the role of modern forms of cognitive behavioral therapy in the management of psychiatric disorders in adolescents

Abstract

It is widely recognized that adolescence is a developmental period which is characterized by a large number of changes: biological, psychological and social. Perhaps it is the combination of these factors that makes this period so important but also challenging. It can be a time of self-discovery, turbulence and playfulness with abstract thinking, conflicts and exploration of identity, sexuality and concerns around intimacy all coming to the fore (Adams, 2000). Major psychotherapeutic schools offer models of treatment for adolescents who experience difficulties during this important stage of development(Malberg et al., 2008). Adolescents experiencing emotional and behavioral problems pose a challenge to themselves, to their families, to their peers, and to the psychologist who seeks to provide psychotherapy. Throughout the history of mental health, special efforts have been devoted to adolescent therapy because downward extensions of adult therapies and upward applications of child therapies have not sufficed (Albano & Kendall, 2002). In working with an adult, the individual self is the most important factor in bringing about therapeutic change; with adolescents, the picture for therapeutic change is a bit more complex. At this critical stage from childhood to adulthood, the individual needs intervention in various aspects of his life, including self, family, school setting and maybe even the community(Bychkova et al, 2011). Adolescent psychotherapy has only recently taken hold as distinct from either child or adult psychotherapy. This new recognition was born of necessity as practitioners saw that theories and techniques developed for treating children and adults were far less effective for treating adolescents. As necessity is often the mother of invention, new models for treating adolescents have emerged. While these models differ in many respects, they share three characteristics: the unique features of adolescents, psychotherapists requiring specialized knowledge and skills, and the need for adolescent psychotherapy to involve the broader systemic context of the adolescent’s life (Rubenstein, 2003). There are several types of psychotherapy for adolescents that involve different approaches, techniques and interventions as: psychodynamic psychotherapy, cognitive behavioral therapy, dialectical behavior therapy, interpersonal therapy, family therapy, and group therapy (Delgado, 2008). Cognitive behavioral therapy (CBT) is a psychotherapeutic approach that emphasizes the important role of thinking in how we feel and what we do, it is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this fact is that we can change the way we think to feel / act better even if the situation does not change. The name refers to behavior therapy, cognitive therapy, and to therapy based upon a combination of basic behavioral and cognitive principles and research (Schacter et al., 2010). In contrast to other forms of psychotherapy, cognitive therapy is usually more focused on the present, more time-limited, and more problem-solving oriented. In addition, patients learn specific skills that they can use for the rest of their lives. These skills involve identifying distorted thinking, modifying beliefs, relating to others in different ways, and changing behaviors (Kendall, 2000). Modern forms of Cognitive behavioral therapy include a number of diverse but related techniques such as exposure therapy, stress inoculation training, cognitive processing therapy, cognitive therapy, relaxation training, dialectical behavior therapy, and acceptance and commitment therapy. Despite the effectiveness of face-to-face Cognitive behavioral therapy, numerous barriers to treatment exist, including the direct and indirect costs of treatment, the limited availability of mental health professionals, stigma, and the difficulty of patients attending treatment during office hours. Alternatives to face-to-face therapy have been developed that have the potential to overcome some of these barriers, and several innovative approaches for improving access to evidence-based care have been proposed(Mewton et al., 2014). Cognitive behavioral therapy is thought to be effective for the treatment of a variety of mental disorders commonly observed in adolescents including mood, anxiety, personality, eating, substance abuse, tic, and conduct disorders. Many Cognitive behavioral therapy treatment programs for specific disorders have been evaluated for efficacy; the health-care trend of evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored