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What Is Cognitive Behavioural Therapy (CBT)?

Cognitive Behavioural Therapy (CBT) is an evidence-based therapy that helps children understand the connection between their thoughts, feelings and behaviours.

The core idea behind CBT is that the way we think about situations can influence how we feel and how we respond. By identifying unhelpful thought patterns and learning practical coping strategies, children can develop healthier ways of managing emotions, solving problems and responding to challenges.

CBT is commonly used to support children experiencing:
  • Anxiety
  • Low confidence
  • Emotional regulation difficulties
  • ADHD
  • Autism-related anxiety
  • School-related stress
  • Social difficulties
  • Behavioural challenges
CBT is highly practical and often involves structured activities, visual supports, games, role-play and problem-solving exercises that help children apply new skills in everyday situations.
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For children, CBT is often adapted to match their age, communication style, developmental stage and individual support needs.
CBT vs ACT: What's the Difference?
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Parents often hear about both Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) and wonder how they differ.
Both approaches are evidence-based and can support children's emotional wellbeing, resilience and coping skills.
Cognitive Behavioural Therapy (CBT)
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  • Focuses on identifying and challenging unhelpful thoughts
  • Encourages cognitive restructuring
  • Helps children develop alternative ways of thinking
  • Uses thought records and problem-solving exercises
  • Often focuses on changing thought patterns
Acceptance and Commitment Therapy (ACT)
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  • ​Focuses on accepting thoughts and feelings without being controlled by them
  • ​Encourages psychological flexibility
  • ​Helps children focus on values-based actions
  • Uses mindfulness and acceptance-based strategies
  • ​Often focuses on changing the relationship with thoughts
Many clinicians use elements of both CBT and ACT depending on the child's needs, strengths and goals.
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Neither approach is universally better than the other. The most appropriate approach depends on the individual child and the challenges they are experiencing.
Cognitive Behavioural Therapy (CBT) for Children with ASD and ADHD
A Parent's Guide
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Cognitive Behavioural Therapy (CBT) is a highly effective therapeutic approach designed to help children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) develop emotional regulation, improve problem-solving skills, and manage challenging behaviours.
This guide explains how CBT benefits children with ASD and ADHD, providing practical strategies for parents to reinforce these skills at home.


How CBT Helps Children with ASD
Children with ASD often experience difficulties with anxiety, social communication, and rigid thinking patterns. CBT is adapted to meet their specific needs, helping them develop strategies to navigate daily challenges.

1. Managing Anxiety
Many children with ASD experience heightened anxiety due to sensory sensitivities, changes in routine, or social interactions. CBT helps children:
✔ Identify Anxiety Triggers – Recognising what situations or events cause distress (e.g., loud noises, unexpected changes).
✔ Use Relaxation Techniques – Deep breathing, progressive muscle relaxation, or visual imagery to calm down.
✔ Reframe Negative Thoughts – Teaching children to shift from "I can't do this" to "I can try my best."

2. Improving Social Skills
Children with ASD often struggle with understanding social norms and non-verbal cues. CBT supports social skill development by:
✔ Role-playing Conversations – Practicing greetings, turn-taking, and asking questions.
✔ Using Social Stories – Simple, structured narratives that explain social situations in a way the child can understand.
✔ Recognising Facial Expressions – Learning to identify emotions in others through structured activities.

3. Reducing Rigid Thinking
CBT encourages cognitive flexibility, helping children adapt to change and consider different perspectives by:
✔ Practicing "What If" Scenarios – Exploring multiple ways to solve a problem.
✔ Introducing Small Changes Gradually – Slowly adjusting routines to help children build adaptability.
✔ Using Visual Supports – Creating visual schedules to ease transitions.

4. Enhancing Emotional Regulation
CBT equips children with tools to understand and express their emotions in a healthy way:
✔ Emotion Charts – Teaching children to label and rate emotions.
✔ The “5-Point Scale” – Helping children gauge emotional intensity and appropriate responses.
✔ Self-Calming Strategies – Using sensory tools (fidget toys, weighted blankets) to self-regulate.


How CBT Helps Children with ADHD
CBT helps children with ADHD manage impulsivity, stay organised, and develop focus through structured strategies.

1. Enhancing Focus and Organisation
Children with ADHD often struggle with attention and time management. CBT provides strategies like:
✔ Breaking Tasks into Steps – Using checklists or timers to maintain focus.
✔ The Pomodoro Technique – Working in short bursts with breaks in between.
✔ Creating a Visual Schedule – Establishing a predictable routine to reinforce organisation.

2. Managing Impulsivity
CBT helps children develop self-control by:
✔ Practicing "Stop and Think" Exercises – Encouraging children to pause before responding.
✔ Teaching Self-Monitoring Techniques – Using journals or apps to track behaviour.
✔ Using Physical Reminders – Wearing a wristband or having a cue word as a reminder to pause before acting.

3. Building Emotional Resilience
Children with ADHD often experience frustration and difficulty managing emotions. CBT helps them:
✔ Recognise Emotional Triggers – Identifying what situations lead to frustration.
✔ Use the “Zones of Regulation” Framework – Categorising emotions into colour-coded zones (e.g., blue = sad, red = angry).
✔ Develop Positive Self-Talk – Replacing negative thoughts with empowering statements like “I can handle this.”

4. Developing Problem-Solving Skills
CBT teaches structured approaches to problem-solving:
✔ The “S.T.O.P.” Technique – Stop, Think, Observe, Proceed.
✔ Making a Decision Matrix – Listing pros and cons to evaluate choices.
✔ Practicing Scenario-Based Problem-Solving – Playing out different solutions to a common challenge.

How Parents Can Support CBT at Home

1. Reinforce Coping Strategies
Encourage your child to use CBT techniques in everyday life:
✔ Create a calm-down corner at home with sensory tools and emotion charts.
✔ Use visual schedules to provide structure and predictability.
✔ Remind them to pause and reflect before reacting in frustrating situations.

2. Provide Positive Reinforcement
Help your child stay motivated by:
✔ Praising effort over results (“You worked hard to stay focused!”).
✔ Using reward systems like sticker charts for practicing self-regulation.
✔ Encouraging self-reflection (“How did you feel about that?”).

3. Practice Social Scenarios
Role-playing and structured activities help children develop social confidence:
✔ Act out difficult conversations (e.g., asking for help, making a friend).
✔ Play games that encourage turn-taking and cooperation.
✔ Watch videos or read books about social interactions and discuss them together.

4. Model Adaptive Thinking
Demonstrate CBT principles through your own behaviour:
✔ Reframe setbacks positively – “I made a mistake, but I can learn from it.”
✔ Use self-talk out loud – “I feel frustrated, but I’m going to take deep breaths.”
✔ Show flexibility in problem-solving – “That didn’t work, let’s try another way.”

By implementing these strategies at home, parents can reinforce the skills learned in CBT sessions, empowering their children to manage their emotions, improve social interactions, and develop lifelong coping skills.
How CBT Is Adapted for Children with Autism and ADHD

While Cognitive Behavioural Therapy (CBT) is widely used with children, it is often most effective when adapted to suit a child's individual learning style, communication preferences and support needs.

Children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) may process information differently from their peers, meaning traditional CBT approaches sometimes require modification.

CBT Adaptations for Children with Autism
Many autistic children benefit from CBT approaches that are:
  • More visual
  • More structured
  • Concrete rather than abstract
  • Predictable and routine-based
  • Individualised to their interests and strengths
Adaptations may include:
  • Visual emotion scales
  • Social stories
  • Visual schedules
  • Concrete examples
  • Role-playing activities
  • Structured problem-solving frameworks
These strategies can help children better understand emotions, social situations and coping strategies in ways that are meaningful and accessible.

CBT Adaptations for Children with ADHD
Children with ADHD often benefit from CBT approaches that support attention, organisation and emotional regulation.
Adaptations may include:
  • Shorter activities
  • Frequent movement breaks
  • Visual reminders
  • Interactive games
  • Goal-setting activities
  • Practical problem-solving exercises
Sessions are often highly engaging and focused on helping children develop skills related to impulsivity, frustration tolerance, organisation and flexible thinking.

Individualised Support Matters
No two children are the same.
Effective CBT focuses on understanding each child's strengths, interests, communication style and support needs. Strategies that work well for one child may not be suitable for another.
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A neurodiversity-affirming approach recognises and respects these differences while helping children develop practical skills that support emotional wellbeing, participation and confidence in everyday life.
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Belong Health's Resource Hub
To further support your child's development, visit our Resource Hub for additional activities, tips, and tools tailored for various needs and diagnoses.
Explore Home Therapy Packs
Our guides provide practical strategies to support children facing these challenges. To further enhance your approach, consider our Home Therapy Packs, designed to engage children and improve focus at home.
Frequently Asked Questions - Cognitive Behavioural Therapy (CBT) for Children

What is Cognitive Behavioural Therapy (CBT)?
Cognitive Behavioural Therapy (CBT) is an evidence-based therapy that helps children understand the connection between thoughts, feelings and behaviours. CBT teaches practical skills that support emotional regulation, coping, problem-solving and resilience.

What happens during a CBT session?
A CBT session may include:
  • Talking about emotions
  • Identifying thoughts
  • Learning coping strategies
  • Role-playing situations
  • Problem-solving activities
  • Practising new skills
Sessions are adapted to suit the child's age, developmental stage and goals.

What are the five steps of CBT?
While different therapists may use slightly different models, CBT often involves:
  1. Identifying situations that cause difficulties.
  2. Recognising thoughts associated with those situations.
  3. Exploring emotions connected to those thoughts.
  4. Challenging unhelpful thinking patterns.
  5. Developing more helpful responses and behaviours.

What conditions can CBT help with?
CBT is commonly used to support:
  • Anxiety
  • ADHD
  • Emotional regulation difficulties
  • Autism-related anxiety
  • Low self-esteem
  • School-related stress
  • Behavioural challenges
  • Depression

Is CBT good for anxiety?
CBT is one of the most widely researched therapies for anxiety and is commonly used to help children understand and manage worries, fears and anxious thoughts.

Can CBT help emotional regulation?
Yes. CBT helps children identify emotions, recognise triggers and develop practical strategies to manage strong feelings more effectively.

Can CBT help children with autism?
Yes. CBT can be adapted for autistic children and may help with anxiety, emotional regulation, social understanding and coping with change. Adaptations often include visual supports, concrete language and structured activities.

Can CBT help children with ADHD?
Yes. CBT may help children with ADHD develop skills related to:
  • Organisation
  • Emotional regulation
  • Impulse control
  • Problem-solving
  • Self-monitoring
  • Coping with frustration

What are some common CBT exercises?
Examples may include:
  • Thought diaries
  • Worry scales
  • Emotion charts
  • Problem-solving activities
  • Role-playing
  • Relaxation exercises
  • Positive self-talk activities

Is CBT suitable for younger children?
CBT can be adapted for younger children using visual supports, stories, games, role-play and age-appropriate activities.

Can parents support CBT at home?
Yes. Parents play an important role by helping children practise coping skills, problem-solving strategies and emotional regulation techniques between sessions.

How long does CBT take to work?
Every child is different. Some children notice benefits after a relatively short period, while others may require ongoing support depending on their goals, strengths and support needs.

What is the difference between CBT and ACT?
CBT focuses on identifying and challenging unhelpful thoughts, while ACT focuses on helping children accept difficult thoughts and emotions while taking actions that align with their values.

Can CBT be used alongside other therapies?
Yes. CBT is often used alongside:
  • Occupational Therapy
  • Speech Pathology
  • Counselling
  • Positive Behaviour Support
  • Psychology services

When should I consider CBT for my child?
You may wish to explore CBT if your child is experiencing:
  • Anxiety
  • Emotional regulation difficulties
  • Social challenges
  • ADHD-related difficulties
  • Autism-related anxiety
  • School-related stress
  • Low confidence
  • Persistent worries

​How can Belong Health help?
Belong Health clinicians may incorporate CBT-informed strategies through Counselling, Psychology, Occupational Therapy and Positive Behaviour Support services to help children develop practical coping skills, emotional regulation strategies and greater confidence in everyday life.
Related Resources

Emotional Regulation ACT & Other Therapeutic Approaches ADHD Resources Autism Resources Behaviour Support Professional Supports

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You can get a referral from your/your child’s GP for OT/SP on a Chronic Disease Management (CDM) plan this gives you 5 sessions for OT per calendar year with a $60 rebate available on each session. A Helping Children with Autism/PDD/ or an eligible disability package (20 sessions between allied health professionals, as set up by a Paediatrician/Psychiatrist) which gives your child under 16 years a $75 rebate per session for the 20 sessions, you can use up to 10 sessions per Health Professional (up to 10 for OT/SP) and you will need a separate referral letter from your child’s Paediatrician for each Allied Health Professional you are seeking services from. 
For Psychology you can request a Mental Health Care Plan (Registered Psychologist) from your GP for 10 individual and 10 group Psychology sessions per year.  Medicare rebate is $96.65 per session.
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Your Private Health fund may cover up to 75% of the cost of OT, SP or Psychology sessions if this is included in your cover, be sure to call them or check your policy for details.

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We are Medicare and Private Health fund registered for OT, SP and Psychology.

EPC/Team care arrangements/Chronic disease (CDM) and Helping Children with Autism (HCWA) or GP management plans and Mental Health Care Plans (MHCP) for Psychology and self-referrals are all acceptable.

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