Tag Archive for: Cognitive Behavior Therapy

Child with anxiety

Benefits of a Worry Box


What Is A Worry Box?

A worry box is a cognitive-behavioral therapeutic approach to addressing excessive worry and anxiety in children. This modality aims to take the worry and anxiety off of the child, and places it onto a tangible  item such as a box.

Materials Needed

A box (typically, an empty Kleenex box is great for this exercise!)

Art supplies (pending the interests of the child)

How it works

Child with anxietyPending the interest/s of the child, this activity begins with the child decorating the box. This helps the child to feel some sort of ownership over the activity as well as empowerment in dictating the physical appearance of the worry box. Some children feel more comfortable talking and expressing difficult or uncomfortable feelings while either moving their body or by being distracted by something else. Therefore, this initial phase of the project serves as a beneficial time for the parent/therapist and child to discuss, explore, and process concepts and ideas relating to the project.

Next, ‘worries’ that the child is experiencing are written down onto strips of paper which are then folded and added to the worry box. Depending on the child’s abilities and age, adult assistance in writing down worries may be required. If this is the case, it is helpful to also allow the child to draw a picture of whatever is being written down. This allows the child to have that connection and ownership over the ‘worry.’

Every day (or however often is deemed appropriate), an adult and child can check in with each other through the use of the worry box. For example, begin by having the child take out one strip of paper at a time. The strips of paper with worries written on them serve as excellent visuals to spur conversation and processing. Through discussion, the child will indicate whether or not that particular worry is still causing them anxiety. If that is the case, the child can fold the paper back up and place it back into the box. If the child feels as though this is not something that is a worry anymore, the child and adult can discuss a ritual for disposing of the paper. For example, maybe the child would like to rip it into several pieces and throw it away. Other children may want to stomp on the paper and then throw it away. This is also an excellent place in the project for the child to exert some independence and control in deciding the mode of disposal.

Similarly, after the child and adult have processed through each worry, the adult can ask the child if there are any other worries that should be added to the box. Providing the child time and space to think is important.

Girl thinking positively

What Is Cognitive Behavioral Therapy?

When deciding the best therapeutic intervention for your child, what type of treatment approach do you choose? Despite your willingness to try out mental health treatment, be cautious as not all service providers practice the same as they operate under different prisms of thought and philosophy. You may have received a recommendation for a cognitive behavioral approach for symptom reduction and have no clue how this differentiates from other modes of treatment.

Here are the basic hallmarks of CBT:

Cognitive Behavioral Therapy is a treatment approach that calls attention to the interrelation of our thoughts, feelings and behaviors. If a person is experiencing negative thinking, such as “I am dumb,” they will have negative feelings and behaviors in alignment with this negative wave of thinking. Thoughts such as “I am dumb,” or “I am worthless” precipitate feelings of sadness or frustration and facilitate negative behaviors that continue to fulfill these negative internal beliefs (i.e  not trying their hardest in class because they don’t feel smart anyways). On the contrary, if a person experiences positive thinking such as “I am smart” or “I am capable,” their feelings and behaviors will be positive in nature.

Girl thinking positivelyThe goal of cognitive behavioral therapy is to assist the client in recognizing their maladaptive thought patterns and then debunk the irrational core beliefs that are facilitating negative behaviors and feelings. The therapist challenges the evidence that the client has to support the belief that they are “not smart” and then supplements the client with more rational, supportive self-talk to replace their typical, negative feedback. For example, if a client feels that they are “not smart” because they failed a math test, the therapist would help the client see that this was one test, it does not change their level of smartness, they have other strengths that prove their level of intelligence, and that this was only one test and they have succeeded on the majority of other tests. Then the client can filter their negative thinking with more balanced, rational thinking to change the course of feeling and behaving.

Cognitive Behavioral Therapy works well with a variety of symptom presentations and mental health disorders such as anxiety disorders, depression, and behavioral challenges. CBT-trained therapists are interactive, solution-focused, and work with the client on solving the problems of most relevance. The therapist trains the client to recognize maladaptive/negative thought patterns and then to replace negative thinking with positive, coping self-talk to reverse the cycle of negative thinking, feeling, and behaving.