterns of flawed thinking, while ANTs are specific, spontaneous thoughts that arise from these patterns.
A CBT therapist will help your teen challenge these thoughts by examining the evidence for and against them. This involves asking questions like “Is this really true?” and “What evidence do I have for this belief?” These kinds of inquiries help them see that their negative thoughts are often based on distortions or false assumptions.
Next, your teen will learn how to transform their irrational thoughts into more balanced, reality-based alternatives. For example, if your child often thinks I always mess things up, they might reframe it to I made a mistake this time, but I can learn from it and do better next time.
Common cognitive distortions addressed by teen CBT
Here are some common cognitive distortions that CBT can help teens recognize and overcome:
- Black-and-white thinking (i.e., all-or-nothing thinking), which is seeing everything in extremes. For example, a teen may believe they are either a total success or a total failure.
- Fortune telling (i.e., jumping to conclusions), which is predicting a future outcome without good evidence. For example, a teen may assume that they will fail a test before taking it.
- Magnification (i.e., catastrophizing), which is blowing things out of proportion and thus overreacting. For instance, a teen may frame a tiny mistake as a massive disaster.
- Overgeneralization, which is making broad statements based on a single event. For example, an adolescent may conclude “I always fail” after just a single setback.
- Personalization, which is blaming oneself for outcomes that aren’t entirely their fault or believing that others are constantly reacting negatively to them.
- Using “should” statements that put pressure on oneself and lead to feelings of guilt and frustration.
- Emotional reasoning, which is believing that feeling a certain way makes it true. For example, teenagers may tell themselves, “I feel stupid, so I must be stupid.”
Other CBT techniques for teens
Journaling
Among the most potent CBT activities for teens is journaling. Most people think of journaling as keeping a diary of thoughts, feelings, and daily events. However, in CBT, journaling serves a much deeper purpose. It’s a tool for gaining insights into the intricate relationships among thoughts, emotions, and behaviors. While some adolescents may journal in a typical diary-like book, others use specific CBT worksheets for teens, which are also known as thought records.
CBT journaling helps teens understand the situations and events that trigger their emotions. By noting these triggers, they can uncover patterns in their thoughts and reactions. Such awareness is crucial because it helps them identify the irrational ways of thinking that are sabotaging their happiness.
The CBT journaling process involves describing situations that caused emotional distress and listing the negative thoughts experienced during and immediately after. For example, when writing about feeling anxious after a social event, a teen may realize that their anxiety arises from thoughts like everyone thinks I’m awkward. Upon recognizing such thought patterns, they can work with their therapist to challenge and replace them with alternative thoughts that are both positive and believable.
Behavioral experiments
Behavioral experiments are practical CBT activities designed to test the validity of negative thoughts through real-life action. Through this technique, instead of just thinking about their beliefs, your teen will actively test them to see if they hold true.
To start, your child will pinpoint a negative belief they want to challenge. For example, they might believe, I can’t speak in public without messing up. With the help of their therapist, your teen will then design a simple experiment to test the belief. If the belief is about public speaking, the experiment might include speaking in front of a small group of friends.
Upon conducting the planned experiment, your teen will observe what happens, paying attention to whether the negative belief proves true. After the experiment, they will evaluate the outcome to determine whether it is as bad as their belief predicted. Often, results show that negative beliefs are exaggerated or unfounded.
Your teen can use evidence from such experiments to adjust their beliefs. For example, if the public speaking went well, their belief may shift to I can speak in public without major problems.
Exposure therapy
Exposure therapy is a CBT tool that helps teens confront and reduce their fears and anxieties. It involves gradually exposing them to the objects or situations they fear in controlled and safe ways, allowing them to build confidence and reduce anxiety.
Instead of avoiding what scares them, teens using this technique gradually face their fears step by step, becoming less sensitive to their triggers. To start, a teen will create with their therapist a list of their fears, ranking them from least to most scary. They then expose themselves to the least frightening situations and work their way up.
During exposure, teens learn to stay calm through relaxation techniques, such as deep breathing and mindfulness. These techniques mitigate anxiety and make facing their fears more manageable.
Cognitive behavioral family therapy
Cognitive behavioral family therapy (CBFT) uses CBT principles to help families improve their relationships and interactions. It focuses on identifying and changing negative thought patterns and behaviors that impact everyone in the family.
In CBFT, the therapist works with the entire family to understand how each member’s thoughts and actions affect the others. For instance, a parent’s stress might contribute to a child’s anxiety and vice versa. By recognizing these patterns, family members can learn healthier ways to think and interact.
A big part of CBFT is learning to communicate better and solve problems effectively. Families practice these skills during therapy sessions and then apply them in their daily lives. This teamwork approach reduces stress, strengthens family relationships, and helps participants resolve conflicts.
CBFT also highlights the importance of family members supporting one another’s mental health. Participants learn to give emotional support and encouragement, creating a more caring and understanding home environment.
A new approach to teen mental health
If you’re Googling “Therapists for teens near me,” believing that your child would benefit from working with a therapist specialized in CBT for teens, one option you might not have considered is online teen therapy. This modern and evidence-based alternative to in-person treatment is highly effective at treating anxiety, depression, and many other mental health conditions, providing your teen the help they need from the comfort of their own space.
Because most of today’s teens are digital natives—so comfortable online that the internet feels like a second home—online teen counseling is a fantastic option. It also allows adolescents to receive professional help without getting stuck in traffic jams or spending hours in crowded waiting rooms. Plus, without the need to travel, they can avoid missing appointments due to transportation limitations.
Another significant advantage of online counseling is its anonymity. Many teens are afraid to seek help because they worry about being judged poorly or running into someone they know. With online therapy, however, teens can have confidential sessions without anyone else knowing that they’re in treatment. This added privacy can make them feel safer and more willing to share their struggles.
CBT for teenagers: Final thoughts
CBT offers numerous benefits for teens struggling with mental health issues, such as improving symptom management, helping with conflict resolution, and boosting emotional well-being, by teaching them to recognize and change negative thought patterns. Over relatively few therapeutic sessions, CBT can reduce anxiety, improve emotional regulation, and foster a more positive outlook.