CBT for Teens: How it Works, Techniques, and FAQs

Adolescence is quite a rollercoaster ride for many teenagers. Whether your teen is dealing with negative emotions or challenges at school, they may often encounter experiences that may impact their mental well-being. There are types of therapy that can help tremendously, one being cognitive behavioral therapy (CBT) for teens. Here, we’ll explore how this form of therapy can empower adolescents and equip them with practical tools to navigate emotional complexities, foster resilience, and build a foundation for lasting mental health.

What is CBT?

CBT is one form of psychotherapy that focuses on making connections between thoughts, feelings, and behavior. This talk therapy can help adolescents and teens identify and improve maladaptive patterns of thinking, feeling, and behaving.

CBT is based on several core principles. These include the following:

• Psychological problems are in part due to faulty ways of thinking.
• Psychological problems are in part due to learned patterns of unhelpful behavior.
• People with psychological problems can acquire coping skills to relieve their symptoms.

CBT focuses on the present issue rather than exploring past issues or the underlying cause of the client’s problem.

How Does CBT for Teens Work?

At the core of CBT is the belief that thoughts affect emotions, which in turn affect behavior. Given this, allowing negative and distorted thoughts to grow can lead to difficult emotions and destructive actions. The opposite is also true; positive thinking will lead to positive emotions and behaviors. The overall goal of CBT is to help teens shift their thoughts, feelings, and behaviors to be more productive and beneficial for their well-being.

In adolescence, it’s common for teens to develop distorted core beliefs about themselves as they mature and form their identities. CBT uses steps to help teens recognize and modify such distortions. Psychotherapists specializing in CBT may start by helping their teen clients recognize unhealthy thought patterns and explain how these contribute to their mental health problems. In later sessions, therapists may teach teens new ways to think about their negative thought patterns and behaviors.

How Effective is CBT for Teens?

Research has shown that CBT is an effective treatment for a multitude of mental health symptoms and conditions in teens. One study found that there was a 49.4% remission rate in anxiety for youth compared to 17.8% for those who had no treatment [*]. Other findings suggest that CBT is effective for adolescents with depressive disorders, particularly when the treatment is administered under routine care conditions [*].

What are the Benefits of CBT for Teens?

There are many benefits of CBT for teens. These include the following:

• Improved self-esteem
• Ability to stop thoughts that lead to self-destructive behaviors
• Better self-compassion
• Improved communication with others
• Better responses to stress
• Improved ability to shift negative thought patterns to more positive thinking
• Ability to manage and reduce irrational fears, anxieties, and phobias
• Improved skills in navigating social situations and interactions

Common Issues Addressed by CBT for Teens

Teens experience a myriad of issues in their adolescent years, and CBT for youth can address some of these.

Anxiety

Some adolescents may deal with excessive worry which can lead to anxiety in teens. Such disorders are common in adolescents (ages 12 to 18) and can lead to significant impairments. One study shows that approximately two-thirds of participants responded favorably to CBT, which had a moderate to large effect [*]. More evidence demonstrates that CBT can significantly reduce the number and intensity of panic attacks in youth.

Behavioral Issues

Teenagers with defiance or oppositional issues can greatly benefit from the self-reflective aspects of CBT. This is because CBT practitioners are skilled at getting to the heart of teens’ issues and offering a range of practical, positive strategies.

Research has shown that CBT provides adolescents with anger regulation and social problem-solving skills that allow them to behave in more independent and situation-appropriate ways [*]. This is especially effective when combined with other psychological treatments, such as interventions targeting multiple systems in adolescence.

Depression

CBT can help teens reduce negative thinking and cognitive distortions that can exacerbate depressive symptoms. Research has been done to examine the effects of a group-based CBT intervention, which led to a reduction in depressive symptoms for the affected group [*]. This illustrates how CBT is effective at treating depression in teens.

Stress

Stress is a state of worry or mental tension resulting from the experience of a difficult situation. Under stressful conditions, some teens tend to feel pessimistic and unable to solve problems. CBT is known to promote more balanced thinking to improve teens’ abilities to cope with stress [*].

Anger Issues

CBT can also help teens with anger issues, which are typically a precursor of conduct disorder. A review has found empirical evidence for CBT as an effective intervention for anger management among adolescents [*]. Specifically, early intervention helps adolescents manage anger in healthier ways.

CBT Techniques and Interventions for Teens

CBT for teenagers involves various techniques and interventions. Here are several that therapists commonly employ in their practice.

Cognitive Restructuring

Cognitive restructuring is the process of breaking down negative thinking patterns through the identification of irrational thoughts and replacing these thoughts with rational ones. The patient’s age can play a factor in what they are able to understand, but skilled CBT therapists can adapt to serve the needs of their patient, no matter where they are in their teen years.

Goal Setting

Therapists often help their young clients set SMART goals so that they can ensure they are specific, measurable, attainable, realistic, and time-specific. Goals should be tailor-fit to age and maturity level, and SMART goals can cater to this need.

Skills Training

Skills training is all about teaching teenagers age-appropriate skills, including healthy lifestyle adjustments, time management skills, social skills, and organizational skills.

Exposure Therapy

For teenagers with anxiety or OCD, the CBT approach uses more exposure therapy for treatment. This involves working with the teen to increase their coping skills when exposed to anxiety-inducing situations. Ultimately, the therapist aims to decrease a teen’s anxiety-related symptoms.

What to Expect During CBT Sessions for Teens?

In CBT, your teen will do plenty of work on identifying negative thoughts, which can be a challenging process. Their therapist will help them to develop new ways of thinking and learn new coping skills.

You can expect your teen to be assigned “homework” to complete outside of their therapy sessions. These assignments may involve practicing the skills they worked on during therapy sessions.

Teens can also expect CBT to be highly structured, which can be helpful in clearly understanding personal goals and expectations.

Frequently Asked Questions

Here are some commonly asked questions about cognitive behavioral therapy for teens.

Should parents involved in the CBT process for teens?

Literature shows that parental involvement plays an essential role in the efficacy of CBT for both children and adolescents [*]. Parents should find some way to be involved, the extent of which will be determined by the therapist and depending on the comfort level of the teen.

Can CBT for teens be combined with other forms of therapy?

CBT is a very helpful tool, either alone or when combined with other therapies such as dialectical behavior therapy (DBT), in treating mental health conditions, such as depression, eating disorders, or PTSD.

How long does CBT for teens take to show results?

Some teens may see improvements in their symptoms within a few weeks of starting CBT. Others may take several months. How effective CBT will be also depends on several factors, such as the specific issue being addressed, the skill of the therapist, and the individual’s commitment to the therapy.

The Bottom Line

Ultimately, CBT for adolescents offers invaluable support for teens navigating the complexities of adolescence. By fostering self-awareness and providing practical tools, CBT empowers teens to manage stress, build resilience, and develop healthy coping mechanisms. Its tailored approach addresses the unique challenges faced by adolescents, promoting lasting positive change. As teens embark on their journey towards emotional well-being, CBT emerges as a transformative ally, offering a roadmap for personal growth and mental health.

References:

1. Pegg S, Hill K, Argiros A, et al. Cognitive Behavioral Therapy for Anxiety Disorders in Youth: Efficacy, Moderators, and New Advances in Predicting Outcomes. 12 November 2022.
2. Walter D, Buschsieweke J, Dachs L, et al. Effectiveness of usual-care cognitive-behavioral therapy for adolescents with depressive disorders rated by parents and patients – an observational study. 24 August 2021.
3. Kendall P & Peterman J. CBT for Adolescents With Anxiety: Mature Yet Still Developing. 1 June 2015.
4. Matthys W & Schutter D. Increasing Effectiveness of Cognitive Behavioral Therapy for Conduct Problems in Children and Adolescents: What Can We Learn from Neuroimaging Studies? 8 March 2021.
5. Idsoe T, Keles S, Olseth A, et al. Cognitive behavioral treatment for depressed adolescents: results from a cluster randomized controlled trial of a group course. 22 May 2019.
6. Nakao M, Shirotsuki K, Sugaya N. Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. 3 October 2021.
7. Anjanappa S, Govindan R, Munivenkatappa M. Anger Management in Adolescents: A Systematic Review. January 2020.
8. Tekbas G & Koçtürk N. Parent Participation in Cognitive Behavioral Therapy for Children and Adolescents: A Scoping Review. 30 September 2023.