How are cognitive distortions addressed in youth CBT?

• A. Identify negative automatic thoughts and restructure them; use thought records.
• B. Ignore negative thoughts and focus only on behavior.
• C. Discuss thoughts only at the end.
• D. Use medication to alter thoughts.

Answer: (D)

In youth CBT, cognitive distortions are addressed by bringing automatic thoughts into conscious awareness and teaching the child to challenge and replace them with more balanced thinking. The most effective approach is to identify negative automatic thoughts and restructure them, typically using thought records.

When a situation triggers distress, the youth learns to pause and write down the immediate thought that comes to mind, the corresponding emotion, and the evidence that supports or contradicts that thought. Then they generate an alternative, more balanced thought and notice how this shifts how they feel and behave over time. This practice makes distorted patterns—like jumping to conclusions or overgeneralizing—more visible and teachable, and it equips the young person with skills to question content, consider other viewpoints, and test thoughts in real life.

In practical terms for kids and teens, the process uses plain language, concrete examples, and often visuals or relatable scenarios. Therapists may involve caregivers to support between-session practice and help with scaffolding new thinking habits. While medications can be helpful for mood or anxiety in some cases, they do not teach the cognitive skills CBT targets, which focus on identifying and restructuring thoughts rather than pharmacological change.