I’m interested…very interested. So much of what parents are given by professionals in terms of parenting advice for any and all children are reward/consequence based strategies of behavior modification. But what if it doesn’t work? What if there isn’t a consequence out there that will stop your child’s negative behavior? What if there isn’t a reward they care a thing about?

Cognitive Behavior Therapy (CBT) is different. It focuses on self-regulation of thoughts that trigger feelings. Used often in treating adults with depression or anxiety, using CBT for troubled children is proving valuable in many ways. In the world of adoptees, trauma is often added to the mix of any special needs a child may have. Children who have been institutionalized, neglected or abused have all been traumatized. CBT has effectively been used for treating PTSD, as well as other anxiety disorders (like OCD) in both children and adults.

CBT is premised on the concept of recognizing faulting thinking processes and altering them, hence altering your feelings about a situation. Our thoughts control our feelings, and thus, our behaviors. The key is that the person (child) must be committed to changing their thoughts and “doing all the hard work” it takes for healing.

In reward/consequence behavior mod token systems, it’s more a parent-driven intervention. CBT, while parents can learn to be coaches, requires more of a “buy-in” from the child. And therein, as they say, lies the rub for some kids.

CBT has been shown to be as effective as EMDR in treating PTSD. It receives high marks as a psychotherapy for depression, OCD, eating disorders and Tourettes. The ABC’s of Cognitive Behavior Therapy are the cornerstones:

A = activating event. The situation that leads to a high emotional response and ultimately to the negative dysfunctional thinking.
B = beliefs. The negative, misleading thoughts the person experiences when faced with the activating event.
C = the conditioned response to these thoughts.

CBT works on helping the child to reframe their thoughts/beliefs and to realize that they can control their emotions when faced with an activating event. No external consequences are imposed. Instead the child/person is helped to see the negative consequences that occur from their own dysfunctional thinking and reactions.

This theory makes so much sense for LuLu. External rewards have held no meaning; external consequences only frustrated her and increased her anxiety. And reinforced her distorted negative self-image. Instead it makes much more sense to teach her how to identify things that cause her anxiety to grow and teach her coping skills and techniques to change her negative self-talk.

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