Foreword: The ABC s of Psychotherapy Harsh K. Trivedi. Preface: CBT inyouth Todd E. Peters and Jennifer B. Freeman

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1 Cognitive-Behavioral Therapy in Youth Foreword: The ABC s of Psychotherapy Harsh K. Trivedi xiii Preface: CBT inyouth Todd E. Peters and Jennifer B. Freeman xv History of Cognitive-Behavioral Therapy in Youth 179 Courtney L. Benjamin, Connor M. Puleo, Cara A. Settipani, Douglas M. Brodman, Julie M. Edmunds, Colleen M. Cummings, and Philip C. Kendall The numerous intervention strategies that comprise cognitive-behavioral therapy (CBT) reflect its complex and integrative nature and include such topics as extinction, habituation, modeling, cognitive restructuring, problem solving, and the development of coping strategies, mastery, and a sense of self-control. CBT targets multiple areas of potential vulnerability (eg, cognitive, behavioral, affective) with developmentally guided strategies and traverses multiple intervention pathways. Although CBT is often considered the first-line treatment for many psychological disorders in youth, additional work is necessary to address nonresponders to treatment and to facilitate the dissemination of efficacious CBT approaches. Cognitive-Behavioral Therapy for Adolescent Depression and Suicidality 191 Anthony Spirito, Christianne Esposito-Smythers, Jennifer Wolff, and Kristen Uhl Cognitive-behavioral therapy (CBT) is a well-established treatment of depression in children and adolescents but treatment trials for adolescents with suicidality are few in number, and their efficacy to date is limited. This article reviews the rationale underlying the use of CBT for the treatment of depression and suicidality in adolescents, the literature supporting the efficacy of CBT for depressed adolescents, and whether CBT for depression reduces suicidal thoughts and behavior. A description of some of the core cognitive, affective, and behavioral techniques used in CBT treatments of suicidal ideation and behavior in depressed adolescents is included. Dialectical Behavior Therapy for Suicidal Adolescents with Borderline Personality Disorder 205 Dena A. Klein and Alec L. Miller Although research to date on dialectical behavior therapy (DBT) for adolescents has its limitations, growing evidence suggests that DBT is a promising treatment for adolescents with a range of problematic behaviors, including but not limited to suicidal and nonsuicidal self-injury. This article introduces dialectical behavior therapy s theoretical underpinnings, describes its adaptation for suicidal adolescents, and provides a brief review of the empirical literature evaluating DBT with adolescents.

2 viii Cognitive-Behavioral Therapy foranxiety Disorders inyouth 217 Laura D. Seligman and Thomas H. Ollendick Cognitive-behavioral therapies (CBTs) have been shown to be efficacious for the treatment of anxiety disorders in children and adolescents. Randomized clinical trials indicate that approximately two-thirds of children treated with CBT will be free of their primary diagnosis at posttreatment. Although several CBT treatment packages have been investigated in youth with diverse anxiety disorders, common core components have been identified. A comprehensive assessment, development of a good therapeutic relationship and working alliance, cognitive restructuring, repeated exposure with reduction of avoidance behavior, and skills training comprise the core procedures for the treatment of anxiety disorders in youth. Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in Children and Adolescents 239 Katharina Kircanski, Tara S. Peris, and John C. Piacentini Obsessive-compulsive disorder (OCD) is a common, chronic, and impairing condition in youth. Cognitive-behavioral therapy (CBT), now widely recognized as the gold standard intervention for childhood OCD, relies on exposure and response prevention, and also includes psychoeducation, creation of a symptom hierarchy, imaginal exposures, cognitive interventions, and a contingency management system. This article reviews the theoretical underpinnings of current CBT approaches, key components of treatment, developmental considerations specific to childhood OCD, and evidence supporting the use of this psychosocial intervention. The current state of knowledge will be aided by further study of predictors and mechanisms of CBT treatment response. Cognitive-Behavioral Treatment for Posttraumatic Stress Disorder in Children and Adolescents 255 Shannon Dorsey, Ernestine C. Briggs, and Briana A. Woods Several cognitive-behavioral therapy (CBT) approaches are available for treating child and adolescent posttraumatic stress disorder (PTSD). These treatments include common elements (eg, psychoeducation, gradual exposure, relaxation). This review (1) delineates common elements in CBT approaches for treating child and adolescent PTSD; (2) provides a detailed review of three CBT approaches with substantial evidence of effectiveness; and (3) describes promising practices in the area of CBT approaches to treating child and adolescent PTSD. Cultural and implementation considerations are also included. Cognitive-Behavioral Therapy for Weight Management and Eating Disorders in Children and Adolescents 271 Denise E. Wilfley, Rachel P. Kolko, and Andrea E. Kass Eating disorders and obesity in children and adolescents involve harmful behavior and attitude patterns that infiltrate daily functioning. Cognitivebehavioral therapy (CBT) is well suited to treating these conditions, given

3 ix the emphasis on breaking negative behavior cycles. This article reviews the current empirically supported treatments and the considerations for youth with weight control issues. New therapeutic modalities (ie, enhanced CBT and the socioecologic model) are discussed. Rationale is provided for extending therapy beyond the individual treatment milieu to include the family, peer network, and community domains to promote behavior change, minimize relapse, and support healthy long-term behavior maintenance. Cognitive-Behavioral Therapy foryouth with Body Dysmorphic Disorder: Current Status and Future Directions 287 Katharine A. Phillips and Jamison Rogers Body dysmorphic disorder (BDD) usually begins during early adolescence and appears to be common in youth. BDD is characterized by substantial impairment in psychosocial functioning and high rates of suicidality. Cognitive-behavioral therapy (CBT) tailored to BDD is the best tested and most promising psychosocial treatment for adults. CBT has been used for youth with BDD, but has not been systematically developed for or tested in youth. This article focuses on CBT for BDD in adults and youth; possible adaptations and the need for treatment research in youth; and prevalence, clinical features, diagnosis, recommended pharmacotherapy, and treatments that are not recommended. Cognitive-Behavioral Therapy for Externalizing Disorders in Children and Adolescents 305 John E. Lochman, Nicole P. Powell, Caroline L. Boxmeyer, and Luis Jimenez-Camargo This article focuses on the use of cognitive-behavioral therapy (CBT) strategies for children and adolescents with externalizing disorders. Following a description of risk factors for youth antisocial behavior, several components common to CBT interventions for youth with externalizing behaviors will be described. Using the Coping Power Program as a model, child treatment components including Emotion Awareness, Perspective Taking, Anger Management, Social Problem Solving, and Goal Setting will be reviewed. CBT strategies for parents of youth with disruptive behaviors will also be described. Finally, the article summarizes the evidence for the effectiveness of CBT strategies for externalizing disorders and presents specific outcome research on several programs that include CBT techniques. Cognitive-Behavioral Therapy for Childhood Repetitive Behavior Disorders: Tic Disorders andtrichotillomania 319 Christopher A. Flessner This article provides an overview of cognitive-behavioral therapy (CBT) for repetitive behavior disorders. Because tic disorders and trichotillomania are the most often studied and most debilitating of these conditions, this article focuses on the efficacy of CBT for these 2 conditions. An overview of CBT for children presenting with these concerns is provided. This review focuses particularly on habit reversal training, which is at the core of most CBT-based interventions. Two recent empirical studies on the immense

4 x potential of CBT in treating childhood repetitive behavior disorders and future areas of research are also discussed. Cognitive-Behavioral Therapy for Children with Comorbid Physical Illness 329 Rachel D. Thompson, Patty Delaney, Inti Flores, and Eva Szigethy In addition to the usual developmental challenges, children and adolescents with chronic physical illness face psychosocial challenges that affect their quality of life. This review describes different aspects of coping with chronic physical illness in childhood and the empirical evidence examining the usefulness of cognitive-behavioral therapy (CBT) for the treatment of children and adolescents with chronic physical illnesses and related psychological comorbidities. Four diseases (diabetes, inflammatory bowel disease, cancer, and sickle cell disease) were chosen as model illnesses to demonstrate key CBT findings in more detail. Future research recommendations in this challenging population are also addressed. Applying Cognitive-Behavioral Therapy foranxiety to the Younger Child 349 Dina R. Hirshfeld-Becker, Jamie A. Micco, Heather Mazursky, Lindsey Bruett, and Aude Henin Cognitive-behavioral therapy (CBT) protocols for anxiety disorders have been shown to have efficacy with older children and adolescents; however, only recently have investigators begun to adapt and pilot such interventions for younger children. This article reviews data suggesting that even very young children can benefit from CBT for anxiety, discusses some of the necessary developmental adaptations when working with children of preschool and early elementary school age, and reviews studies that have implemented CBT for anxiety disorders with youngsters in this age range. The authors conclude with recommendations for future directions for research in this area. Core Principles in Cognitive Therapy withyouth 369 Robert D. Friedberg and Gina M. Brelsford Cognitive therapy (CT) is increasingly being adopted by child psychiatrists for a variety of clinical problems. This article explains the cardinal principles, practices, and processes associated with this approach. More specifically, a brief overview of the treatment model is offered along with an emphasis on case conceptualization and modular format for treatment. The value of collaboration, guided discovery, establishing a good therapeutic alliance, empiricism, and transparency in clinical work, as well as bringing the head and heart to consensus, is explained. Finally, the hallmark session structure that characterizes CT is delineated. Acceptance and Commitment Therapy (ACT): Advances and Applications with Children, Adolescents, and Families 379 Lisa W. Coyne, Louise McHugh, and Evan R. Martinez Acceptance and commitment therapy (ACT) is part of a growing body of literature of third-wave behavioral therapy that finds its roots in the development of mindfulness. ACT for adults has gained empirical support

5 xi across a broad range of psychiatric disorders and behavioral health issues, yet the literature looking at the adaptation of ACT for youth populations is still nascent. This article provides an outline of key components of ACT, a brief overview of the history and development of ACT, adaptations for children, the theoretical underpinnings of ACT, assessment and therapy, and a review of the evidence-based literature to date. Index 401