How CBT Works
CBT helps children:
- Identify unhelpful or distorted thought patterns (e.g. “I always mess things up”)
- Explore how these thoughts influence emotions and behaviour
- Learn strategies to challenge and reframe negative thinking
- Build healthier coping responses over time
The model is typically goal-oriented, time-limited, and adapted for age and developmental stage.
The Role of Residential Staff in Supporting CBT
Even if staff are not delivering therapy, they can:
- Reinforce strategies between sessions (“What did your therapist say might help?”)
- Help children practice skills informally during key work
- Use CBT language consistently across the team
- Encourage journaling, drawing, or reflection as coping tools
- Model emotional regulation and cognitive reframing in their own behaviour
Consistency between home and therapy is critical for children learning new cognitive and behavioural patterns.
CBT in Practice: Key Concepts Professionals Should Know
Cognitive Distortions
A child believes “Nobody likes me” after a peer conflict. Staff help them test this belief.
Behavioural Activation
Encouraging small positive actions (e.g. going for a walk) to shift mood.
Thought Records
Writing down situations, emotions, and automatic thoughts to develop insight.
Socratic Questioning
Asking guided questions: “What’s the evidence for that thought?”
Coping Skills
Teaching grounding techniques, breathing exercises, or positive self-talk.
Welcare staff receive training in these principles to reinforce therapeutic goals outside of formal sessions.
When CBT Is Most Effective
- Anxiety
- Depression
- Low self-esteem
- Emotional regulation difficulties
- PTSD (with adapted trauma-focused CBT)
Working with CBT Therapists
Professionals in children’s homes should:
- Communicate regularly with external CBT therapists (with consent)
- Share behavioural observations that may inform treatment
- Attend review meetings to align goals
- Support homework assignments and skill rehearsal
- Ensure all staff understand and follow consistent emotional support plans
Welcare homes prioritise collaborative relationships with CAMHS and other therapeutic providers.
Cautions and Ethical Considerations
CBT should never be:
- Used punitively (“You know what your therapist said!”)
- Delivered untrained or without supervision
- Over-applied without attention to trauma or neurodiversity
Empathy, attunement, and relationship always come before technique.