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Cognitive behavioral therapy is also used for children with conduct
disorder, which is characterized by aggressive, antisocial actions, inclu-
ding hurting animals and other children, setting fires, lying, and theft.
Through a cognitive behavioral approach (which generally works better
with adolescents than with younger children
because of the levels of
thinking and control involved), young people with this disorder are
taught ways to handle anger
and resolve conflicts peacefully. Through
instruction, modeling,
role playing, and other techniques, they learn to
react to events in socially appropriate, nonviolent ways. Other childhood
conditions for which cognitive behavior therapy has been effective in-
clude generalized anxiety disorder and attention deficit/hyperactivity
disorder. It can help children with ADHD become more controlled and
less impulsive; often, they are taught to memorize
and internalize the
following set of behavior guidelines: “
Stop—Listen— Look—Think—
Act.”
The treatment is based on the principle that maladaptive behavior
(ineffective, selfdefeating behavior) is triggered by inappropriate or
irrational thinking patterns, called
automatic thoughts.
Instead of reac-
ting to the reality of a situation, an individual automatically reacts to his
or her own distorted viewpoint of the situation.
Cognitive therapy
focu-
ses on changing these thought patterns (also known as cognitive distor-
tions), by examining the rationality and
validity of the assumptions
behind them. This process is termed cognitive restructuring. Cognitive
therapy is a treatment option for a number of mental disorders, including
agoraphobia, Alzheimer’s disease, anxiety or panic disorder, attention
deficit-hyperactivity disorder (ADHD),
eating disorders, mood disor-
ders, obsessive-compulsive disorder (OCD), personality disorders, post-
traumatic stress disorder (PTSD), psychotic disorders, schizophrenia,
social phobia, and substance abuse disorders. It can be useful in helping
individuals with anger
management problems, and has been reported to
be effective in treating insomnia. It is also frequently prescribed as an
adjunct,
or complementary, therapy for patients suffering from back
pain, cancer, rheumatoid arthritis, and other chronic pain conditions.
Cognitive therapy
is usually administered in an outpatient setting
(clinic or doctor’s office) by a therapist trained or certified in cognitive
therapy techniques. Therapy may be in either individual or group ses-
sions, and the course of treatment is short
compared to traditional psy-
chotherapy
(often 12 sessions or less).
140
Therapists are psychologists (Ph.D. or M.A. degree), clinical social
workers (M.S.W., D.S.W., or L.S.W. degree), counselors (M.A. or M.S.
degree), or psychiatrists (M.D. trained in psychiatry). Therapists use
several different techniques in the course of cognitive therapy to help
patients examine thoughts and behaviors.
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