Table Of ContentCOGNITIVE THERAPY TECHNIQUES
FOR CHILDREN AND ADOLESCENTS
Cognitive Therapy
Techniques for
Children and
Adolescents
TOOLS FOR ENHANCING PRACTICE
Robert D. Friedberg
Jessica M. McClure
Jolene Hillwig Garcia
THE GUILFORD PRESS
New York London
© 2009 The Guilford Press
A Division of Guilford Publications, Inc.
72 Spring Street, New York, NY 10012
www.guilford.com
All rights reserved
Except as indicated, no part of this book may be reproduced, translated, stored in a retrieval
system, or transmitted, in any form or by any means, electronic, mechanical, photocopying,
microfilming, recording, or otherwise, without written permission from the Publisher.
Printed in the United States of America
This book is printed on acid-free paper.
Last digit is print number: 9 8 7 6 5 4 3 2 1
LIMITED PHOTOCOPY LICENSE
These materials are intended for use only by qualified mental health professionals.
The Publisher grants to individual purchasers of this book nonassignable permission to
reproduce all materials for which photocopying permission is specifically granted in a
footnote. This license is limited to you, the individual purchaser, for personal use or use
with individual clients. This license does not grant the right to reproduce these materials for
resale, redistribution, electronic display, or any other purposes (including but not limited
to books, pamphlets, articles, video- or audiotapes, blogs, file-sharing sites, Internet or
intranet sites, and handouts or slides for lectures, workshops, webinars, or therapy groups,
whether or not a fee is charged). Permission to reproduce these materials for these and any
other purposes must be obtained in writing from the Permissions Department of Guilford
Publications.
Library of Congress Cataloging-in-Publication Data
Friedberg, Robert D., 1955–
Cognitive therapy techniques for children and adolescents : tools for enhancing practice / Robert
D. Friedberg, Jessica M. McClure, Jolene Hillwig Garcia.
p. cm.
Includes bibliographical references and index.
ISBN 978-1-60623-313-9 (hardcover: alk. paper)
1. Cognitive therapy for children. 2. Cognitive therapy for teenagers. I. McClure, Jessica
M. II. Garcia, Jolene Hillwig. III. Title.
RJ505.C63F755 2009
618.92′89142—dc22
2009018760
About the Authors
Robert D. Friedberg, PhD, ABPP, is Associate Professor, Director of the Cognitive
Behavioral Therapy Clinic for Children and Adolescents, and Director of the Psychol-
ogy Post-Doctoral Fellowship program in the Department of Psychiatry at Milton S.
Hershey Medical Center, Penn State University College of Medicine. A clinical psy-
chologist, Dr. Friedberg is author of five other books, and his scholarly publications and
national and international presentations span the globe. Dr. Friedberg also supervises
trainees at the Beck Institute for Cognitive Therapy and Research. He is a Founding Fel-
low of the Academy of Cognitive Therapy and a board-certified diplomate in cognitive-
behavioral therapy.
Jessica M. McClure, PsyD, is a clinical psychologist at Cincinnati Children’s Hospital
Medical Center. She is coauthor, with Robert Friedberg, of the book Clinical Practice
of Cognitive Therapy with Children and Adolescents. She has also written articles and
book chapters and given presentations on cognitive-behavioral therapy with children
and adolescents. Her expertise includes cognitive-behavioral treatment of children and
adolescents with anxiety, depression, behavioral disorders, and pervasive developmen-
tal disorders. Dr. McClure is currently active in an initiative at Cincinnati Children’s
Hospital Medical Center to help clinicians translate evidence-based treatment protocols
to everyday practice as a way of spreading evidence-based care for children and adoles-
cents.
Jolene Hillwig Garcia, MD, is completing psychiatry residency training in the Depart-
ment of Psychiatry at Milton S. Hershey Medical Center, Penn State University College
of Medicine, and has completed a fellowship in child and adolescent psychiatry. She
received an MD from Penn State University College of Medicine and a BS in Biology and
BA in Art–Commercial Design from Lycoming College. Dr. Garcia has been involved
in scholarly research and publications, as well as professional presentations on topics
of interest in child and adolescent psychiatry. In addition, she continues her work in
graphic and fine art.
v
Acknowledgments
As always, “props” must be fully directed to my wonderful wife, Barbara, whose giv-
ing and loving nature makes me a better person. A big “shout out” is also merited to
my now grown daughter, Rebecca, whose evanescent mind and wit (“Oh c’mon Dad!”)
persistently amaze me. My prime coauthor, Jessica, “rocks” and is simply the best col-
laborator ever! Jolene, a new and valued colleague, kept the material real and fresh with
her illustrations and insight. A project like this one reminds me that I stand on the shoul-
ders of my mentors: Christine A. Padesky and Raymond A. Fidaleo. Special thanks go
to Penn State University Milton S. Hershey Medical Center and College of Medicine for
providing me the opportunity to pursue my clinical service and research. Finally, I am
honored to have the privilege of caring for the many children, adolescents, and families
who entrusted their well-being to me in my work at the Cognitive Behavioral Therapy
Clinic for Children and Adolescents at the Milton S. Hershey Medical Center.
RobeRt D. FRieDbeRg
Thank you to my husband, Jim, and daughters, Lydia and Juliana, for their encourage-
ment and support. I am grateful to my coauthor, Bob, for his creativity and collabora-
tion. I would also like to acknowledge the children and their families who have inspired
the techniques in this book.
Jessica M. MccluRe
Thank you to my family for their love, support, and consistent example of faith, espe-
cially to my husband for his undying patience and continued encouragement to follow
my calling. Thank you to my colleagues and friends for their humor and inspiration
during this process. I am grateful to my teachers and mentors for their knowledge and
advice, and of them, a very special thanks to Robert Friedberg and Jessica McClure for
inviting me along and shepherding me through the duration of this endeavor. And to my
patients and their families, thank you for the honor of learning from you and the joy of
caring for you.
Jolene Hillwig gaRcia
vii
Contents
CHAPTER 1. Beginnings 1
CHAPTER 2. Using Assessment Efficiently 12
CHAPTER 3. Psychoeducation 55
CHAPTER 4. Behavioral Interventions 79
CHAPTER 5. Self- Instructional and Cognitive Restructuring Methods 121
CHAPTER 6. Rational Analysis 189
CHAPTER 7. Performance, Attainment, and Exposure 240
CHAPTER 8. Final Points 291
References 297
Index 319
The reproducibles are also provided in a large-size format on Guilford’s website (www.guilford.com/p/
friedberg2) for book buyers to download and use in their clinical practice.
ix
Description:Providing a wealth of practical interventions and activities--all organized within a state-of-the-art modular framework--this invaluable book helps child clinicians expand their intervention toolkits. Building on the bestselling Clinical Practice of Cognitive Therapy with Children and Adolescents, w
