Counselling and Cognitive Behavioural Therapy with Children and Adolescent

Helping Teenagers understanding their world view and the others

The first vital thing for any parent to understand when choosing a therapist to work alongside children and adolescents in their care is that any therapist who does so needs a certificate from the Criminal Records Bureau, as well as to have received appropriate training in the field of child and adolescent psychotherapy.  A background check performed by the Criminal Records Bureau is commonly referred to as a CRB and a clear enhanced disclosure from the CRB is an essential pre-requisite for any person who wishes to work with children or vulnerable adults.

Is your teen in trouble?  Just what is a troubled teen?

As any parent will know, raising children is very hard work.  While each developmental stage presents its own difficulties, adolescence is certainly one of the hardest for parents to negotiate and the journey becomes especially tortuous if children experience emotional difficulties.  What makes it harder, however, is the fact that it is all too easy to get lost ourselves in the emotional storms and breakdowns which overwhelm our children.

But what truly defines a troubled teen, and when does a parent really need to seek intervention?  Is your teen troubled or just a normal adolescent going through the growing pains of becoming an adult?  Which teenagers are at high risk of such behaviours as drug or alcohol abuse, dropping out of school, pregnancy, violence, depression, or suicide?  These are just some of the questions which serve to illustrate the immense difficulties that parents commonly face in knowing how to recognize the sometimes subtle signs of behavioural problems and to measure the seriousness of the situation.

Although it is tempting to compare your child to other adolescents, this is not truly indicative of a teen’s need for outside intervention.  The reality is that parents will always do best to look at their individual situation and decide for themselves if their teenager is on the path to self-destruction  after all, nobody knows your son or daughter like you do.  Changes in behaviour can often indicate that there is a problem and a depressed adolescent may, for example, become disruptive, begin showing academic difficulties or start to develop problems with peer relationships.  They may become irritable and aggressive, and often the only way that they can express their feelings is by saying that they hate themselves and their families.  They may even threaten suicide, but just because they don’t does not mean they are not at risk.  Always trust your own instincts and take action before the situation has the chance to get out of control.

Parents often have difficulty distinguishing between the normal behavioural and emotional growing pains of adolescence and the signs of deeper psychological problems.  It is important to recognise when a teen is not merely adjusting to the pressures of adolescence, but is indeed suffering from more serious behavioural or emotional problems.  Here are just some of the general signs which might indicate your teen is experiencing behavioural, emotional or developmental problems which require assessment by a mental health professional:

• Decline in school performance regardless of how hard they are working
• Withdrawal from friends, family, usual activities or hobbies
• Sleep problems (insomnia, sleeplessness or nightmares)
• Hyperactivity or irritability
• Frequent bouts of anger or aggression or acting out
• Continual resistant or hostile behaviour (such as towards those in authority)
• Refusal to go to school – skips school frequently
• Frequent and excessive anxiety or worry
• Depression, thoughts of death or suicidal feelings or tendencies
• Lying, cheating, or stealing
• Destructive behaviours such as vandalism or self-harm
• Threatening self or others
• Drug or alcohol abuse
• Acting out sexually
• Numerous physical complaints

Early intervention in the case of such problems tends to result in the best outcome.

The rites of passage

Did you know that as many as 14% of children will experience at least one episode of major depression by their 15th birthday, and that girls are significantly more likely than boys to experience depression after the age of 16?  Early identification and prompt treatment of depression, however, can reduce its duration and severity, along with minimising any associated functional impairment.

A depressed teen might not appear depressed in any classical or typical sense, but instead may show signs of being irritable or having a low frustration threshold.  Whilst there is a normal tendency for adolescents to seek privacy in their emotional lives, the hallmarks of which are phrases such as I don’t want to talk about it and Everything is fine, sometimes these do not square with what parents might actually be seeing.

Adolescents, however, do feel a real need to become separated and independent from their parents and this need, along with the peer pressure that they experience, means trying to find new ways of negotiating their way through life, which often provoke anger, conflict, low self-confidence, depression, and emotional distress. Counselling offers a safe space for teenagers to negotiate these new waters and to avoid asking for help from their parents with child-like dependency.  It helps the adolescent to differentiate between mature dependency, which includes the capacity to request advice, and a pseudo-independence which places a premium on going it alone.

What does the therapeutic treatment of children and adolescents involve?

The treatment of depressive disorders in children and adolescents often involves short-term psychotherapy or medication, or a combination of the two, as well as targeted interventions involving the home or school environment.

To what extent can counselling help teens?

Research into Cognitive Behavioural Therapy carried out with children and adolescents has not only been meticulous, but has also yielded significant and positive results. 

In fact, recent research shows that certain types of short-term psychotherapy, and particularly Cognitive Behavioural Therapy (CBT), can help to relieve depression in children and adolescents. 

Based on the premise that people with depression suffer from cognitive distortions in their views of themselves, the world and the future, CBT focuses on changing these distortions to ensure a healthier and more balanced view of the world.

What are the outcomes of adolescent counselling and psychotherapy?

The treatment of adolescents via counselling and psychotherapy can help teens to:

• Examine, challenge and change (through cognitive behavioural therapy) their former unhelpful beliefs about themselves and their world
• Move between acceptance and change
• Restore their emotions to their proper levels
• Break through the impasse by heading off guilt and self-blame
• Learn who they are and what is right for them
• Control their impulses
• Gain the skills that they need to succeed socially
• Turn down the temperature on the emotional upheaval and increase the possibility of positive emotional experiences
• Deal with the distress caused by unavoidable life events such as the loss of a loved one