Is Your Teen Struggling? Cognitive Behavioral Therapy (CBT) Can Help.
CBT & the Family
When we have a teen who is struggling with teen depression, teen anxiety, teen trauma, teen PTSD, or other struggles, it can be very disheartening as a parent. We try a variety of parenting tools from our parenting tool box only to find that the issues may decrease for a period of time then come back just as strong, stronger, or it doesn't seem to make a dent in the issues. Teens are also fairly savvy in camouflaging the problem leading parents to think it has improved only to learn that it was simply better hidden.
As parents explore options on how to help their teens at home, one option or 'tool' that parents can add to their parenting tool box is Cognitive Behavioral Therapy (CBT). This can be accomplished by working with a counselor trained in CBT who can not only provide CBT therapy for your teen, but work with the family system in teaching you these skills so that you can implement them in the home. So, what is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a time limited, problem focused, talk therapy approach in effectively treating a variety of problems. CBT is highly regarded as an effective approach to therapy and also can boast the largest treatment studies of teen depression. Included are three of the studies and outcomes of those studies (study 1, study 2, & study 3). The following are a few of the more common difficulties that CBT has been shown to be effective in treating:
Suicidal thoughts and behaviors
How CBT Works
Cognitive Behavioral Therapy follows a fairly simple structure of helping teens through their current struggles:
Cognitive Behavioral Therapy utilizes a Socratic method where the counselor asks the client questions that are designed to elicit thoughts and insight that aim to dive deep down to the roots of core, negative, irrational thoughts and beliefs one may hold about themselves.
As the counselor helps the teen identify what those core, negative, irrational beliefs are, they can then start to explore the unrealistic or irrational thoughts that stem from those deeply held, irrational beliefs.
Over time and as these negative thoughts continue and become repetitive, they have a tendency to become automatic thoughts that filter the perception the teen holds of the world around them in addition to their internal perception of themselves. Sometimes these automatic thoughts become unconscious to where it simply is a negative filter that is always running in the background influencing mood, emotion, and/or behavior.
As the teen has a deeply held negative core belief, has developed automatic thoughts around this negative core belief, and these automatic thoughts color or filter the internal and external perceptions, negative behavior follows. The behavior could be internally focused resulting in isolation, avoidance, self-harm, suicidal thoughts, or the behavior could be externalized leading to anger outbursts, substance abuse, oppositional behavior, etc. Let me give 2 simple examples of the impact of core beliefs and how they influence thoughts and behavior:
Example #1: Positive Core Belief and the Impact
If through life experiences and/or a genetic predisposition, I'm a typically happy person who at the core, believes that I am of worth, value, and have something great to contribute to the world, the thoughts that will arise from that core belief will be positive about myself and the world around me. As a result, my actions, or behavior, will likely be goal oriented, motivated, confident, etc.
Example #2: Negative Core Belief and the Impact
Now let's say that I had one, or several life experiences, that left an indelible impression on my psyche. Keep in mind, that the life experience(s) do not have to be something large and terrible like physical abuse (though that would fit). It could simply be being teased and bullied repeatedly for a period of time, or have struggled or continue to struggle academically. In the developing brain, whether as a child or a teen, these experiences can leave an imprint of negativity that frames the internal perception of and/or the perception of the world around the individual.
As a result of the above, I now have a core belief that I am 'weak', 'incapable of standing up for myself', a 'loser' like the bullies made me feel or that I'm 'stupid' because of struggling in school. The thoughts that will arise will be geared toward insecurity, fear, uncertainty, hesitancy, incompetence, etc. and the impact could result in depression, anxiety, or other difficulties.
Targets of Therapeutic Change
As we discuss the negative, irrational, core beliefs, the automatic thoughts that develop as a result, and the behavior that arises out of this scenario, below are some examples of the 'cognitive distortions' that can develop and drive mood, emotion, and behavior:
This is when an individual will make everything about them however, in a negative way. benign comment someone makes that is not directed at anyone strikes a cord with the teen and the teen is sure they were talking about them negatively which then reinforces the negative core belief they hold of themselves.
Personalization also takes the form of feeling as though everything is the their fault
even when the they had no influence or control over those things. An indicator of this is a teen who over apologizes for things that to everyone else, it's clear that it is not their fault. Feelings of guilt and shame arise from this form of personalization.
Think of a colander that strains out the water when you cook spaghetti. Filtering is when the mind allows all the positives to filter out and run down the drain while only leaving the negative behind. This cognitive distortion takes on a pervasive quality in the individual's life where any positive tossed their way in life doesn't stick but the negative's cling on each and every time.
Catastrophizing is when a person expects the worst to happen in any situation. For example, a teen gets into a fight or an argument with a friend and is convinced that that friend will never be friends with them again and they have ruined the relationship forever. Or, a teen gets a bad grade on one test and 'know' for a certainty that they will fail the class and will never do well in school again.
This is a tough one for teens particularly. We tend to see teens as 'mini-adults' when in reality, they are more like 'bigger children'. Their brains are continuing to develop and at a significantly faster pace during adolescence. Neurons are firing and wiring together, brain development is accelerated, and that includes the emotional development of our teens. Emotional reasoning is simply, "I feel like a bad person so therefore it must be true". Instead of looking at the facts, analyzing, and looking at the incident objectively, the emotions or feelings make the judgement instead of rational thought.
There are several other cognitive distortions that arise from the core irrational beliefs and automatic thoughts. Some of these include:
black and white/all or nothing thinking,
jumping to conclusions,
fallacy of fairness, etc.
Elements of The CBT Change Process
When we are able to identify the core irrational belief, the negative automatic thoughts, the cognitive distortions, and the resultant behavior experienced (either internalized behavior or externalized behavior), we have the information necessary to start the change process. Some approaches in changing these core beliefs, thoughts, and cognitive distortions are:
Detaching a bit from oneself and looking in from the outside in as an 'objective observer' is one of the first steps. Like a police officer collects evidence with strict, factual standards in order for that evidence to stand up in the court of law, fact checking takes on a similar strategy. In fact checking, we employ the same standards when we examine the core irrational beliefs, the automatic thoughts, and the cognitive distortions. If there is no evidence that a crime occurred, no crime occurred. If there is no evidence that the person is "stupid", then we need to look at what is true.
With the automatic thoughts that pop up (out of no where often times), it is essential that the therapist and the client develop thought challenges to these automatic thoughts based on the facts and evidence they gathered in the 'Fact Checking' stage. Each time a irrational thought pops up, challenging the thought internally with reminding ones self of the evidence behind that thought being irrational, will start to change and replace the negative thoughts with the positive thoughts.
Once the irrational beliefs and thoughts are fleshed out and there are replacement beliefs and thoughts identified, journaling is a helpful tool. Through journaling, the individual can identify what was happening just prior to the thought, what the thought(s) was/were, the feelings associated with the thoughts, and the factual challenge used to disrupt that irrational thought and the proceeding feelings following the thought challenge. This is a powerful way to be able to identify, in concrete, factual ways, experiences that may trigger these irrational thoughts where the individual can predict these experiences more regularly and be armed with the appropriate thought challenges moving forward.
Sometimes taking an experience where the individual perceives it as negative and looking at it from other perspectives is helpful. For example, if a friend makes a good natured joke and people start laughing, instead of catastrophizing "everybody thinks I'm stupid", choose to look at it from a different perspective such as, "I must be an accepted part of this group for them to feel comfortable joking around with me like this. They must like me."
Cognitive Behavioral Therapy & Family Counseling
One of the benefits of CBT is its very logical framework and its ability to be generalized, utilized, and supported in the home between counseling sessions. It is common where 'home work' assignments will be provided for the teen to work on and complete prior to the next session. This is where family therapy can be a game changer for your teen.
As the counselor and the teen are digging in and identifying core beliefs, automatic thoughts, cognitive distortions, and strategies to restructure the thought process, the family can also participate by way of family therapy to learn these concepts and how best to help and support their teen. It will be important that the teen be a part of this process to be able to help you as parents know the best approaches for you to help them and certain approaches that may cause some resistance.
As parents, having a firm grasp on best approaches of support and the concepts that the teen will be practicing outside of therapy can be a powerful resource for your teen. Having a parent or parents able to help tactfully identify cognitive distortions and encourage the strategy to challenge and change those distortions can be a game changer in your teens progress.
How Can I Help My Teen Who is Struggling?
If you have a teen who may be struggling with teen depression, teen anxiety, teen trauma, teen PTSD, self-esteem struggles, or behavioral struggles, Cognitive Behavioral Therapy can make a real difference in your teen and family's life. Part of the reason I enjoy working with teens, and have made a career out of doing so, is the knowledge that helping make changes at this age means that these complicated issues do not continue to layer, build, and follow them into their adult lives. Quite literally, intervening at this age can chart a completely different outcome, for the best, in their future adult life.
Contact us today at Katy Teen & Family Counseling to talk about the struggles your teen may be facing and let's talk about how we can help your teen overcome those struggles. Draw on our expertise in teen and family counseling that has been developed and honed since 2003. To start your teen's CBT journey, you can follow these simple steps:
Contact Katy Teen & Family Counseling
Speak with one of our CBT therapists
Start your CBT journey of healing with our teen and family specialists
Neurofeedback Therapy for Teen ADHD
How to Begin Teen Therapy or Family Counseling
To begin teen therapy or family counseling, simply contact Katy Teen & Family Counseling through our website or by calling 346-202-4662. Our Owner and Lead Clinician answers each phone call to help match you with the right therapist for you teen and family.
About the Author
Jason Drake is a Licensed Clinical Worker. He is a Specialist in Teen Therapy & Family Counseling. He has provided therapy to teens and families since 2003. Through his expertise, he helps teens who struggle with depression, anxiety, trauma, ADHD/ADD, and PTSD. He works with talented teen athletes who have experience mental blocks. Gifted students have unique challenges that Jason understands well. Jason uses CBT, EMDR, Neurofeedback, FFT, and Motivational Interviewing. We only work with teens and families which allows us to focus on what teens and families of today need. Resolving the struggles of today can assure a more successful tomorrow. Proudly serving Katy, Tx and Houston.