Cognitive–Behavioral Modification

Cognitive–behavioral interventions integrate thoughts and behaviors into problem-assessment approaches, conceptualization, and intervention. The cognitive–behavioral approach views problems as resulting from both environmental and cognitive antecedents, and combines what has typically been called the behavioral or learning approach with the cognitive or semantic approach. Cognitions are seen as necessary concerns for treatment of mental or behavioral problems in children and adolescents. Cognitions are viewed as mediators of behavior and learning. Learning-based methods that have been used to alter overt behaviors are also used to alter cognitions. The cognitive–behavioral therapist works to alter the individual's internal dialogue and images and external context to produce behavior change.

In 1971, Meichenbaum and Goodman published the first study of the use of the cognitive–behavioral approach with children. They reported on the use of self-instructional training to alter problematic thoughts of behaviorally impulsive youngsters. The focus of this program was on teaching the children to generate guiding verbal self-commands that would bring their behavior under their own control.

[Page 96]The cognitive factors related to the problems of children and adolescents have been described as cognitive distortions and cognitive deficiencies. When cognitive distortion occurs, situations are misinterpreted; cognitive deficiency results in actions that have not been thought out. When using the cognitive–behavioral approach, the therapist guides the child in learning new cognitive, behavioral, interpersonal, and emotional skills. The child is helped to understand how thoughts affect emotions and behavior, and is helped to construct a coping template, which is a strategy and structure for thinking about interactions with others and life events.