What to Know When Looking for a CBT Therapist for Your Child

As a parent, your life is filled with making tough decisions. You want to help your child and do what is best for them. So, when you see your child experience worry or sadness that gets in the way of their ability to function, you want to act, and quickly. You may be familiar with Cognitive Behavioral Therapy (CBT), the gold standard treatment for several childhood psychiatric disorders including anxiety, depression, and behavioral problems¹. Perhaps you have even made the decision to seek out a CBT-oriented psychotherapist. But how will you know they are faithfully and competently applying this flexible approach?

There are a few basic things you should know about CBT with youth. First, CBT is primarily defined by its conceptual model². Second, CBT clinicians practice according to the principles of collaborative empiricism and guided discovery³. Agenda setting, regular progress monitoring, therapy homework assignment and review, and eliciting client feedback are fundamental parts of each session. CBT techniques are properly applied in an experiential, here-and-now fashion so treatment is relevant to children’s and caregivers’ concerns⁴​​​​​​. Finally, CBT practitioners employ a variety of change-inducing procedures, such as behavioral activation, mindfulness, social skills training, cognitive restructuring, and exposure. Exposure techniques, in particular, are vital when treating anxiety disorders.

While many behavioral health clinicians profess to faithfully adhere to the approach, not every clinician provides genuine CBT. In fact, one study found that some therapists self-proclaim to practice CBT, but when observed they fail to follow basic CBT principles⁵. Therefore, interviewing prospective therapists will allow you to make a well-informed decision on who is equipped to deliver authentic CBT. Here's what you need to know to help you with the interview process.

1. CBT involves lots of collaboration, enabling you, your child, and the therapist to co-engineer treatment plans: In the first few sessions, your therapist will interview you and your child by conducting an assessment and asking questions about the frequency of symptoms, duration, intensity, and interference in your child’s life. After your therapist diagnoses your child, you will collaboratively discuss a treatment plan and an estimated treatment timeframe. You will have opportunities to ask questions and actively participate in treatment.
2. An agenda is set at the beginning of every session: Therapy sessions are not haphazardly conducted. Rather than sitting on a couch and venting about the previous week, your therapist will collaboratively set an agenda with you and your child in the first few minutes of every session. Typically, the previous week’s homework is reviewed, you and your child will prioritize agenda items, and a plan for addressing these issues is conjointly designed.
3. CBT is action-oriented, so there will be homework/self-help assignments throughout the course of treatment: CBT is an active, goal-oriented, short-term treatment. Coping skills are first acquired and then applied. This requires the practice of new, learned skills. Therapy homework assignments to generalize these skills are essential parts of the process.
4. Clinical sessions focus on challenging thoughts and behavioral experiments: “How will my child deal with distressing emotions?” Most CBT therapists will answer that children manage their distress by facing their fears and anxieties. They learn to tolerate negative emotions via active coping and learning to approach and accept previously avoided thoughts, feelings, and situations.
5. Symptoms are tracked to ensure progress: Assessment measures track your child’s progress throughout treatment. Qualitative reports, such as your beliefs about your child’s progress, as well as quantitative reports, like symptomatic measures, guide treatment planning. Parents, teachers, and children all have the opportunity to complete measures to assess your child’s progress. Therapists may pivot in therapy if your child is progressing more slowly or quickly than expected.

We hope this information will help you find a therapist who helps your child. If you want to check whether a therapist has certified CBT training, there are resources available.

To find a therapist near you, visit the Psychology Today Therapy Directory.