Cognitive Behavioral Therapy (CBT) is an empirically-based treatment for psychological disorders of adults, adolescents and children. CBT for the treatment of children has been effective in the treatment of anxiety, depression and behavioral problems. There are various challenges a cognitive behavioral therapist may face when working with children.
Challenges for Child Therapy
Rapport building is one of the first hurdles in CBT for children. A therapist must be vigilant of the child's motivation to engage in treatment and work with the child at his own level. Therapists often choose to meet with the child along with his parents during the first few sessions, especially if separation anxiety is prominent, using games, coloring or drawing to build rapport. Once the child appears ready to meet alone, the therapist may excuse the parents to the waiting area for a limited period, being careful not to overload a sensitive child with too much material too soon.
CBT Goal Setting
It is important to set behavioral and emotional goals in conjunction with parents and child. Parents play an integral role in treatment. Behavioral goals must be specific and address particular behaviors the child exhibits.
CBT Treatment Planning
For children under seven, a therapist will often meet alone with parents first for parenting-skills training, providing psychoeducation about behavioral management, identifying triggers (external or internal, like mood/fatigue/hunger) that set off maladaptive behavior, and teaching parents about reinforcing consequences (e.g., ignoring attention-seeking behavior, or providing consistency for escape/avoidance behavior).
For an updated, more in-depth look at this topic, see How to Help a Child with Anxiety & When Seek Therapy.