Join us in our upcoming CBT for Youth live virtual workshop and learn to improve your work with youth clients.
CBT for Youth
May 12 – 14, 2025
Robert D. Friedberg, PhD, Beck Institute Faculty
When I was in my doctoral program in the early 1980’s, disco was ending, MTV was born, and the Buggles sang, “Video Killed the Radio Star.” CBT was a new entrant into the psychotherapy curricula. In fact, only a few students in my program embraced this new approach. We joked that we got the worst classrooms and time slots for course selections. Over the next 40 years, CBT became the gold standard for treating most psychiatric conditions presenting in youth. CBT is empirically supported and deployed in multiple settings with diverse populations—and new applications and settings are always being researched and implemented. So, what’s new?
From my perspective, delivering CBT in integrated pediatric settings is the new frontier. General pediatric and pediatric subspecialty settings represent a robust new path for CBT to demonstrate its effectiveness and efficacy. There is much evidence to recommend a union between pediatric care and CBT (Friedberg & Paternostro, 2019; McClure et al. 2024).
Pediatricians are the most trusted health care professionals by parents and caregivers. They are also the health care professional most commonly consulted first and are faced with caring for youth experiencing behavioral and emotional difficulties. Yet they often lack clinical expertise to handle these challenges. That’s where CBT-trained clinicians come in!
CBT with youth offers a time-efficient, evidence-informed and case conceptualization-guided approach to mitigate a variety of conditions (McClure et al., 2019; Friedberg & McClure, 2015). Case formulation represents the nucleus for CBT with youth (Friedberg, 2015). Competence on the domains tapped by the CTRS-R (Miller, 2022) and CTRS-CA (Friedberg & Thordarson, 2014) is imperative in these integrated sites. Additionally, adhering to the maxim of practicing with flexibility within fidelity is essential (Kendall& Frank, 2018).
While the scientific evidence of the effectiveness of CBT is strong for internalizing and externalizing disorders in youth (Riise et al., 2023, Wergeland et al. 2021), the treatment paradigm is also helpful with patients experiencing comorbid psychological and medical conditions as well as reducing associated problems such as non-adherence, swallowing difficulties, and pain management (Friedberg et al., 2024). A recent special issue of ABCT’s flagship journal, Cognitive and Behavioral Practice (Cognitive and Behavioral Practice | Special Series: Applications of Cognitive Behavioral Therapy to Psychological Disorders and Co-Morbid Medical Conditions in Pediatric Patients | ScienceDirect.com by Elsevier), was devoted to CBT for pediatric patients experiencing comorbid medical and psychological conditions.
The articles contained in this special issue address implementing CBT with pediatric patients diagnosed with pediatric rumination disorder, ARFID and restrictive eating, sleep problems, toileting refusal, Type 1 Diabetes, stress related to endometriosis and post-concussive symptoms. This issue also explored expanding access to CBT in integrated settings, DBT for pediatric patients, culturally adapting CBT for Pakistani youth experiencing comorbid psychological and physical symptoms, and supporting caregivers of pediatric cancer patients with CBT interventions.
As President John F. Kennedy said, “We stand at the edge of a new frontier.” The psychotherapy marketplace is changing and dynamic shifts in how, where, and by whom services are delivered are commonplace. CBT aligns well with the imperatives of integrated pediatric health care. Proper training in traditional CBT spectrum approaches will likely prepare clinicians to care for pediatric patients effectively and efficiently. While some adjustments from siloed mental health settings will be necessary, there are no absolute barriers to bringing CBT into the medical setting. Opportunity is calling.
References:
Friedberg, R.D. (2015). Where’s the beef: Concrete elements in supervision with CBT with youth. Journal of the American Academy of Child and Adolescent Psychiatry, 54;27-531.
Friedberg, R.D., & McClure, J.M. (2015). Clinical practice of cognitive therapy with children and adolescents: The nuts and bolts (2nd Edition). Guilford Press.
Friedberg, R.D., & Paternostro, J.K. (Eds) (2019). Handbook of cognitive behavioral therapy for pediatric medical conditions. Springer Nature.
Friedberg, R.D. & Thordarson, M.A. (2014). The Cognitive Therapy Rating Scale for Children and Adolescents (CTRS-CA). Center for the Study and Treatment of Anxious Youth.
Friedberg, R.D., Neelley, M., Zucker, J., Hanna, A., Mendelsohn,A., Greenberger, A., & Dunevich, N. (2024). Cognitive behavior therapy for medical non-adherence: A topical review and clinical recommendations. Journal of Exploratory Research in Pharmacology, 9; 213-222
Kendall, P. C., & Frank, H. E. (2018). Implementing evidence‐based treatment protocols: Flexibility within fidelity. Clinical Psychology: Science and Practice, 25; e12271
McClure, J.M., Friedberg, R.D., Thordarson, M.A., & Keller, M. (2019). Cognitive behavioral therapy-Express. Guilford Press.
McClure, J.M, Merk, F.L., Anderson, J., Aggarwal, A., & Stark,L.J. (2024) Expanding Access to Cognitive Behavioral Therapy: A Purposeful and Effective Model for Integration. Cognitive and Behavioral Practice, 31; 286-298.
Miller, A. (2022). The Cognitive Therapy Rating Scale-Revised (CTRS-R). Beck Institute.
Riise, E. N., Haugland, B. S. M., & Wergeland, G. J. H. (2023). Cognitive Behavioral Therapy (CBT) with Children and Adolescents. In J. Matson (Ed.) Handbook of Clinical Child Psychology: Integrating Theory and Research into Practice (pp. 407-424). Springer International Publishing.
Wergeland, G.J.H., Riise, E.N., & Ost, L-G. (2021). Cognitive behavioral therapy for internalizing disorders in children and adolescents in routine care: A systematic review and meta-analysis. Clinical Psychology Review, 83; 101918.