St. Louis CBT for Kids
What language do you use when you talk to yourself?
When you make a mistake, do you tell yourself, "Well, I can try again next time. I can address X, Y, or Z and that may help"? Or do you say, "I'm an idiot. This is useless. There's no point in trying"?
Not so surprisingly, one of those thoughts is more helpful than the other.
And it's not just adults who engage in these unhelpful thoughts. As counselors in St. Louis, we know that kids and teens with anxiety are particularly prone to unhelpful self-talk. Their brains are primed to think through the worst case scenario as a protective measure - which means that they want to think the worst things possible, even if it’s about themselves.
As anxiety therapists in St. Louis, we know that what we tell ourselves changes how we feel, and that changes how we act.
Going through the above example, if we say to ourselves "This is pointless and I'm an idiot" those defeated, worthless feelings can directly lead to us giving up and shutting down.
Cognitive-Behavioral Therapy for kids addresses these three components - thoughts, feelings, and behaviors.
For children, we have to hep them identify what thoughts they tell themselves, and help them start to restructure or "flip" these thoughts.
CBT Explanation Walkthrough for Kids:
Here’s the exact script that our therapists use with kids or teens when we’re explaining the cognitive triangle and the power that thoughts have when it comes to impacting our feelings and our reactions.
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In this script below, allow for any and all answers. A few guidelines:
Feelings aren’t bad or good, they just are
Thoughts aren’t bad or good either, they’re just thoughts
Behaviors might get you into trouble, and it’s never ok to hurt someone else or hurt yourself, but behaviors can all be understandable
Because we’re working on helping your anxious or angry kid or teen build this language and better understand their thoughts, feelings, and behaviors, we want to view our role as GUIDE rather than GATEKEEPER. We don’t get to decide what they’re saying, feeling, or acting - we just get to teach them about what might be going on, and what they could do about it.
Feeling like you could use some parent support?
Our parent coaching program is like therapy for parents, helping you gain confidence as you GUIDE your anxious or angry kid or teen.
Let's pretend you walk into a lunchroom, and a table of kids starts laughing as soon as you walk up.
What’s the first thing that might pop into your head?
>>Allow for the kid to share any thoughts here. No wrong answers!<<
That’s really interesting! A lot of times, someone might tell themselves, “Oh, that group of kids must be laughing at me.”
Alright, we walk into the lunchroom, a group of kids starts laughing, our brain says “They must be laughing at me!” How would that make you feel?
>>Again, allow for any self-identified feelings!<<
So we know what we’re thinking, and we know what we’re feeling. What would your body want to do next? What would be the action?
>>Allow for any self-identified behaviors here, and share other relevant suggestions. If someone is scared, maybe they run away. If someone is angry, maybe they go up and yell at the table of kids. In this example, we’ll explore an anxiety-driven anger response.)<<
You tell yourself they’re laughing at you, you feel really mad, and then your body wants to go and hit them. See how one leads to the other? It makes sense to tell yourself that thought, feel that feeling, and have that reaction.
But what if they weren’t actually laughing at you. What if they were laughing at something else?
We don’t actually know for sure that they’re laughing at you, right? It might feel true, but it might not be 100% true. What else could be going on? What other thoughts could we tell ourselves?
>>Work together to identify at least 5 other thoughts or explanations. If your child can’t come up with any thoughts, you can provide a few examples to help them. Maybe they were laughing at a joke! Maybe they were laughing about something totally different that happened in class. Maybe they were laughing at you, because they really hate you, and so does absolutely everyone else at school. You can identify helpful and unhelpful thoughts in this work - the important thing is to recognize that the first thought that pops up isn’t the only thought that you can have, or the only suggestion!<<
Looking at this list of different thoughts, what one seems the most helpful to you?
Let’s walk through our triangle again! If we told ourself this thought, what feeling would that lead to? What behavior after that?
So, one time you get mad and hit another kid. This time, you feel curious and you ask what’s funny. Two totally different outcomes, right? Both times that group of kids laughed, but one time you had a reaction that probably would have gotten you in trouble, and the other time you maybe got to make some new friends. Why did we have two totally different examples?
>>Encourage the child to come up with the explanation for these two different outcomes. Some kids have trouble with this piece, but we want to guide them to recognizing that the only thing that changed was what they told themselves. The situation was entirely the same, and they felt differently and reacted differently purely based off of their thoughts.<<
CBT is a framework that helps us explore and identify where our thoughts can change and become more helpful.
CBT allows us to come up with alternate reasons that the table of kids starts laughing. Maybe they told a funny joke. Maybe they're talking about someone else. Maybe I could go ask them if something funny happened earlier. Flipping our first thought thought to this more helpful one directly leads to a change in feelings and behaviors.
It's alright that our brains tell us "They're laughing at me." Our brains are trying to protect us. But it is important to take the time and think through it. We have to ask, "Do I know this thought to be 100% true, or is there something more helpful I can tell myself?"
Assess if your child is using helpful or unhelpful language.
Talk through problems with your child and teen, even problems that you are experiencing, to model how to use effective positive self-talk. If you help your kid with their homework and they come upon a difficult problem, model for them by saying "This is really challenging, even for me! I wonder if there is a good place to figure out how to solve this?" Or if you're driving a car and stuck in traffic, say "Sometimes getting stuck in traffic makes me feel super frustrated! But I know we'll get through it soon."
Skills are reinforced at home.
If you are modeling and demonstrating positive self-talk, you are already going a long way in helping your child develop positive thinking skills.
Want more CBT? Thinking you might need CBT counseling in Missouri?
Our therapists all specialize in anxiety and anger management therapy for kids and teens, and incorporate CBT skills into their work. If you live in Missouri, you can schedule a free phonecall right here:
Curious to hear more about anxiety therapists in St. Louis, or are you a little reluctant about counseling? Compassionate Counseling St. Louis provides specialized anxiety and anger management therapy for kids, teens, and college students. We work in Clayton, MO and serve kids, teens, and college students throughout St. Louis City, St. Louis County, Ladue, University City, Town and Country, Webster Groves, Creve Coeur, Kirkwood, Richmond Heights, and Brentwood. You can set up your free phone screening to see if we’re a good fit for your needs right on our website.
This post was originally published April 1, 2017 and updated February 14, 2023.