CBPT is based on cognitive and behavioral techniques. Some of the interventions include positive reinforcements, modeling, self-monitoring, comparison of irrational thoughts and involvement of the child. Techniques such as bibliotherapy, games, puzzles, drawing, storytelling and puppets are used to help the child manage their behavior. CBPT has specific therapeutic goals that are based on evaluation and incorporate research-based techniques to eliminate unwanted behaviors.
Many behavioral techniques, designed for adults, have also proven to be effective with children. Behavioral therapists believe it is necessary to help children modify their behavior appropriately, identifying the factors that reinforce and maintain their problematic behaviors.
Behavioral approaches consider learning by observation and therefore the contribution of parents and teachers to the development of more adaptive behaviors outside the therapeutic context is important.
Cognitive therapy is a structured approach that helps us make changes in thinking, perception and, consequently, in behavior. The literature on cognitive therapy has confirmed its effectiveness with children, adolescents and adults.
However, intervention strategies used with adults are often thought to require only minimal adaptations for the treatment of older children and adolescents. This is more difficult for young, preschool age children. Adapting cognitive therapy to children is complex. Young children do not yet have the cognitive skills necessary to engage in such an intervention.
Therefore, it is necessary to consider methods to make cognitive interventions more appropriate from a developmental point of view and more accessible to children.
INTEGRATION OF APPROACHES
The value of the child’s involvement in therapy can be considered from several points of view. In fact, on an evolutionary level, children need to demonstrate a sense of mastery and control. Therapy with preschool and school children requires an integration between behavioral and cognitive approaches
Behavioral interventions aim to reinforce adaptive behaviors in order to consolidate them and reduce unwanted ones. With the integration of the cognitive component, the child has an active role in the treatment and acquires a sense of control, mastery and responsibility in the process of understanding and change. The integration of cognitive and behavioral interventions, through the combined effect of the two approaches, appears to be the most efficacious strategy.
SOME METHODS AND INTERVENTIONS
Most cognitive-behavioral interventions with children of all ages include some form of modeling. This is especially true for CBPT, where modeling is a fundamental component of play. In CBPT, modeling is very important, because it is a critical component during play. It allows the child to transmit adaptive coping skills through a toy that acts out the behavior that the therapist wants the child to learn. Modeling can also be presented in other forms, such as books, movies or television shows.
Another of the techniques used in CBPT is role-playing, where the child practices the skills learned with the therapist. It is often more effective with school-age children, although role playing itself can also be achieved through modeling. For example, the models can be role playing and the child observes and learns by watching models.
Direct and indirect approach
CBPT interventions can be classified as behavioral or cognitive. Behavioral therapies (BT) for children were developed, in part, to help children and parents translate and use the knowledge gained through therapy in their daily life. Often, the BT to management of the child, are taught directly to parents or other significant adults involved the child’s life. At other times, these techniques are applied directly to the child, for example if the child’s problem is adverse to the parent (Knell & Moore, 1990); whether the parent-child relationship inhibited the child’s development of skills and self-control (Klonoff, Knell & Janata, 1984; Klonoff & Moore, 1986); or if there are control problems.
Classical and operant conditioning
Whether the therapy is direct or indirect through a significant adult, the therapist tries to identify factors that reinforce and maintain problematic behaviors so that they can be altered. Many interventions are based on classical conditioning (e.g., Systematic desensitization) and operant conditioning (e.g., contingency management). Interventions based on social learning theory have also placed emphasis on observational learning and more cognitive aspects of behavior, which have provided much of the impetus for the development of cognitive therapy.
The cognitive and behavioral methods usually focus on the modification of activities, while cognitive methods focus on thought changes. Because maladaptive thoughts generate maladaptive behaviors, changes in thinking should produce changes in behavior. Through cognitive interventions, children learn to identify maladaptive thoughts, replace them with more adaptive thoughts and, ultimately, change maladaptive behaviors. CBPT is based on modeling and integrates more appropriate developmental adaptations in order to provide interventions that are as suitable as possible for children.