Cognitive Behavioral Therapy

A practical approach to addressing negative thought patterns and behaviours.

Canadian classrooms are oversaturated with students; schools are even employing pop-up classrooms outdoors to accommodate with teachers and support staff seeing classrooms with as many as 40 students. With such high volume, school staff often struggle to give the necessary attention to the students that would benefit from social and psychological assistance. Accordingly, school counsellors today need strong and effective applications at their fingertips to be able to identify and create meaningful treatments for students. However, with limited time and resources along with so many in need, how are counsellors to know what will work effectively and reach the largest population?

What is CBT?

Cognitive Behavioral Therapy, or CBT as its commonly known, is a form of mental health treatment that is regularly used with adults and youth alike to help them cope, maintain and thrive in basic daily living.  Created and founded by Dr. Aaron T Beck, as an alternative option to the psychoanalytic approach that was popular in the 1960s. CBT is effective in treating many different mental health concerns such as anxiety, depression, self-esteem issues, PTSD and OCD to name just a few. CBT has been particularly effective in the treatment of youth and teens, who are displaying significant rates of anxiety through the school years. Left untreated, these symptoms can lead to suffering with their mental health through adulthood, which can leave a long-term impact to daily functioning and general wellness.

The success of CBT lies in its practical application, as students become actively involved in their sessions and have to use their own thinking, experiences and thoughts to create an impact in treatment. Since CBT is action based, along with documenting the thoughts and feelings, students become the driver in the process and create meaningful change for themselves.

How is CBT applied with students?

CBT works by teaching students to identify how their thoughts and behaviors interact to create a resulting action. School counsellors can work with students to recognize how their self-talk and negative thought patterns influence their feelings and behaviors, thus creating emotional responses that can be both internal and external.

 Part of the school counsellor’s role while applying CBT in session is to gently intervene where necessary to support changing negative thought patterns, teach CBT skills (most commonly done through writing), and change negative behaviors. Charting thoughts, moods and patterns is essential to the long-term success of treatment.

However, before starting to challenge negative thought patterns, students need to understand and firmly grasp the relationship between their thoughts, feelings, and behaviors. This is where working with writing will be the main tool for the student, as through writing they will start to make the connections between their thinking, moods, and how it impacts their actions that follow. Hundreds of CBT worksheets are available online or through workbooks like Christine Padesky’s Mind Over Mood, specifically directed towards thought records and engaging in the charting part of the CBT process. Examples of thought records are easily accessible online to help the student get some ideas on what would be most meaningful to them and create the most change in their personal experience.

Counsellors can then ask the student to identify their thoughts by practicing writing them down in session, and then completing the thought record throughout the week or as needed to continue the work at home. Although there are many different styles of thought records, it should have some basics such as areas to describe situations that they experience, record the thought they had during that situation, and then the resulting consequence (both a behavior and emotion). In the absence of identifying how thoughts and emotions are linked, the most significant core thoughts and beliefs will pass by unnoticed and unchallenged.

But be mindful…

Students have a stronger sense of empowerment and accountability working with CBT if they have a strong understanding of the counselling process. Make sure they fully understand what is expected of them, and how to do it. Examples are so important here, and practicing in session is essential to success. If the process is rushed or not fully understood, feelings of failure may arise for the student and set back the process. 

Encourage your students to really celebrate any successes they achieve in practicing CBT, as each success is a building block to further achievement in treatment. Encouraging your students to celebrate their achievements in treatment builds further self-esteem and sense of self, which complement the exercises within CBT and support change in thinking.

Why CBT is so successful with students

CBT is an evidence-based practice that continues to demonstrate success with students and adults alike. It is considered to be one of the most effective methods for creating change even in one session; the skills learned in the session are transferable and can prompt the smallest change in thinking, which can lead to change in behavior. 

Since school counsellors do not always get sufficient time with their students, CBT charting is an effective way to keep up the most meaningful work in between sessions; not only do students master the skill themselves, but they gain a strong sense of accomplishment in working on their mental health and learning to gain some level of control. This is a different approach to other modalities of counselling where change and impact only happens inside the session, but little change takes place in between those sessions. This can create a reliance on the school counsellor as being the pinnacle for change, whereas CBT supports active practice and experimentation outside of counselling sessions, and this is where the real success happens. Moreover, CBT is an ideal tool for school counsellors because not only does it treat such a plethora of mental health issues and can be applied to a wide range of individuals, it is structured and measured, which lends itself to identifying improvement throughout the counselling relationship. CBT can continue to be practiced over the summer when students are out of classes, to keep up the momentum of change and continue to be the driver in the maintenance and improvement of their mental health. CBT is also accessible by almost any age. Even young children that cannot write or read can start to practice CBT with the support of a counsellor, and working with pictures, faces or drawings to identify thoughts and feelings and then connect them to actions and behaviors.

By Zara Canteenwalla, M.T.S., TSA, CCC

Robert L. Leahy, PhD, Cognitive-Behavioral Therapy: Proven Effectiveness. CBT is the treatment of choice. Psychology Today, 2011
Edmund J. Bourne, The Anxiety and Phobia Workbook, Fifth Edition, 2010
Padesky, Christine PhD, Mind Over Mood, First Edition: Change How You Feel by Changing the Way You Think, 1995
Therapy Aid, CBT For Kids: Thoughts Feelings Actions, 2018