One of the most researched and evidence-based approaches to therapy is cognitive behavioural therapy, also known as CBT.
CBT involves a combination of identifying and challenging negative thinking patterns, and learning behavioural strategies to cope with varying presenting issues including depression, anxiety, anger and trauma.
When utilising CBT techniques with children, there are a lot of arts and crafts, games, toys and role playing activities involved. Children usually find it a fun experience, helping them to stay motivated in the process and letting them express their feelings and experiences in a safe, therapeutic environment.
CBT Techniques for Children
To give you an idea of what your child’s counselling session might look like, I have listed some of the CBT techniques I commonly use with children:
- Arts activities can be used to help children talk about their emotions. We might draw different feelings onto a page (eg What would your anger look like if you drew it? What colour would it be? What shape?). Or, we might use a cut-out of a person to colour in different feelings in the body (eg butterflies in tummy, clenched fists, tightness in chest). This helps children identify their own different emotions, and how to recognise them in their own bodies. Once they can identify these, it is easier to learn strategies to cope with these feelings.
- To learn coping skills, we might use craft activities. Stress balls can be made out of balloons and flour to squeeze in stressful times, calm-down jars can be created out of a plastic bottle filled with sparkly water to shake when feeling angry, or ‘worry boxes’ can be created from a decorated paper mache box to keep worries in. I find that children respond well to using tangible objects that they have helped to create.
- Controlled breathing has been proven to help adults and children reduce their anxiety levels. To help make this fun for children, we might use a bubble blower to try and blow one bubble at a time, or we might imagine a balloon in our stomachs and breathe in slowly to fill the imaginary balloon with air, before slowly breathing out and deflating the balloon.
- Progressive muscle relaxation (PMR) is a skill where you slowly tense and then relax each muscle group in turn to provide a physical release of tension. When teaching this skill to children, I often use make-believe scenarios to help the children with the activity. For example, we might imagine we are ‘squishing our feet into a muddy puddle’, or ‘squeezing lemons in our hands’.
- For negative thoughts, we might write them down and then challenge them like ‘thought detectives’. We look for the evidence that the negative thought is true, and the evidence that it isn’t true. Then we write down any changes in our beliefs and how differently we feel with the new belief.
- I sometimes use dolls or puppets for children to act out distressing experiences. Children often feel more comfortable externalising their experiences and talking about them when focusing on a puppet family. They can also act out any feared situations to practice mastering their fears. This can help them become more comfortable with the scenario, before being exposed to it in real life. This gradual exposure has worked well with children who have simple phobias or anxiety.
- Relaxing Imagery. We might start by talking about a safe, happy place that the child has been to, or can imagine. This place is then described by the child in detail, utilising all five senses. The child closes their eyes and takes themselves to their safe, happy place. They describe what the place looks like, the sounds and smells there, and anything they can touch or feel on their skin. The child can visit their safe place in their imagination whenever they like.
These are just some of the techniques I use to make therapy fun and engaging for children. I have found that children are able to get the most out of therapy when they are having fun and being ‘hands-on’ and creative.
Yet at the same time, this allows them to learn valuable coping skills that they can then transfer into areas of their lives that are causing distress, and help them to improve their overall functioning and personal wellbeing.
Author: Tegan Gonczar, BA (Hons), Grad Dip Ed (Secondary).
Tegan Gonczar is a Brisbane psychologist with experience in providing psychological counselling to children, adolescents and adults; she has a passion for working with people of all ages, to help them overcome obstacles, learn effective ways of coping and lead happier and more fulfilling lives.
Bookings and Fees: To make an appointment with Brisbane Psychologist Tegan Gonczar, try Online Booking – Loganholme or call M1 Psychology (Loganholme) on (07) 3067 9129.
- Johnson, S. (1997). Therapist’s guide to clinical intervention: The 1-2-3’s of treatment planning. New York, NY: Academic Press.
- Kendall, P.C. (2000). Child and Adolescent Therapy: Cognitive-Behavioural Procedures. The Guildford Press, New York.
- Lowenstein, L. (2011). Favourite therapeutic activities for children, adolescents, and families: Practitioners share their most effective interventions. Canada: Champion Press.