In order to be able to build self-esteem in your children, it’s important to know what it is and how much of a role it plays in people’s lives. Self-esteem is described as a person’s overall subjective sense of personal worth or value. It’s defined by many factors including self-confidence, feeling secure, identity, sense of belonging, and feeling competent. It plays a big part in influencing our motivation, our mental health, our decision making process, our relationships and our overall quality of life. To flourish, kids need to be able to believe in their own abilities as well as know how to manage it when they aren’t successful. Below are several ways in which you can help instill confidence and build self-esteem in your child.
As parents, we want our children to have high self-esteem but remember you aren’t perfect either so be patient with yourself. You may not always get it right and that’s okay. The most important thing is to let your child know that you love them no matter what. Your unconditional love will go a long way with bolstering your child’s self worth.
What to expect from Cognitive Behavioral Therapy (CBT) for your child or teen By Kate Gibson, PsyD, ABPP
What is CBT?
Cognitive Behavioral Therapy (CBT) is a structured goal-oriented treatment approach that can be shorter in length than other forms of psychotherapy. CBT is based on a combination of cognitive and behavioral theories about the mind, emotions and behavior. CBT is based on the concept that thoughts, feelings and actions are interconnected, and therefore that making changes to even one of these leads to changes in the others. What we think affects how we feel and how we feel affects how we act and the choices we make. CBT operates under the notion that there are maladaptive thinking patterns involved in many of the things children and teens struggle with.
What does CBT treat?
CBT can be used to treat a variety of disorders and problems that kids face. This includes diagnoses such as separation anxiety, social anxiety, specific phobias, major depression, post-traumatic stress disorder as well as areas of struggle that may not reach the point of a diagnosis such as low self-esteem, chronic negativity, low grit or resilience, anger management difficulties and fear or worry. There are few things for which CBT cannot provide some benefit.
What is involved in CBT/What will my child learn?
Your child or teen will be learning new ways to REACT to tough situations! And each letter in the word REACT tells us something that will be worked on in CBT treatment: Rapport, Education, Affect awareness, Coping skills, Thought restructuring. Practice of all that is worked on in CBT is critical to your child or teens success in treatment and will be discussed at the end of this blog. First here is more information about what the steps involved in CBT in the REACT acronym.
Who is involved in CBT?
Much of the work of CBT with a child or teen will be done one on one with the therapist. It is important for caregivers to be regularly involved as well to be able to support the child or teen in using the skills or strategies they are learning outside of session. It is common to get an update from a caregiver at the start of session, and then to have the caregiver re-join again at the end for the child to either teach the caregiver what they have learned, or if culturally that is not comfortable to be provided an update from the therapist.
How much therapy is needed?
CBT usually involves weekly therapy sessions that are 45-60 minutes in length. Sessions may be shorter for younger children or for children with limited attention spans, however at least 45 minutes is typical so that there is adequate time to update the caregiver about the session and what to work on at home or school. The more straightforward the issue the shorter the course of treatment will be, and likewise more complex issues will likely require more sessions. CBT is generally thought of as a shorter-term therapy that a child will graduate from once attaining their treatment goals. It is not uncommon to return for shorter episodes of care in the future if there is a flare-up of the child’s struggles.
Why is my child getting homework for therapy?
Homework, or real-life practice, between sessions is an important part of CBT so that we are not just thinking and talking about these ideas but actively putting them into practice. If they are learning a new coping skill they need to practice it regularly to get comfortable enough doing it that they can actually later be able to use it in the moment when having a challenging thought or emotion. For anxiety the home practice is often referred to as “exposures” meaning we are exposing the child to the things that makes them nervous or frightened through planned practice. For depression the practice may involve behavioral activation or positive event scheduling. Expect that your child or teen will have assignments of things to work on outside of therapy. Your support may be required for some of the practice, and other times there may be things for your child or teen to do on their own.
CBT helps give concrete strategies and education to lay the foundation for healthy thoughts, feelings and actions, and resilience in the face of life’s stressors.
The past year has meant more time at home apart from friends and people outside of the family. Many children and teens struggled to remain connected socially or learn remotely. Others experienced a relief from social pressures and anxiety. With the recent availability in COVID vaccines, there will be more opportunities for children and teens to participate in social activities and the return to in-person learning when school has been virtual. This change might bring excitement and a welcomed relief, as well as an increase in anxiety.
Being apart from parents or caregivers might be particularly difficult when there was separation anxiety pre-pandemic. It is also likely complicated with new fears about health and safety.
What is Separation Anxiety? https://childmind.org/article/what-is-separation-anxiety/
Separation anxiety is a normal and expected part of development for infants and during early childhood. It typically subsides when children are 7-8 years of age. Anxiety is also usually temporary (lasting less than a month at a time) and mild. Anxiety to be apart from parents and caregivers serves a protective and adaptive function. Like all types of anxiety, it is the body’s way of trying to protect- just doing so when there is no actual threat of danger.
Strategies to help with typical separation anxiety with babies and toddlers see: https://www.nationwidechildrens.org/conditions/health-library/separation-anxiety.
What can you do to support your children or teens?
These websites also provide helpful tips for parents:
Separation Anxiety. Dos and Don’ts to Help Your Child (and You) be Brave: https://gozen.com/separation-anxiety-dos-and-donts-to-help-your-child-and-you-be-brave/
What to say when your child does not want to go to school: https://www.understood.org/en/learning-thinking-differences/understanding-childs-challenges/talking-with-your-child/what-to-say-when-kids-with-learning-and-thinking-differences-dont-want-to-go-to-school
Books that are helpful for children:
Help your dragon overcome separation anxiety by Steve Herman
What do do when you don’t want to be apart
When is Separation Anxiety a problem?
Some children and teens experience prolonged anxiety about separating and being away from parents/caregivers. The anxiety affects children’s thoughts, emotions, and behaviors. There are also physical symptoms, usually stomach aches or headaches. Separation anxiety is a problem when it causes extreme distress and negatively affects a child’s ability to function at school or with friends. When anxiety is intense, lasts more than 4 weeks, interferes with going to school or participation in social activities it might indicate a Social Anxiety Disorder (SAD).
To meet criteria as a Separation Anxiety Disorder (SAD), this lasts longer than a month.
For more information about SAD see:
For parents: Help your child overcome separation anxiety or school refusal by Eisen and Engler.
If the anxiety is intense and interferes with participation in school, learning, or engagement in otherwise enjoyed social activities it is important to get support. Talk with your pediatrician or a child therapist who can evaluate and provide treatment to manage fears and build coping strategies.
Parent and Child Psychological Services is a private practice serving children and families in the Sarasota, Florida area. The practice is owned and operated by Dr. Gibson, a Licensed Psychologist who is Board Certified in Clinical Child and Adolescent Psychology.