Learning Your ABCs: using the ABCs of CBT with children and teens

Using a CBT-based reflection worksheet can be great for debriefing after an incident. I have found this really helpful to get a slow-motion narrative of an event, especially from kids who tend to react impulsively and need support to slow down and THINK before reacting.

"These simple forms help us to build awareness of ‘how’ we think – they help us to see patterns and links over time – and most importantly, they help us see that our thoughts are often irrational, illogical and unhelpful, so that we can dispute them and replace with positive self talk."

You can use this worksheet with older kids and teens to practice applying the ABC sequence (Activating event - Beliefs - Consequences) to real life events. Something about having it written down in a little flow-chart really seems to help it sink in and reinforces that it is our thoughts and interpretations of a situation that determine our feelings and actions, not the situation itself.

With younger children who may struggle to build and express a coherent narrative of a stressful incident, I have used the same worksheet to take notes as they explain what happened. This helps me to remember what information to elicit about an event, and helps them to structure their experience.

To support a younger child to identify their beliefs about a situation, I might ask about the beliefs of other's that were involved rather than their own - "What do you think they were thinking when they did that? Why do you think they might have done that?" It is generally easier for a child to be able to express the belief "They hate me" than to reflect on their own thoughts and come up with "I think they might hate me".

If the child or young person is still very upset at the time they are explaining what happened, I usually leave the reflection part blank until a later time, when we can re-read the narrative with a little bit of distance. This nearly always leads to an "AHA" moment with a little bit of prompting - "What could you do differently next time?" "What thoughts could help you to do that?" "Were your thoughts about this at the time helpful or unhelpful?"