How CBT can help change anxious thought patterns

Therapists will often use CBT (cognitive behaviour therapy) with young clients who can talk and discuss and understand. 

Their ability to cooperate is brought on board when the ideas are presented as fun, with visuals, drawing, toys, experiments and laughter.

But parents, too, can use elements of cognitive behaviour therapy. 

I’ll outline some of the main ones here. I’ve mentioned a few activities throughout the site, but I’ll add a few examples here so you can stay on the one page for now.

If you see something that feels a good fit for your child, you can start straight away – you know them best!

What are the basics of CBT?

CBT uses the idea that thoughts (even ones we didn’t realise we had) affect our mood and body, and then our behaviour, which affects what happens next. Usually another negative thought, because the feedback “proved it”!

A thought is just a thought – not a fact!

But there are many thoughts that become like facts in our minds and are NOT helpful:

  • Foretelling the future – no other perspective possible
  • All or nothing thinking – no half-way places to settle on
  • Using "should"," ought", "must" etc when describing our current situation – it leads to self-blame
  • Mind-reading – deciding in advance what other people are thinking or might do
  • Catastrophic thinking – it will be a disaster, no doubt
  • Overgeneralising – “all the time”, “never” and “always” figure frequently
  • Irrational thinking – that something unlikely will definitely happen.

You can see how all these types of thinking lead to anxiety and panic. They don’t leave room for squirming, let alone free movement. 

And when we feel trapped – even by our own thoughts – survival mode jumps to its feet and sabotages our thinking brain. We panic: run from the situation, fight it, play dead (ie deny it exists) etc. 

Perfect set-up for maintaining the status quo – and the anxiety!

How does CBT work in general?

The idea behind cognitive behaviour therapy is to challenge the present thinking – rather than dredge up old events. Of course, old events may have contributed to current negative thinking, but the point is to challenge the thinking and find new, healthier thoughts. 

That’s why a parent can probably help with CBT techniques just like a therapist does.

You can work on challenging your child's thinking in a variety of ways:

  • Teach them to relax – no one can think in the middle of anxiety
  • Go through the thoughts>feelings>behaviour cycle (see below) so they understand it
  • Get them to tell you what they’re thinking – they might need help to work it out, though
  • Help them write their thoughts down to check against later, to see how things are changing for the better
  • Help them work out an alternative thought that is less extreme or might be more likely
  • Help them state what their goal is – what they would prefer to be feeling or doing
  • Role play doing something as a rehearsal for really acting on the new thought
  • Work on a way of gradually trying out something that is causing anxiety – in little steps.

All these things (or any of them) help challenge the present way of thinking in order to allow a different outcome in future. That is, no extra anxiety (a little is always good).

Of course, your child will need to want to sort things out, and you’ll have to go slowly. It’s not a quick fix, more a proven path to tread. 

And you’ll be collaborating with your child, helping them think of new ideas and new experiments to work on. Because when they’re involved like scientists, they’ll feel empowered. Which is no bad thing.

And self-directed CBT has been found to be very effective.

It will work in the home: it has good provenance with reducing anxiety and depression!

Plus, if your child went for therapy, the therapist would still expect you to back them all the way and help your child do the experiments.

Let’s have some examples

How does CBT work for anxiety: 1

Suppose your child is anxious about a test at school. They learn the facts but are panicking thinking they will forget them, mess up and fail, and be told off in front of the class.

That’s a scary thing to face – with tears, temper, feeling sweaty, shaky and with a foggy brain. Great!

We’ll make a chart. Get your child to help and do the labelling and writing. Your job is to empathise and encourage – gently. 

It may take a while and it may end up looking something like below. This kind of chart is useful for all sorts of anxiety using your own child’s thinking about their own particular problem.

Do the chart in any way that suits your child - the format isn't important. You're looking to gather the information and change it a bit.

Tweak the thoughts so that the rest will also alter.

chart to analyse negative thoughts for CBT

How does CBT work for anxiety: 2

Suppose your child’s been having panic attacks. Your child is anxious about all sorts of things (and you’ve been helping them deal with that) but it’s the panic attacks that bother them. 

They hate going out in case they have one. 

In this case, you do have to gently challenge the thinking behind the fear, of course – same as with all CBT stuff (it’s got a good name, hasn’t it: the thinking that causes the doing!). 

But when that’s been talked about and understood by your child, you also have to help them work out a series of tiny experiments. These will test out either the old or the new thinking. 

The tests scientists do are to prove something right or wrong. That’s why it’s a test. If it’s wrong they change their idea and test that again. Yes, I know you know this, but it’s what you have to help your child see!

So – can they disprove the old? Can they validate the new? Let’s look what happens here.

chart showing CBT coping with panic attack

You’ve asked you child about their awful thoughts – which I shall call red thoughts – and they’ve written them down.

They seem scary, dangerous and volatile, so “red” is a good word to use.

“Blue” will be quiet, calming stuff – positive and more helpful thoughts, plus some facts. You encourage them to think of a new thought, and maybe supply some of those facts yourself.

It might look like my chart – or not. You don’t have to draw a neat chart, just jot things down, maybe with arrows and colours etc to join things up and make sense of it while you talk.

The idea is to get thoughts, new positive thoughts and possible tests talked about. Not all at once. You know your child. But in a friendly, encouraging way, and on a child-friendly diagram.

Gradually you get to work on the tests and help your child to NOT refuse to do what scares them. When parents agree the child needn't do something, it actually continues the problem.

You have to steel yourself to seem hard! It's down to practice and persistence – and then the problem gets solved.

(I do hope you aren't getting the idea that CBT is a Child Badgering Tool!)

How does CBT work for anxiety: 3

Let’s look at talking with your child about anxiety in general. Advantages and disadvantages of anything can be weighed against each other for any fear or topic.

Here we look briefly at anxiety in general and how to compare two aspects: the benefits of worrying a little (usually life needs us to worry a little) and the disadvantages or problems of worrying too much (which, as we know, spoils wellbeing).

The chart might look like this:

CBT chart showing benefits and disadvantages of worrying

Just going through this exercise with your child – one who is old enough to hold a discussion when they’re calm – is really helpful.

The reason?

In addition to this general chart (above), you can then compare advantages and disadvantages of anything they bring up.

For example, “doing tests” in school.

You’ll see I’ve expanded this to 4 quadrants. But choose your own way of doing it and writing things down.

Your child may well then realise what items are most important to them in the long run – which gives impetus to working with you to change their anxiety about something.

CBT chart of benefits and disadvantages of doing tests

How does CBT work for anxiety: 4

One final look at a CBT way of thinking. This is the flow chart method, just to show up how working through a problem can go right – or be defeated!

The idea of drawing such a chart is to do it with your child and help them think of all the alternative routes they could take and then choose the way they would like to be able to get through the problem. 

After that you can start laying a plan with them.

I only chose spiders as I’ve been there and done that! Actually, if I’m truthful, I’m at the “calm down and kill them myself” stage. My aim is to humanely remove them to the garden – even if they’re house spiders. We all have to adapt and be flexible. Don’t we??

CBT flowchart example about spider fears

You can find information on calming your child on this page (the first few entries) – because you can't undertake any of these strategies here with an aroused child!

There's a special idea for choosing your best method of relaxing here.

There's an example of working out small steps to tackle a particular problem here. You can apply this to any anxiety. It's just to give you the idea!

There's a "windmill" example for thinking about thoughts/feelings and behaviour here.

I hope you've found this page helpful. The negative cognitive bit is the all-important thing to work with! There are three places it shows up:

  1. Negative views of the world (people can't be trusted)
  2. Negative views about the future (anxiety is always about the future – I'll surely fail)
  3. Negative views about self (I'm rubbish at everything)

As parents, we can try to spot this happening and stop such thinking in its tracks before our children get so anxious they need professional help.

But if they do, you can find out a safe way of getting help here.

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