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Using Cognitive Behavioral Therapy (CBT) in Social Skills Groups

Cognitive behavioral therapy is based on the idea that undesired behavior can be changed by changing maladaptive thoughts. Negative maladaptive thoughts include: “reading” the minds of others incorrectly, overgeneralizing, increasing negatives or catastrophizing. These types of thinking are termed cognitive distortions.

Many of the children we work with have cognitive distortions, misperceive social cues, are incorrect when they “read” the minds of others, or perseverate on negatives. This causes them to act out in a manner that damages social relationships and gets them in trouble at home or at school. Here is an example to consider: Billy is standing in line at the water fountain. When it’s almost his turn, James cuts in front of him. Billy thinks maladaptive thoughts, such as: “He did that on purpose,” “He is always cutting in front of me,” “He did that because he hates me,” “He thinks he is better than me,” or “He is out to get me.” These thoughts cause Billy to become upset and lash out at James. He hits James and is sent to the principal’s office.

With CBT, we can teach Billy to pause before acting and think different thoughts, such as: “Wow, James sure is in a hurry,” “Maybe he’s sick and needs water fast,” “Maybe he didn’t see me,” or “Maybe he just ate something spicy.” Thinking these type of thoughts can result in a much different behavior and may prevent Billy from hitting James.

In social skills groups, we frequently discuss challenging our thoughts and coach group members to implement cognitive thought change. Group members’ thoughts are challenged and calm, positive thoughts are stated aloud to get their internal dialogue to adapt to this new way of thinking. At the same time, we encourage other group members to share their actual thoughts when they cut in line, take a turn first, choose a favorite game piece, blurt out, or engage in another behavior that upsets others. When group members learn what others are thinking, it helps them understand that their own assumptions of someone’s thoughts are not always correct. At the same time, reminding group members to “stop and think” then “change their thoughts” helps them begin to use more positive thinking which results in more acceptable behavior. Group is a great place to learn and practice these new thinking skills because others in the group frequently want to have the first turn, choose a specific game piece, win a game, etc. Group members gain numerous opportunities for positive thinking in just one session, and in the moment coaching from the therapist helps the skills to generalize into everyday life.

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