Cognitive Therapy with Children and Adolescents: From Theory to Practice

Abstract

Cognitive therapies are now well established as a component for the treatment of a wide range of child behaviour problems. There is a great deal of evidence to suggest that deficits and distortions in cognitive processes play a role in disorders of affect and behaviour in children and adults alike. This has led to the development of many different cognitive therapy approaches which aim to influence cognitive products, structures and operations. Cognitive assessment methods continue to lag behind the developments in therapy, and there is a marked need for the development of reliable and valid measures. Empirical studies support the value of cognitive interventions, although it is recognised that most cognitive therapies include aspects of behavioural techniques, making it difficult to draw valid conclusions. Certainly, the results of recent meta-analytic studies have produced optimistic conclusions and justify the continued use of cognitive therapy methods in clinical practice, with a wide range of behavioural problems. Cognitive therapy techniques have something to offer with internalising and externalising disorders alike. Future research should now focus on the identification of methods to enhance the effects of cognitive therapies and to determine the characteristics of children who are most likely to benefit from these methods. There is some evidence to suggest that younger children may benefit less from cognitive therapies than do adolescents. This perhaps reflects differences in cognitive and language development. Further consideration needs to be given to adapting cognitive therapy methods to the developmental level of younger children. Cognitive therapy approaches are now well entrenched within many multi-component programmes for most emotional and behavioural disorders in children. The degree to which cognitive therapies add to the effectiveness of behavioural methods, however, remains to be demonstrated for many types of behaviour problem. It is also unclear whether the changes in affect and overt behaviour produced in these intervention programmes is actually related to improvements in the cognitive activities that were targeted in therapy. From a theoretical perspective, however, cognitive therapies have a high degree of face validity. If deficits or excesses in specific cognitive events or processes are found during assessment, which can be hypothesised to underlie disturbances of affect of behaviour, then there is a strong case for attempting to change these aspects of cognition.

Work stress and depression among direct support professionals: the role of work support and locus of control

“…Further research is needed to examine what types of interventions may facilitate this process. Such interventions, for example, may involve role playing, or working with coworkers to resolve on‐the‐job problems, as learning better communication methods has been shown to help workers develop more control within their work environments (Spence 1994; Schmitz et al. 2000).…”

Relationship between burnout and occupational stress among nurses in China

“…Information on factors influencing nurses’ feelings of burnout, such as coping resources, could be disseminated to improve their psychological health. For example, social skills training has been shown to improve interpersonal problem‐solving and practical skills (Spence 1994). This could be introduced into nurses’ basic training to improve coping skills.…”

Peer Relations of Children With Attention‐deficit Hyperactivity Disorder

“…To make matters worse, the short-acting effects of psychostimulants can leave the child unmedicated during critical social periods in school (e.g., during lunch time or at the end of the day when unstructured play is more likely to occur); (see Erhardt & Hinshaw, 1994). However, there is encouraging evidence that medication may enhance the effectiveness of other interventions designed to address the peer problems of children with ADHD (see Pelham, 1993 Losel, 1994, andSpence, 1994, for reviews), and psychopharmacological regimens that have obvious relevance for children with ADHD. In addition, some programs rely on coaching and modeling, efforts to restructure social activities (e.g., the use of class skits), whereas others enlist the aid of popular classmates as social agents (Bierman & Furman, 1984).…”