Perspectives on cognitive-behavioural therapy from children and young people receiving support and practitioners providing support
Further reading
Abstract
Cognitive-behavioural therapy (CBT) helps children and young people (CYP) understand their thoughts, feelings, and behaviours; and teaches them techniques to reduce emotional distress. Quantitative evidence, using randomised controlled trials (RCTs), has established that CBT is effective for many people. However, many people, perhaps up to 50%, do not achieve positive outcomes from CBT.
The Review Paper sought to explore how CYP conceptualise ‘positive outcomes’ from CBT and how CYP view the facilitators and barriers to positive outcomes. A systematic literature search identified 19 studies for review. A thematic synthesis identified 34 conceptualisations of positive outcomes, 57 facilitators, and 49 barriers. Descriptive and analytic themes were identified. The latter were worded as practice recommendations: acknowledge CYP’s perspectives on outcomes, teach tangible CBT techniques, balance autonomy and support, frame CBT as ‘upskilling’, explore nuanced barriers to engagement, and consider the power of group dynamics.
The Empirical Paper explored how practitioners use a non-manualised CBT workbook (Think Good – Feel Good, TGFG) when working with CYP. In RCTs, manualised protocols are used to ensure practitioners deliver the same treatment to all participants. However, in reality, practitioners have mixed views about the value of manuals, with some preferring to work based on professional judgment. For the current study, a convergent mixed-methods design was employed, with an online survey producing qualitative and quantitative data from 238 respondents and semi-structured interviews with 6 practitioners. Data were analysed separately using content and statistical analysis (surveys) and thematic analysis (interviews) before being integrated using a joint display. Findings are discussed in terms of how practitioners decide to use TGFG, how TGFG is employed in practice, and the role of supplementary resources within the therapeutic space. Recommendations for practice, recommendations for future research, and limitations are discussed.
