Magazine article Clinical Psychiatry News

Flexibility Is Crucial to CBT with Adolescents. ( Vary Length, Frequency of Sessions)

Magazine article Clinical Psychiatry News

Flexibility Is Crucial to CBT with Adolescents. ( Vary Length, Frequency of Sessions)

Article excerpt

PHILADELPHIA -- Achieving effective outcomes with cognitive-behavioral therapy in adolescents requires maintaining a flexible approach and keeping developmental factors in mind, Eva L. Feindler, Ph.D., said at the annual meeting of the Association for Advancement of Behavior Therapy.

Age-appropriate adaptations might include varying the length and frequency of sessions, using e-mail, and allowing the patient's family or friends to attend sessions, said Dr. Feindler, professor of psychology at Long Island University Brookville, N.Y

Although the pace of development varies enormously, by their teens most individuals have achieved the kinds of language and cognitive skills that facilitate the "talk" part of cognitive-behavioral therapy (CBT) and can easily engage in abstract thinking and hypothesis testing. "Most adolescents love to talk, to analyze interactions," Dr. Feindler said.

Their cognitive style is recently formed and, in general, readily influenced by interventions. Adolescents "show more flexibility than adults. ... They are more willing to try new ways of thinking," she said Generally they are "wonderfully suited to the usual kinds of CBT," but there are certain attributes common in adolescents that need to be considered when planning their treatment.

In the developmental stage, a belief in "the complete uniqueness of [their] emotions and experiences" is typical, she noted. What would be considered a useful attempt to relate to an adult client by saying, "I know just what you're talking about," can seem "horrible" to adolescents. "They are repelled by the notion that you were once like them. ... It's more successful to convey an attitude of awe at their individuality," Dr. Feindler said.

Adolescents can readily deal with the psychoeducation aspects of CBT; they will learn the principles without difficulty if interested and motivated to do so. …

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