A person’s belief system is comprised of both rational and irrational beliefs. Children and adolescents, like adults, have a particular belief system. Rational beliefs are those that usually tend to be consistent with objective reality and lead to self-enhancing emotions and goal-directed behaviors. Irrational beliefs are generally distortions of reality, are expressed automatically, and lead to negative feelings that often block goal attainment. Irrational beliefs may also remain dormant or inactive and only be activated in specific situations or stressful events.

Although cognitive therapy has been defined and explained to some extent, I have yet to describe how cognitive therapy process can be explained to children. To describe cognitive therapy as an action-oriented, directive verbal therapy in which the therapist challenges irrational beliefs and distorted thinking in an attempt to replace them with more rational, alternative ways of thinking may be appropriate for adults, but it is too abstract for children. In more concrete terms, cognitive therapy is a kind of “talking therapy” in which the therapist helps children spot negative ways of thinking or feeling during problem situations and teaches them the connection between thoughts and feelings. More specifically, children are taught that the emotions they feel are caused by the thoughts they are thinking. When children engage in bad self-talk, automatic negative thoughts and feelings, they may feel sad, angry, down in the dumps, or disappointed with themselves or the people around them. The therapist’s main task is to help children challenge, or change, bad self-talk by using rational responses, or, in more concrete terms that children can understand—good self-talk. Good self-talk consists of words or statements children can say to themselves that will eliminate or decrease negative thoughts, beliefs, and feelings.

Some therapists may disapprove of using the words bad and good to illustrate the basic concepts of cognitive therapy. However, the terms bad self-talk and good self-talk are easily understood by children, particularly those who have limited cognitive abilities and who function intellectually within the low to average range. It has been determined that, starting from early childhood, children can acquire beliefs that are untrue and irrational about themselves and their surrounding world. These beliefs may then crystallize during later childhood and adolescence in response to school, family, peer pressure, or other interpersonal stressors.

The major objectives of therapy are

• relief of depressive symptoms
• prevention of the recurrence of depression by helping the child to identify and modify faulty thinking and dysfunctional behavior
• helping the child recognize and change cognitive structures leading to dysfunctional ideation and behavior

Excerpt from Treating Depressed Children: A Therapeutic Manual of Cognitive Behavioral Interventions by Charma D. Dudley.