Singapore Brain Development Centre

COGNITIVE BEHAVIORAL THERAPY FOR CHILDREN

Cognitive behavioral therapy for children

Cognitive Behavioral Therapy (CBT) encompasses a range of psychological techniques that help children identify and explore ways to control their emotions, thoughts and actions.In this article, we’ll explore everything you need to know about CBT:

What is Cognitive Behavioural Therapy?

CBT is a type of Talk Therapy which aims to help children identify and replace negative thoughts with more positive ones. Reframing the underlying thoughts behind an action is integral to navigate effectively through personal challenges that a child may face during his childhood. This helps children discover new ways to interpret situations, evaluate their emotions and respond appropriately to negative experiences.

For example, a child may say “Reading is so boring and difficult for me. I give up, I am never ever going to read books again!”. CBT can help replace this thought with a more objective and positive one like “Reading may be a challenge for me, but I am not going to give up. I am just as smart as the other kids and I will overcome this challenge.”
CBT also focuses more on the present and the future, rather than the past. This helps children understand that they have no control over what has happened in the past and should look forward to what they can do to regulate their thoughts and behaviour.

Conditions that CBT may help with

Techniques used in Cognitive Behavioural Therapy

The goal of CBT is to replace negative thoughts with more encouraging ones. These are some techniques which have been proven to be effective in treating conditions such as anxiety disorders, depression, behavioural issues and Post-Traumatic Stress Disorder (PTSD).

Exposure Therapy

One of the most important techniques to treat anxiety in Cognitive Behavioural Therapy is Exposure Therapy. The idea is to safely expose the child to anxiety triggers in an incremental way. This helps the child become more accustomed to the negative experience, helping him cope and regulate his emotions.

Exposure therapy first begins by identifying the “hierarchy of fear”. For example, if a child has a fear or anxiety of dogs, a qualified therapist might ask for a degree of fear on a scale of 1 – 10. From here, the therapist will expose the child to forms of a dog progressively, for example, he would first start with a picture of a cartoon dog, to a picture of a real-life dog, to an actual dog on the street. While the child faces these situations, a qualified behavioral therapist will support him and ensure that he is safe. With each instance, the therapist will check in with the child on his “hierarchy of fear”. This ensures that the anxiety diminishes over time and he gains mastery over those situations eventually.

Modelling Therapy

Modelling Therapy is a Cognitive Behavioural Therapy technique based on social learning theory. This therapeutic treatment technique emphasises on observing and imitating role models to induce behavioural change. In this form of therapy, a child must pay attention to the desired behaviour, retain what they have learnt and reproduce the desired behaviour. Typically, a form of reward or motivation is used to encourage the desired behaviour.

Restructuring Therapy

Restructuring therapy is a Cognitive Behavioural Therapy technique that challenges cognitive distortions and negative thoughts. The basis of this technique is to first identify Cognitive Distortions which trigger an automated negative response from the child. While most children brush off cognitive distortions easily, children with anxiety issues unconsciously hold on to these negative thoughts, resulting in undesired behaviour.
The child will then have to dispute the thoughts rationally in his mind to determine if the response is appropriate. For example, he may ask himself “Are my thoughts based on facts or feelings?” or “Am I reading this situation correctly?”.
The last step of this therapy is to replace each negative thought with the desired behaviour or response. One way to do so is to teach the child how to conduct a mental trial in their mind. He will be taught how to use evidence in the situation to justify a particular action. After which, he can prosecute the action to test if it is a rational thought.

Types of Cognitive Behavioral Therapy

Individual CBT

Individual Cognitive Behavioral Therapy involves only the child and the therapist. This allows for a more individualised attention and assistance from the therapist. The child may also feel less anxious during individualised CBT.

Group CBT

Group Cognitive Behavioral Therapy is a session which involves other children who are being treated for the same disorder. A child can feel supported by others and develop friendships with others, helping him make progress after the therapy session.

CBT with Parents

This form of CBT enables parents to learn parenting techniques which can help them better manage their child’s anxiety disorders. Parents are directly involved in the therapy session and are taught how to handle a child’s behavioural issues at home.

Finding Cognitive Behavioral Therapy for children in Singapore

While there are many Brain Training Centres in Singapore offering Cognitive Behavioural Therapy, it is critical to look for a therapist that has rich experience working with children. It is best to search for a learning centre that can provide individually designed programs and curriculum that will address each issue and weakness faced by a child. Do some research and make sure that the programs are delivered by trained and experienced facilitators.

Tips on what to look out for in a Cognitive Behavioural Therapist:

Experience

A Cognitive Behavioral therapist should have a wealth of experience working with children or adolescents. A therapist who has only been working with adults in the past may not have experience in providing therapy services for a child.

Credentials

A legally qualified Occupational Therapist in Singapore should be licenced by The Singapore Association of Occupational Therapists (SAOT), a local professional association for Occupational Therapists.

Transparency

A good therapist should provide parents with a professional treatment plan as well as an initial assessment of the child’s behavioural state. After every therapy session, there should be a review with the parents to inform them on how the child has progressed during therapy.

Common FAQs about Cognitive Behavioural Therapy

Research has shown that CBT is the most effective treatment method to help children suffering from depression and anxiety.

Sessions should generally last for one hour and be conducted on a weekly basis. This of course depends on the child’s progress during therapy sessions.
As every child’s needs are different, it is hard to give an exact number. However, on average, a child would need to go for CBT therapy for as short as 12 weeks to as long as 20 weeks depending on his progress during therapy sessions.

1.Occupational Therapists
2.Psychologists
3.Social Care Workers
4.Counsellors

SCHEDULE A COMPLIMENTARY CONSULTATION

A good therapist should provide parents with a professional treatment plan as well as an initial assessment of the child’s behavioural state. After every therapy session, there should be a review with the parents to inform them on how the child has progressed during therapy.