What is CBT?

Cognitive Behavioral Therapy (CBT) is an evidence-based treatment shown to be effective for chronic pain and illness, injury (e.g. concussion), anxiety, depression, sleep, and other issues. CBT targets both sides of pain and illness by identifying and resolving stressors that trigger flare-ups, and by teaching coping skills to manage pain after it starts.


CBT focuses on the relationship between thoughts (what's happening in your head), feelings (emotional and physical), and behaviors (how we act). For example, the thought, "I'm broken, I'll never get better" might trigger feelings of sadness, hopelessness and fear. Emotions also manifest physically: for example, stomach "butterflies," nausea and tension headaches are common physical manifestations of stress and anxiety. Stress and anxiety, natural consequences of being sick or in pain, subsequently trigger and exacerbate medical symptoms. These thoughts, negative emotions, and physical feelings then lead to unhealthy behaviors like staying in bed, missing school and isolating from friends - which ultimately make your child feel worse. 


Research shows that the experience of pain is mediated by multiple factors - including stress, anxiety, mood, and attention. High stress, high anxiety, low mood, and focusing on pain (e.g. staying in bed, missing school) actually make pain physically feel worse. The converse is also true: being relaxed, happy, social and distracted can help pain feel less bad. In this way, managing thoughts and emotions can help your child manage pain.


CBT helps challenge and change negative self-talk, addresses negative emotions like anxiety, fear and sadness, teaches stress management, and replaces unhealthy coping behaviors with healthier ones. CBT helps teens develop effective strategies to manage pain, and learn how to take back control when pain or illness seems to be in charge. CBT also addresses activity reduction - a common result of pain and illness - and helps your child learn to reclaim her life, so that she can return to school and the activities she loves.