CBT for Adolescents: Developmentally Appropriate Cognitive Behavioral Therapy (CBT)
CBT is an empirically-based form of psychotherapy used to treat children, adolescents and adults. CBT for adolescents is effective, yet poses specific challenges particular to this age group, a therapist must have a thorough understanding of the developmental level and common cognitive processes of this age group.
CBT Therapists and Parents
One challenge in working with adolescents is that parents are often the catalyst for therapy, and the adolescent may express poor insight into the necessity of treatment, sometimes blaming parents for problems at home. It's the therapist's job to build rapport with the adolescent client in order to progress with treatment, rapport building may take one to ten sessions depending on the client's openness. If a therapist doesn't establish rapport, the adolescent may become increasingly resistant and treatment ineffective. Egocentricity is a trait of adolescence, a tendency to view the world in terms of one's own viewpoint, with more difficulty reflecting on others' viewpoints, plus a sense of invincibility and increased risk-taking behaviors.
Adolescent Depression
Adolescents may experience significant depression, which may manifest as withdrawn behaviors, sadness, sleep and/or appetite disturbance and suicidal thinking. Different from adults, depression in adolescents often manifests with increased irritability and agitation rather than the high level of sadness typical in adults (though sadness still occurs). Anxiety is another common reason adolescents seek CBT, social anxiety is quite common, given the outsized importance of peers at this stage of life relative to family.
Peer Rejection
Peer rejection is another common theme in adolescent treatment. Bullying can have detrimental effects on an adolescent's self-esteem and psychological functioning. Since the rise of social media, cyberbullying has been just as harmful as in-person bullying, providing bullies a forum to taunt victims in front of an audience of hundreds or thousands. Cognitive behavioral therapists are faced with treating both bullies and victims.
CBT for Parent-Child Discord
Family issues are often a target of CBT for adolescents, parental discord, communication problems (which the therapist may help both parents and adolescents address), and sibling rivalry (e.g., an adolescent feeling like the less-favored sibling and harboring resentment). The therapist works with the client to restructure beliefs about the family system and may work with parents to help remediate the issue.
For an updated, more in-depth look at this topic, see Adolescent Bullying, Victimization, and Hopelessness.