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What is cognitive behavior therapy? A guide for neurodiverse families

Cognitive behavior therapy: What parents should know

Updated: August 29, 2023 · 4 Minute Read

Kyle Gravel, Director of Counseling Program Development at Cortica

Reviewed by:

Kyle Gravel, Director of Counseling Program Development at Cortica

Highlights

  • Cognitive behavioral therapy is a popular type of talk therapy that can help support children with autism and other developmental differences.
  • Therapy sessions are personalized to the child’s unique goals, with a focus on the connection between their thoughts, feelings, and behaviors.
  • The therapist will share various strategies to teach your child how to exchange unhelpful thoughts with positive and realistic ones.
  • Parent or caregiver involvement in their child’s therapy has been found to improve outcomes. You might join in during therapy or attend separate coaching sessions (also known by some as parent training).

Cognitive behavior therapy: What is it?

Cognitive behavioral therapy (CBT) is a type of talk therapy that helps kids and adults identify and change unhelpful thoughts and behaviors. CBT is a combination of two therapies: cognitive therapy (understanding our own thoughts) and behavioral therapy (changing our patterns of actions and behaviors). CBT guides children to become more confident and independent thinkers.  

 

 

What are the benefits of CBT?

Cognitive behavioral therapy can help your child understand the link between their thoughts and their behaviors. It can also help your child see the control that they have over their behaviors and mindset. Your child will also learn strategies to:

  • Cope with stress, anxiety, and depression
  • Overcome fears or limiting beliefs
  • Replace irrational and faulty thoughts with positive and beneficial ones

 

Is CBT effective for autism?

Cognitive behavioral therapy has a solid research base demonstrating its ability to treat mental health conditions in children and adults. However, neurodivergent children do experience unique challenges that may make CBT difficult to administer. CBT is considered psychotherapy, or “talk therapy.” Some children with autism, for example, may not yet have the communication skills needed to actively participate in CBT, but for those who have developed stronger language skills, CBT has been extremely helpful for their growth. 

 

What other developmental disabilities can CBT help with?

Many studies have demonstrated CBT’s effectiveness in supporting children with autism and other neurodevelopmental differences.1 It can also help with: 

  • ADHD
  • Anxiety disorders or phobias
  • Depression
  • Eating disorders
  • Sensory processing disorders
  • Post-traumatic stress disorder (PTSD)

 

What will my child do during CBT sessions?

Research shows that kids benefit the most from mental health therapy when their parents are also involved.⁵ Parent involvement may include parents joining in during therapy sessions or attending separate caregiver coaching sessions. Here’s what you can expect:

 

  1. Complete an assessment. A psychologist or other mental health professional trained in CBT will meet with you and your child. They will complete an assessment to determine your child’s individual strengths and needs. The assessment process will include an interview with you to determine what your goals for treatment are. 
  2. Review the recommended treatment plan. Once the assessment is complete, a treatment plan will be created, which will be reviewed prior to officially beginning therapy. If there are any recommendations that you are not comfortable with, let your therapist know and advocate for what you think is best for your child. 
  3. Start therapy sessions! Your child will share their thoughts, feelings, and behaviors. The therapist will then use various strategies to teach your child how to exchange unhelpful thoughts with positive and realistic ones. Modifying thoughts can impact behavior. The therapist will help your child modify behaviors that cause challenges for themselves and others. 
  4. Manage homework and learning outside of therapy. At the end of the session, the therapist will give your child homework, which is a core component of CBT. The therapeutic process continues after the session so that your child will retain what they’ve learned outside of therapy.

 

Consider this example. A child is struggling to understand their math homework. After trying for a short time, they shout “I’m so stupid! I suck at math!”. This negative line of thinking may affect the child’s ability to problem-solve and work through the obstacle. Through CBT, a goal for this child might be to replace those thoughts and statements with something more positive such as “this is hard, but I can do hard things.” The therapist would further teach the child problem-solving strategies to resolve the problem. Asking an adult for help or skipping the problem you’re stuck on and coming back to it are a few possible strategies in this scenario. 

 

How long are CBT sessions? How long will my child need CBT?

Each CBT session will typically last between 30 to 60 minutes. CBT is not intended as a lifelong treatment. Instead, you can expect sessions to occur over 12 to 20 weeks. CBT is a problem-focused and goal-oriented approach. The goal is for the child to develop strategies and coping skills over those weeks, which can be applied to new challenging situations when they arise in the future. 

 

Is CBT affordable?

CBT is considered a cost-effective treatment due to the short duration, as compared to other treatment methods like ABA which are more time-consuming. CBT is a covered service through insurance plans that cover psychotherapy. The costs associated with CBT will depend on your insurance plan and whether the provider is in your network. Paying out of pocket without insurance generally runs between $100 and $300 per session. 

 

Next steps

If you believe your child may benefit from CBT, seek an evaluation from a psychologist or other mental health professional. Reach out to your insurance provider to obtain a list of in-network providers. You can also find autism-friendly pyschologists in your area here.

Dive Deeper

Article References

  1. Thoma N, Pilecki B, McKay D. Contemporary Cognitive Behavior Therapy: A Review of Theory, History, and Evidence. Psychodynamic Psychiatry. 2015;43(3):423-461. doi:10.1521/pdps.2015.43.3.423
  2. Kose LK, Fox L, Storch EA. Effectiveness of Cognitive Behavioral Therapy for Individuals with Autism Spectrum Disorders and Comorbid Obsessive-Compulsive Disorder: A Review of the Research. Journal of developmental and physical disabilities. 2018;30(1):69-87. doi:10.1007/s10882-017-9559-8
  3. Belsky G. Cognitive behavioral therapy: What is CBT? Understood. https://www.understood.org/en/articles/faqs-about-cognitive-behavioral-therapy. Published May 2, 2022. Accessed December 9, 2022.‌
  4. Staff Perspective: CBT for Depression – Elements of Session Structure | Center for Deployment Psychology. deploymentpsych.org. Accessed November 30, 2022. https://deploymentpsych.org/blog/staff-perspective-cbt-depression-elements-session-structure#:~:text=The%20components%20of%20a%20typical%20CBT%20session%20include%3A
  5. Walczak M, Esbjørn BH, Breinholst S, Reinholdt-Dunne ML. Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up. Child Psychiatry Hum Dev. 2017;48(3):444-454. doi:10.1007/s10578-016-0671-2