CBT for Youth

Well hello again, Sunday Morning Coffee-ites. Always a pleasure to be greeting you at the end (or start) of the week. I hope yours has been full of wonder and that the upcoming one will be equal parts peaceful and aspirational!

I spent a lot of time this week meeting with organizations about solutions for juvenile crime, opportunity youth, and emerging adults, all in the context of how to best serve these young people who are at risk of entering or reentering the justice system or coming home from incarceration. It’s a tough question. What we know about youth crime waves is that they’re just that…waves. Crime rates ebb and flow, historically, and they do so no matter how many kids we incarcerate. We seem to be at a peak right now, and it’s not just in your city. My meetings this week spanned the country. Cities everywhere are seeing similar trends.

One effective strategy, in my 39 years of working with at-risk young people and adults, to combat criminogenic behavior is to first tackle criminogenic thinking. Otherwise known as cognitive behavior therapy (CBT).

CBT is an evidence-based form of talk therapy that can be a particularly effective treatment modality for adolescents. You can use CBT for teens to help them become aware of irrational or negative thinking so they can see situations clearly, process them, and respond to them in healthy ways. CBT intervention for young people can be a powerful part of an integrated treatment plan for adolescent mental health disorders and/or for those who are system-impacted and need to form healthy habits that will support them as they enter adulthood.

At its core, CBT operates on the belief that our thoughts influence our emotions, which in turn affect our behaviors. When teens harbor distorted and negative thoughts, they’re likely to experience difficult emotions and engage in destructive actions. Conversely, positive thinking leads to positive emotions and behaviors. CBT aims to help teens shift their thoughts, feelings, and behaviors towards a more positive trajectory.

Understanding Cognitive Distortions

CBT interventions focus on identifying and correcting distorted thinking patterns, also known as "cognitive distortions." When we teach CBT strategies to young people, we call them ‘thinking errors.’ These thinking errors don’t accurately reflect reality and can lead to negative emotions and behaviors. Common examples include:

Black-and-White Thinking: Viewing situations in extreme terms. For instance, if a teen argues with a friend, they might label the friend as "bad" and feel upset when others don't take their side.

Fortune-Telling: Jumping to conclusions without all the facts, like assuming someone is angry with you when they’re just preoccupied with their own issues.

Magnification: Exaggerating the significance of mistakes and downplaying achievements, often leading to a pessimistic outlook. This can also take the form of exaggerating the actions of others that may trigger a heightened response.

CBT Interventions for Teens

CBT can help young folks by giving them the tools to recognize and shift these distorted thinking patterns, resulting in positive emotions and behaviors. Some effective CBT approaches include:

Cognitive Reconstruction (Thought Reframing): This involves identifying negative thought patterns, such as always expecting the worst, and learning to reframe these thoughts more positively. For example, changing "I’m really bad at math,” to “I didn’t do so well on this math test, so maybe my teacher can give me a little extra time to explain it to me.”

Guided Discovery: Therapists use this technique to understand a teen's perspective and encourage them to question their assumptions. By examining evidence for and against their beliefs, teens can broaden their viewpoints and see situations more clearly. We teach our students to always verify their own thoughts. Is what you’re thinking actually true? How do you know? Trust, but verify.

Cognitive Journaling: Unlike free-form journaling, cognitive journaling is structured to help teens set goals and track their progress. They might document specific situations, their emotional responses, physical sensations, thoughts, and subsequent behaviors. This process helps them analyze and reframe their thoughts.

Combining CBT with Mind-Body Techniques

Stressful thoughts often trigger physical reactions. Combining CBT skills with self-soothing exercises can help teens manage both mental and physical stress. Techniques include:

Paired Muscle Relaxation: Flexing and relaxing different muscle groups can reduce physical tension.

Relaxed Breathing: Deep breathing exercises can calm the nervous system and reduce anxiety.

Temperature Change: Using temperature changes, like a warm shower or sipping ice water, can soothe the nervous system.

Short-Term Benefits of CBT for Teens

CBT can produce quick results, often within about 15 or fewer sessions. The engaging and interactive nature of CBT activities keeps teens involved and interested, reinforcing the principles they learn. By taking ownership of their progress through "homework" outside sessions, young people become more accountable and empowered to manage their own lives.

Long-Term Benefits of CBT for Teens

The long-term benefits of CBT are profound. Teens who actively practice CBT skills develop increased emotional intelligence and self-awareness. These skills become a natural part of their thinking, helping them shift negative thought patterns, respond to stress healthily, manage social interactions better, and be more self-compassionate. Over time, CBT helps reduce unhealthy behaviors and equips teens with tools to manage anxiety, fears, and phobias effectively.

When asked how I think we can stop nation-wide trends in youth and emerging adult crime, my response is always to arm them with practical tools to navigate their thoughts, emotions, and behaviors positively. When a kid commits a car-jacking, there’s more going on than just the thrill of the act (although, for folks under the age of 25, that rush can’t be discounted totally). Behaviors are best taught, rather than leaving a child to figure out life and its complexities of pro and anti-social behaviors on their own. We should be teaching our children how to anticipate and navigate short-term challenges and to foster in them long-term emotional resilience if we want them to build a healthier, more balanced approach to life.

My second response, which maybe runs parallel with my first and isn’t actually second after all, is that everyone needs purpose (both daily and life-long), so we should be working hard to connect young people to education and the workforce, while we’re teaching them to change their thinking.

And that’s my two cents folks. Backed up with almost four decades of working with young people, seeing what works and what doesn’t, and getting to witness a lot of success stories. If you want to know more about CBT and other strategies for working with opportunity youth to emerging adults, you can contact me here.

Cheers my friends! I raise my coffee mug in salute to your good work and big hearts.