What's the Best CBT Techniques for Adolescents
What are the best CBT techniques for adolescents? How do you use CBT technique for rewarding good behavior? What is contingency management? What is Somatic CBT? These are some common questions I’ve come across, which we will explore here in this article.
But first… what is CBT?
What is Cognitive Behavioral Therapy?
CBT created by Beck in the 1960’s, has proven to be highly effective for a variety of concerns and with various populations over the years, to include depression, anxiety, ADHD, and other concerns. There are nuances as to how to practice with different concerns and demographics, and over time it has evolved. As a somatic practitioner, I value bringing the body into practice, and during my Masters in Clinical Counselling, I eagerly explored what techniques beyond Somatic Therapy could support individuals.
I came across a few terms for the same thing, which is commonly referred to as Somatic CBT. This involves going beyond the typical awareness and modifications of our thoughts and behaviour, to further incorporate awareness around our physiology and emotions in various situations. This is important as physiology and emotions precede behavioural and cognitive responses (Brom et al., 2017; Morton et al., 2022). I have found that the Somatic CBT approach can be a gentler introduction to Somatic work for those who may not be comfortable going right into their physiological and emotional experience - which is many people for a wide variety of reasons. This Somatic CBT approach can be very helpful for all to understand how our behaviours, thoughts, emotions, and physiological (or sensation) experiences are inter-related and how we can create positive change for ourselves. In short, it's quite empowering and individuals can then use it for themselves beyond therapy if they wish.
Understanding CBT for Adolescents
Adolescence is a transformative period marked by emotional and physical changes, identity development, and social pressures. CBT techniques can help teenagers develop healthier thought patterns, 'regulate' (or understand and express) emotions, and adopt positive behaviors. In our disconnected world today, taking this further step of bringing awareness to our body sensations and emotions empowers us to connect with our body wisdom to make healthy choices for ourselves. For adolescents, Somatic CBT is especially beneficial because it equips them with tools to:
Challenge negative thought patterns that fuel anxiety, depression, or low self-esteem
Develop problem-solving skills to navigate social and academic challenges
Foster self-regulation by identifying triggers and creating strategies to manage them proactively
Choose healthy behaviours to build further confidence and align with their values and goals
Honour body wisdom by being able to tune in to sense what feels 'healthy' or not
Given the heightened sensitivity and rapid development of the adolescent brain, tailoring CBT techniques to this age group is crucial for their effectiveness. Again honouring this growth in independence, I would strongly recommend this choice come from the teen themselves, however; as parents we can plant seeds. Let’s dive into the techniques that work best.
The Best CBT Techniques for Adolescents
1. Cognitive Restructuring: Cognitive restructuring helps individuals identify and challenge distorted thoughts that lead to negative emotions or self-defeating behaviors. For example, a teen might think, “I failed this test, so I must be stupid.” Through CBT, they can reframe this to, “This was just failure on one test, in one subject. I didn’t do well on this test, but I can study differently or get more support next time.”
Why it works: Cognitive restructuring helps us understand that thoughts aren’t facts. It fosters resilience and a growth mindset, essential for overcoming setbacks. Explore how much factual evidence there is to support a thought, and what counters this.
2. Behavior Choices: We have the power of choice to choose how we respond, and by choosing behaviours that support our long term health and wellbeing can be powerful! Focus on activities that bring peace, joy and are connected with your greater purpose - going for a walk, working on a hobby, or a social outing.
Why it works:Choosing activities that nourish us and are aligned with our values and goals, help mitigate stress and anxiety, and improve our mood! This reinforces further positive behaviours.
3. Mindfulness and Somatic Awareness: Techniques, such as deep breathing, grounding exercises, or body scans help us to stay present and reduce rumination. These can be combined with somatic CBT, which incorporates awareness of physical sensations and emotional responses.
For example, if you are feeling anxious before a big presentation, notice what you are feeling and where. If you are feeling tightness in the chest, try a breath practice or progressive muscle relaxation.
Why it works: Many struggle to verbalize emotions because we are over stimulated, or our bodies don’t feel safe - we are often disconnected. By bringing awareness to the sensation, we are able to process this and come into a more relaxed state to then articulate and better understand.
4. Thought Diaries: Keeping a thought diary helps to track thought patterns and triggers. By writing down situations, thoughts, feelings, and alternative responses, we can gain insight around our patterns.
Why it works: This technique builds self-awareness, an essential skill for managing emotions and making informed decisions. And we can start to understand if the patterns are serving us, become curious as to where and why they originated, and begin to release and replace them with healthier ones.
5. Exposure Therapy: For those with phobias, social anxiety, or OCD, gradual exposure to feared situations or objects can reduce avoidance and build confidence. This technique involves facing fears in small, manageable steps with the support of a therapist.
Why it works: Exposure therapy empowers teens to confront challenges rather than avoid them, fostering courage and self-efficacy. An example may be visualizing writing an exam, noticing how it feels in your body and when you visualize completing it and seeing the positive result. Titrated awareness through the process is key to acknowledge underlying concerns.
The Role of Somatic CBT
Somatic CBT integrates traditional cognitive-behavioral techniques with body-centered practices to address the interplay between mind and body. From childhood to adulthood, we often experience symptoms of emotional experiences in our body before we notice, such as headaches, stomachaches, or fatigue. Anxiety is another great example, particularly for those who have felt disconnected from their body for a variety of reasons. The subtle signals of anxiety in these cases are often overlooked until our bodies are ‘screaming’ at us, and we can no longer ignore it, often showing up as burnout or chronic illness. Somatic CBT offers a practice in helping to connect with our bodies, process what led to the disconnection, to develop greater emotional and physiological awareness for our long-term health and happiness.
Some Somatic CBT Techniques
Grounding Exercises: This helps us bring awareness to our physical body and earth supporting us in the moment. In our world of overstimulation, it’s common to be disconnected from our physical body, particularly if trauma has been experienced.
Mindfulness Exercises: This helps us to stay anchored in the present moment by focusing on their senses. Below is a link where I share how to explore this practice.
Body Scans: This can be done in a variety of ways, with a simple version being noticing your feet connected to the earth and slowly scanning body sensations all the way to the top of the head. Body Mapping is another incredible tool to add on to this.
Progressive Muscle Relaxation (PMRT): Adding in PMRT to the second layer of a body scan can be a great way to release some excess energy by squeezing our fists, feet, and every part of our body… and as we exhale, release
Movement Therapy: This is one I commonly share with parents and children alike - noticing the area in the body where you feel sensation, maybe there is an emotion word or not, and exploring the colour, shape or how it might sound to release the energy from the area. With young children perhaps anger is a stomping dinosaur, or for an adult going for a hard run in nature or the wood chopper breath. Movement is absolutely key to help us release stored emotions.
Benefits of Somatic CBT
Reduces the physical symptoms of anxiety and stress
Enhances emotional awareness by connecting feelings with bodily sensations
Practical tools to move through challenging emotional situations, commonly called “self-regulation”
Preventative awareness and practices before the emotions become heightened
Life-long skill to move through challenges in a healthy way
Another Common Application of CBT is to Motivate
Positive reinforcement is a cornerstone of CBT, which can help us to change our responses to situations, or help motivate us. The search term “cbt technique for rewarding good behavior” is a common one, but this isn't quite how CBT works, as it needs to be driven by the individual. Here’s an example as to how we can use CBT to support our motivation:
Set a Clear Goal: What is a specific, measurable outcome (typically a behaviour) to work on, such as completing homework, or managing anger constructively.
Explore the Somatic CBT Model: When we look at a challenging situation, perhaps homework or anger, what does it look like from a cognitive, behavioural, emotional, and physiological perspective? Thoughts may be “I’m a bad person”, “Why can’t I do this?” Emotions may be denial, shame, guilt etc. Sensations may be low energy, heavy shoulders, hot, or feeling sick to the stomach. Behaviours could be procrastinating or inappropriately reacting, which could result in further anger, shame and guilt. Not very rewarding but important to understand the effects.
Reworking the Situation: Now let’s look at this situation through the CBT Somatic model for a healthier perspective: Behaviour could be doing 30 minutes of uninterrupted homework or choosing to go for a walk when triggered into an anger response, rather than engaging. Thoughts might then be “I did it!” or "I feel more calm now and can see the real issue." Emotions would likely be pride, joy, and diminished anger. Sensations might be cooler, more energy, lighter feeling, or strength.
Identify Meaningful Rewards: The experience of the healthier choice itself can be the reward, which is intrinsically motivating. However, sometimes an additional extrinsic reward may also be helpful to further reinforce. A reward for doing homework might be a 10 minute break of something enjoyable between 30 minute sets. For handling anger triggers in a healthy way, likely the reward is a closer bond with others or even the self. If using extrinsic rewards, they should align with interests and values. You can also create a token system for yourself after earning 10 tokens for example. Ultimately, the reward should be as soon as possible to connect with the positive behaviour. I recommend taking time to notice the intrinsic reward - that happy feeling!
CBT Approach to Further Motivate Our Children
As a parent, understanding our children’s love language is helpful. Do our children feel appreciated with our words of affirmation, quality time and connection (which most crave), physical closeness, acts of service, or with gifts? Here are some further ways we can reinforce positive behaviours:
Model Healthy Behaviors: Demonstrate emotional awareness, explain why you make certain choices, take responsibility for actions, and demonstrate proactive self-care for stress management and wellbeing.
Encourage Open Communication: Create safe spaces for family to share their thoughts and feelings without judgment, and without needing to fix - just to be heard. Ask how they would like your support - perhaps it’s a hug, acknowledgement the situation was challenging, or maybe they do want to bounce ideas around to problem solve.
Celebrate Progress: Acknowledging even small steps toward positive change builds confidence. Celebrate the little milestones everyday!
As parents, much like the CBT model, we want to empower our children to be inter-dependent, whole, self-actualizing people. Exploring the Somatic CBT model can absolutely be powerful in helping to foster this growth when faced with tricky situations that may seem daunting. It also helps us to understand the inter-related aspects of emotions, phsyiological sensations, thought patterns, and behaviours to choose healthier ones. This tool can be a holistic, life-skill to help us navigate challenging times as we learn and grow.
Want to Learn More?
This video explores Mindfulness, to help root into the present moment
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