Cognitive Behavioral Therapy

Parenting Panel Guest Expert:  Anne Morris, PhD

For more information, visit Dr. Morris' website


Anxiety is becoming more and more common, both in children and adults. Some studies say that 1 in 5 children are affected by anxiety. Many times, in children, it begins as tummy aches, nightmares and trouble sleeping, and not wanting to participate in certain activities (go to school or school activities, or play with other children).  

The problem with anxiety is, what starts as a tummy ache, left untreated, can grow into "the anxiety monster" as I describe it to many clients (kids and adults alike!). Before long, it can seem to "takeover" one's life to where you dread even the most basic of day-to-day activities. It then turns into a vicious cycle where you get anxious over just thinking about something that you'll have to do later that makes you anxious. Because of this, I always encourage people to address anxiety head-on at the first signs of it.  

Research shows that the best way to do this is through Cognitive Behavioral Therapy, or CBT. CBT has been shown to be one of the most effective ways to treat anxiety both in children and adults (whether it's generalized anxiety, OCD, panic attacks, or phobias). As you might have guessed, CBT addresses both the thoughts and the behaviors associated with the anxiety. Everyone can think of a time when they thought or felt one way, and that led them to do something. ("It's 6pm, it's time to start dinner"…cue the oven) The reverse can also happen: you do something and it makes you think or feel a certain way.  

I often tell people, we can't control our thoughts (quick, whatever you do, don't think of a pink did that work for you?), but we CAN control our reactions to those thoughts and what we do with it. CBT does just that.  For many, "therapy" can be a daunting endeavor. I find CBT to be more palatable with people because it's intended to be short-term and very problem-specific. We identify very specific thoughts related to the anxiety (i.e. "Everyone will think I'm dumb." "Something bad will happen if Mommy isn't here." "The other kids won't like me." "I'll be a failure." "The dog will bite me.") and we investigate the validity of that statement. Has that ever been true before? Has that ever happened before? And if it did (which sometimes it has!), what happened then? Almost always, we find that the catastrophic outcomes that we attribute to these thoughts are actually just plain false, or at the very least much worse than what actually happens. Once we identify these maladaptive thoughts, we then can come up with beliefs and thoughts to tell ourselves when these bad thoughts happen. We also do the same thing with behaviors in CBT. 

Many times with anxiety, these behaviors come in the form of avoidance. What was once a protective, innate reflex (fight or flight), has now become a false alarm in our bodies and is preventing us from participating in life. We, very naturally, avoid things that our bodies tell us are scary. Only, now, our body tells us that EVERYTHING is scary and we're on constant alert. Although avoidance seems to make sense at the beginning (who wants to feel all of the emotional and physical sensations associated with anxiety?), it ultimately ends up maintaining the anxiety. By not going into situations that cause anxiety (or by leaving them as soon as we feel anxious), we teach our brains that the only way to not feel anxious is to avoid (or leave) the situation. Exposure therapy is a part of CBT which involves approaching (and "exposing" ourselves) to whatever stimulus is anxiety provoking. By systematically and repeatedly approaching these stimuli over prolonged periods of time, our anxiety WILL go down (physiologically, this has been proven!). With children, this particular part of therapy is a great opportunity to involve parents. Many times, parents are asked to encourage and facilitate exposures at home.  Although CBT has been shown to be very effective in treating anxiety, it's always best to address the anxiety early on. 

Like anything else in life, the longer a habit has lasted, the harder it is to change. Be proactive in getting help for your kids, even if you think it's nothing, or it'll pass, bring it up with your pediatrician or family physician. And, just like with all other aspects of parenting, be sure to keep yourself in check. Are you naturally anxious? Do you deal with anxiety regularly? What kind of message are you sending your kids with your words and actions? Kids don't just mimic their parents' words, they also learn to mimic their emotions and attitudes. Anxiety is very treatable, get them (and you!) the help they need! 

Don't Miss

Latest News

Video Center