Presentation on theme: "Effective CBT Strategies for Working With School-Age Children Presented by Dr. Caren Baruch-Feldman firstname.lastname@example.org Scarsdale Psychologist Meeting."— Presentation transcript:
1Effective CBT Strategies for Working With School-Age Children Presented by Dr. Caren Baruch-Feldman Scarsdale Psychologist Meeting July 7, 2010
2GOALS FOR TODAY’S TALKApplying CBT Principles to Working With Children.2. CBT Strategies That Can Be Used in an Office or School Setting.
3Why Choose REBT/CBT When Working With Children? EffectiveShort-termSimilar to School
5Experiment 1 Florida Old Lonely Orange Bingo Conservative wrinkle WorriedFloridaOldLonelyOrangeBingoConservativewrinkle
6Experiment 2Picture yourself in the following situation: You are standing in line at the bank. There are about 50 people around. A robber enters and fires his weapon. You get shot in the arm, but no one else is hurt.Would you consider yourself lucky or unlucky?
7Experiment 3What Do You See? Look around the room and try to find all the examples of RED you can see.What have you spotted?
8Changing Ones Thoughts Step 1:Identify Negative Thoughts.Step 2:Question and Challenge Those Thoughts.Step 3:Come Up With More Realistic and Optimistic Thoughts to Feel Better.
9Step 1: Identifying Negative or Irrational Beliefs Demandingness – SHOULDsAwfulizing – It Is Terrible!Low Frustration Tolerance – I Can’t Stand It!Global Rating of Self/Others. Self-Downing.
10Core Irrational Beliefs For Children It’s Awful If Others Don’t Like Me.I’m Bad If I Make a Mistake.Everything Should Go My Way; I Should Always Get What I Want.Things Should Come Easily to Me.The World Should Be Fair.
11Step 2: Question and Challenge Those Thoughts Where is the Evidence?Is It Helpful How I Am Thinking?Am I Shoulding on Myself?Am I Exaggerating?Am I Focusing Just on the Bad Things?Is My Whole Self Worth Attached to One Event?
12Step 3: Develop Rational Beliefs/Thoughts PreferencesLiving in the GrayI Can Stand ItTotal Self Acceptance
13Irrational vs. Rational RATIONAL BELIEFSPreferencesLiving in the GrayRealizing That They Can Stand ItNot Judging ThemselvesSelf AcceptanceIRRATIONAL BELIEFSDemandingness – SHOULDsAwfulizing – It Is Terrible!Low Frustration Tolerance –I Can’t Stand It!Global Rating of Self/Others - Self Worth Tied to 1 Behavior or Action. Self-Downing
14Let’s PracticeStep 1: Identify Negative Thoughts. Step 2: Question and Challenge Those Thoughts. Step 3: Come Up With More Realistic and Optimistic Thoughts to Feel Better.
15CBT Therapy With Children: Special Considerations Children Rarely Initiate Treatment.May Have Some Difficulty with the Cognitive Aspect.Need to Explain in Fun and Engaging Ways What Thoughts, Feeling, and Behaviors Mean.Explicit Reinforcement Is Important When Working With Children.Need to Work With the School and Parents.
16How Do You Introduce CBT to Children in An Engaging and Understanding Way Visuals - Thought Bubbles; Cartoons; Picture BookBaseball MetaphorButterfly Thoughts WorksheetThought Flower GardenRational or Irrational? GameBest Friend TechniqueReverse Role PlayingEmpty Chair TechniqueErase the IrrationalAnalyze TV Shows or MoviesPuppetsRational Advice ColumnRational Emotive Imagery“Meet Thoughts, Your Thought Maker” by R. Avery
17Rational Emotive Imagery Picture a bad event clearly. One that has either already happened or that you believe likely to happen. Take your time. Fill in the details. Visualize the people involved, hear them talk, describe the environment, let the situation happen in your mind. Feel the emotions; you can do it. Keep imagining until the emotions are as disturbed as you can get them.After a minute or two, change your emotions from disturbed to merely unpleasant. For example, from depressed to sad. How did you do it? If you changed the facts of the matter, you noticed that when the event is different you will feel differently. Why? It is because you think differently about different facts. Check it out. Get into your disturbance with the correct facts. Once done, live with the image a minute or two. Now, change your emotions without changing any relevant factual material. You can do it. Take your time. Once you have it, reflect on how you did it. You changed the things you thought about the event. Its the thinking that causes the emotions.
18Internalizing Vs. Externalizing Disorders : The Thought Pattern Associated with these Disorders Children Deal With Problems By Acting Out. Problem behaviors Are Directed Towards Others.Causes Distress Primarily to Others.Beliefs (B): Musts and Shoulds About Others, Awfulizing, Low Frustration Tolerance.Consequences (C): ODD, CD, ADHD, Aggression.InternalizingChildren Deal With Problems Internally Rather Than Acting Out.Cause Distress To The Child.Beliefs (B): Self Downing, Catastrophizing, Awfulizing, Expecting the Worst about the Situation and Oneself.Consequences (C): Depression and Anxiety.
19CBT Approach to Working With Children Who Are Anxious Psycho-Educational(3) Changing One’s Behavior(physiological and avoidance)(2) Changing One’s ThoughtsNo?Yes!
20Psycho-Education: Understanding Worry Nervous SystemsGenetic PredispositionWorry as a Bad HabitChoose a Different Path
21Changing One’s Thoughts: Worry Something bad might happen; it must not happen.I can’t stand being anxious. I should not feel anxious.Something is wrong about me as a person because I am worrying.If something bad happens it will be terrible.How One THINKS About A Situation Affects How One Feels
22Mom, I’m Worried! Expecting the Worst Test Anxiety I am going to fail! It is going to be terrible!I will need to repeat the grade.If I fail I am a bad person!
23Disputing Negative Thoughts Where is the evidence that what I am expecting will happen?Am I exaggerating?Am I jumping to conclusions?Am I focusing just on the bad things?Is it helpful how I am thinking?
24Realistic and Positive Thoughts Mom- I’m Confident!Confident Test TakerRealistic and Positive ThoughtsThere is no evidence that I will fail. I haven’t failed previous tests.Even if I fail, I am exaggerating how bad the results will be. Nobody gets left back in 4th grade because of one test.Worrying is really the worst thing I can do. Since when I worry, I am not paying attention fully to the test.
25To Sum Up: Worry - Changing Ones Thoughts Identify Negative Thoughts.Look for Expecting the Worst.Question and Challenge Thoughts.Where is the Evidence?Is it Helpful?Come Up With More Realistic andOptimistic Thoughts to Feel Better.1)There is no evidence…2) Worrying won’t help……
26Changing Behavior: Physical Sensations Be A DetectiveRather than think of fear as a signal to RETREAT, consider it a CUE to go forward.
27Changing Behavior: Physical Sensations Spell Your Name with Belly BreathsBreathing Happy ThoughtsDeep Muscle RelaxationGuided ImageryChange Your Breath
28Changing Behavior: Don’t Avoid Facing One’s Fear or StressManageable and Hierarchical MannerSuccess Breeds Success
30Coping Cat- FEAR Plan F = Feeling Frightened? E = Expecting Bad Things to Happen?A = Attitudes and Actions that can Help.R = Results and RewardsFEAR Ladder or Situation Cards
31Other Internalizing Disorders: Depression Beliefs Associated With DepressionB = Self-downing, Awfulizing, Black and White Thinking, Seeing Only the NegativeCognitive Errors = Permanence, Pervasiveness, Personalizing.Strategies for Childhood DepressionExerciseEating and Sleep RightBe A Good Role Model/ Mirror NeuronsIdentify Strengths and Talents/FLOWGrateful ActivityJournal the PositiveRandom Acts of KindnessTake Action“When You Need A Helping Hand” - A. VernonMake It a Habit
32Other Internalizing Disorders: OCD Talking Back to OCD and OCD in Children and Adolescents : A Cognitive Behavioral Manual by J. MarchPsycho-Education: What is OCD? What Does OCD Look Like? What Causes OCD? How is It Treated?Identifying Obsessions and Compulsions - Children’s Yale Brown Obsessive Compulsive ScaleTalking Back to OCD: Naming and MappingDeveloping a Hierarchy; Exposure and Response Prevention
33Externalizing Problems Beliefs Associated With Externalizing Disorders (Anger)B = Musts Instead of Preferences; Low Frustration Tolerance;I Can’t Stand It!Examples:I must have what I want!The world should be fair!Other people must treat me the way I wanted them to, and when they don’t they deserve to be punished!Challenges for Anger Related Irrational BeliefsWhere Is It Written That You Should Always Get What You Want, That The World Must Be Fair, and That You Always Have To Get Your Way?Functional DisputesHow Is Your Anger Helping You? Or, is it Like Pouring Salt On An Open Wound?
34Interventions for Externalizing Disorders (Anger, Aggression) Act Now Pay LaterStep Into Their Shoes
35Interventions for Externalizing Disorders (Anger, Aggression) It’s All How You Look At ItMad Dog
36CBT Approaches for the Classroom or Group Setting Smart Board Presentation:What is the Situation?What Is the Feeling Associated With That Situation?What Are Your Thoughts About The Situation?Challenging Those Thoughts.Alternative Way Of Thinking About the Situation.New Feeling.
37References What Works With Children and Adolescents by Ann Vernon. Rational Emotive Behavior Therapy With Children and Adolescents by Jerry Wilde.Meet Thotso, Your Thought Maker by Rachel Robb Avery.The Relaxation & Stress Reduction Workbook for Kids by L. Shapiro and R. Sprague.Bringing the Science of Positive Psychology to Life by S. Anchor & E. Peterson.The Coping Cat by P. Kendall.Stop and Think by P. Kendall.