CBT Sessions

Witihn sessions it can be beneficial to adapt and match the techniques and concepts of Cognitive Behavioural Therapy to the developmental age of the child, as it may help to overcome some of the pervcieved developmental issues of the child. Material used within CBT should be pitched at the appropraite level so children can understand and engage in intervetion. Instructions should be clear and simple to comprehend. (Stallard, 2002)

CBT should be fun!! Children are more likely to engage and learn if the work that they are doing is enjoyable and intersting for them.

Accessing and communicating thoughts
Different ways to get children to start thinking about there thoughts. (Stallard, 2002)

• Direct questioning, to gain information about their thoughts and self-talk. Asking the children what they are thinking. Some children may not respond well to this style of gathering information. It doesn't mean that they are unable to access their thoughts, the therapsit may need to try another style.
  
  



• Ask the children to think of difficult situations that they have been in. The therapist can help the child to describe it, draw a picture about it and while doing so may be able to describe the situation. E.g thoughts about event. Children may need prompted throughout session.
  



• Some young children may have difficultly describing their own cognitions, but may be able to talk about what someone else may be thinking. The therapist may be able to use puppets to role play the child's difficult situation, and then the child can be asked what the puppets might be thinking, which will highlight the child's thoughts witihn the situation. The therapist could also write down different options of cognitions that the child could choose from.
  



• Thought bubbles. Another idea would be to use the child's favourite cartoon charater or others and put thought bubbles out of the side, for the child to fill in what the characters might be thinking.

Activities
Therapists can engage child in activities so they are able to monitor the child's thought processes throughout the activity, and challenging any unhelpful automatic thoughts that may arise while involved in the activity. (Everett, Donaghy & Feaver, 2003)

Meaningful Occupation
An activity that is meaningful for the child, carried out by both the therpist and client can create a safe environement in which the client is able to discuss experiences that they are finding unhelpful or distressing. (Evertt, Donaghy & Feaver, 2003)

Length of sessions
CBT sessions are intitially held weekly until the end of the aggreed sessions, when the therapist may meet less frequently, depending on the child's needs. The duration of each session is usually 45 to 60 minutes.

Structure of sessions
CBT sessions are well structured so that the children know what to expect when they come to treatment. (Boyes, 2011)

Beginning of the session- the therapist will do a brief overview of the last session and what has happended in the time since the last session. i.e at home, school etc.

• Feedback from homework, chid will show homework sheets and therpist will discuss these with the child, finding out what was helpful and unhelpful.
  



• Set an agenda for the main part of the session. The child can add anything that they want to talk about witihn session. There is usually one main focus of session. eg working on thoughts emotions or behaviour. ( Boyes, 2011)
  



• Towards the end of the session, the therapist will set homeowrk for the child- a self-help task for them to do at home. The idea of homework is for the client to put what they have learnt in the session into practice.



• Some sessions will include a relaxation activities or another warm down task at the end of the session.
  

Both homework, reading and relaxation are both important strategies used within the Cognitive Behavioural Approach, with homework being the most important. Therapy sessions can be seen as 'training sessions' where clients can try and out and practice what they have learnt in between sessions with their 'homework'. Relaxation activities are important for the client to learn in order to help manage stress and anxiety.

Boyes, A. (2008-2011). Cognitive Behavioural Therapy. Retrieved September 2nd, 2011, from http://www.aliceboyes.com/cbt/

Everett, T., Donaghy, M., & Feaver, S. (2003). Interventions for Mental Health: An Evidence-based Approach for Physiotherapists and Occupational Therapists. New York: Elsevier Science.

Froggatt, W. (2006). A Brief Introduction to Cognitive- Behaviour Therapy. New Zealand.

Stallard, P. (2002). Think Good- Feel Good. A Cognitive Behaviour Therapy Workbook for Children and Young People. Chichester: John Wiley & Sons Ltd.