Cognitive Behavioral Therapy (CBT)
I use Cognitive Behavioral Therapy (CBT) techniques for some older children (6-7 year olds) with mood or emotional concerns.
In CBT, your child will learn about his/her emotions, the connection between thoughts and emotions, and how to challenge negative thoughts. For example, it is common for children with anxiety or depressive symptoms to have strong negative thoughts ("I'll never be able to do it!" "No one likes me"). Naturally, many parents feel disheartened and exhausted trying to convince their child that these thoughts are untrue-- and it often doesn't work! CBT techniques give you and your child tools to address these persistent negative thoughts. Relaxation techniques are also introduced and practiced to help children manage negative emotions and more effectively calm down when they are experiencing big emotions.
With young children, the concept of "challenging negative thoughts" can be really hard to grasp (it's hard for many adults, too!) This is why CBT is typically recommended only for older children who are at least 7, although this is very dependent on the child. I will work with you and your family to determine if CBT is a good fit. Including caregivers in this treatment can be helpful, as you will also learn skills to help support your child at home.
Many children with anxiety also tend to avoid situations which are difficult or anxiety-provoking. This can lead to some accommodations which can actually increase anxiety. For example, a child who is afraid of the dark sleeps with the lights on. In the short term, this may help avoid tears and meltdowns at bedtime; however, in the long run, sleeping with all the lights on leads to more night wakings and poor sleep overall (which then leads to more irritability and challenging behaviors!) In addition to relaxation techniques and understanding emotions, treatment also focuses on developing a plan to safely expose your child to these anxiety-provoking situations with support. This approach, which is related to CBT, is known as exposure therapy and is very effective for treating child anxiety.
With CBT, I will often meet individually with your child for a portion of these sessions to discuss and practice these skills. This gives your child a safe space to discuss their experiences. I will not share the specifics of what your child and I discuss unless I am concerned about your child's safety or if they give me permission to discuss it with you.
However, parent involvement is key to help reinforce and practice the skills at home, so I will always meet with you to review the overall focus of the session and homework.