1. Cognitive Behavior Therapy for Kids Toolkit for Elementary School Counselors Kathie Guild McDougle Elementary School Counselor kguild@chccs.k12.nc.us 919-969-2435 x64350 https://sites.google.com/a/chccs.k12.nc.us/kguild/ https://www.facebook.com/pages/Mcdougle-Elementary-School-Counseling/684793301549512 https://twitter.com/MEScounseling

2.  Psychotherapy also known as cognitive therapy  Focus on the present  Time-limited ( 6-12 sessions)  Problem-solving oriented  Students learn specific skills that they can use for the rest of their lives. These skills involve identifying distorted thinking, modifying beliefs, relating to others in different ways, and changing behaviors. http://www.beckinstitute.org/cognitive-behavioral-therapy/

3. CBT  Instructional & Directive  Socratic Questioning  Collaborative Relationship – partnership  Assumptions: 1) student capable of becoming aware of one’s thoughts and behaviors and changing them 2) sometimes thoughts might be distorted and fail to reflect reality accurately

4.  It is not the event ( a = activating event) but the thought about the event (b = belief or automatic thought) that creates emotional distress (c=consequences). This is known as the ABC formula. School counselor helps students recognize their automatic thoughts and consequent emotions and behaviors. Automatic Thoughts

5. A-B-C formula A= activating event B= automatic thought about the event C= consequences

6. Thought Cycles in CBT

7.  A-=activating event * B-=belief ( dogmatic thought) * C= consequence  C= what is the consequence. What do you do? (physical reaction) How do you feel? (emotional response) The Art of Scaling Scaling – rate your feeling on a 1-10 scale

8. CBT Thought Record Example

9.  D- Dispute the dogmatic belief. What is the evidence for it? What is the evidence against it? What else might this be? If you were to ask someone else about the situation what would they say? If someone came to you about this, what advice would you offer them? Adding D E F * E- Evaluate. Thinking about it in this light, how does this belief make you feel ( scaling)? Use different words to describe the situation. * F- Future Plan. Develop a plan for reframing this thought if this situation happens again. When you think of this event again, put in your replacement thought

11.  Dogmatic Thoughts  Create Emotional Distress  Dictate Moods  Block Hope and Change Help Students Recognize Their Own Automatic Thoughts

13. Automatic Thoughts Effect Feelings & Behaviors

14.  All or Nothing Thinking  Overgeneralization  Mental Filter  Discounting the Positive  Jumping to Conclusions  Magnify/Minimize  Emotional Reasoning  Labeling  Catastrophizing  Shouldizing & Musterbation  Fairness Common Automatic Thoughts Identified by Beck

15. CBT Critters Black and White Thinking Mental Filter Overgeneralizations “That Stinks” Skunk General Ostrich Filtering Flamingo If I am not perfect I have failed. Either I do it right or not all. Seeing a pattern based upon a single event. Being overly broad in drawing conclusions Only paying attention to certain types of evidence Noticing our failures, but not seeing our successes.

16. CBT Creepers Discounting the Positive Jumping to Conclusions Magnifying/Minimizing Count Batula Leap Frog Puffer Fish Discounting the good things that have happened or that you have done. “That doesn’t count.” Mind Reading + Fortune Telling Imagining we know the thoughts of others & predicting the future Seeing things out of proportion. Either way too big or way too small

17. CBT Creepers Labeling Catasphorizing Shouldizing Fairness Lamb “that’s baaaad” Catastrophic Cat Shrew Fair Falcon You should Assigning labels to ourselves or others. “I’m a loser.” Thinking something is far worse then it actually is. “It is the end of the world.” Using critical words such as should, must, ought makes us feel guilty and like we have already failed. Applying shoulds to others results in frustration. Thinking things are unfair for you or believing unfairness is directed at you creates resentment and anger. “it is not fair that I always get stuck doing the hardest work.”

18. How does this problem prevent you from living the life you want to? If you didn’t have this problem, what would you be doing? What would you be doing differently? What if…?

19.  Thought Journals  Pleasant Activity Scheduling  One good thing that happened and one thing to look forward to daily  Journaling feelings  Before event, write down fears and what your core beliefs are.  Practice deep breathing, visualizations, and replacements thoughts routinely. CBT Homework Examples

20. 1. Introduce concept of brain power. Our brain is the Command Center of entire body to include thoughts feelings & behaviors. 2. Introduce CBT triangle. Our automatic thoughts create feelings and behaviors.

21. 3. Give concrete examples of how our thoughts effect our feelings and behaviors. Ask students for their own examples. Connect CBT to a real life situation within their experience. I am going to fail It is going to be terrible I won’t know anything I will have to repeat the grade I am stupid and a loser Ask: What feelings will these thoughts create? What behaviors? Example: Automatic Thoughts on testing:

22. CBT Simple Worksheet for Groups (ABC) 4. Students complete worksheet either individually, as a group or verbally. Leader calls out scenerios the students face. Such as, EOGs, benchmark assessments, doing a class presentation, being home alone, being corrected by a teacher. For a test anxiety group, group leader can say different subjects such as p.e., music, recess, and so forth. It is important students say/write each area of worksheet so they understand the connection between thoughts, feelings, & behaviors. Instructions

23. 1. Automatic Thought 2. Feelings 3. Scaling ( rating) 4. Behavior

24. Introducing CBT Critters and the Shadow 5. Introduce students to some of the CBT critters. I suggest half one week and half the following week. For example, Catastrophizing Cat automatic thoughts might be,” I will never get out of 3 rd grade. I will be the oldest kid in my school in 3 rd grade. I will just die if I don’t pass. If there is a question about place value I will totally bomb it.” Leapfrog automatic thoughts might be “ I will never pass these stupid tests” ( predicting the future). Or “ My teacher probably wishes I wasn’t in her class” ( mind reading).

25. CBT Simple Worksheet for Groups (DEF) 6.D.E.F. deals with replacement thoughts or reframing. Teach students to examine the evidence for and against their automatic thought. What else could this be? How might someone else view this situation? If a friend came to me about this situation, what would I tell them to do? Is this fact or opinion?

26. 1. 2. 3. 4. ______________________________________ ____________________ ______________________ 5. 6. _______________________________ ABC+ DEF

27. Thought Bubbles Optional

28. 7. On an index card have students color in 5 zones ( blue, green, yellow, orange,red). Number the zones between 1-10. At the top of the card have students write things they enjoy doing, that give them a sense of calm or fulfillment. When students have a CBT Critter automatic thought, they complete worksheet and practice what is on their card.

29. 8. Assign homework to group members:  Situation worksheet  Thought bubbles  Pleasant activity scheduling  Journaling ( write down fears, worries, etc.  Practice index card strategies

30.  Anxiety by Paul Stallard materials/worksheets found at http://media.routledgeweb.com/pp/resources/CBTCHILD/worksheets.pdf http://media.routledgeweb.com/pp/resources/CBTCHILD/worksheets.pdf * Pinterest: CBT http://www.pinterest.com/marheinrichs/therapy-ideas-cbt/ * The Beck Institute ( CBT) * http://www.teacherspayteachers.com/Product/CBT-AnimalsStories-and- Worksheets-to-Teach-Children-about-Cognitive-Distortions-1133066 Resources http://www.beckinstitute.org/cognitive-behavioral-therapy/ CBT Animals by Closet Counselor * S ocial Thinking ( zones of regulation) www.socialthinking.com