1 11

CBT
Toolbox For
Children&.
Adolescents I
!
t
t
t
t
t Over 200 Worksheets & Exercises
t for Trauma. ADHD. Autism. Anxiety.
t
t
Depression & Conduct Disorders
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I LISA WEED PHlFER.DEd. NCS?
I AMANDA K. CROWDER MSW. LCSW
I TRACY ELSENRAAT.MA. LPC. ATR-BC
I ROBERT HULL.EDS. Med. N~
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Contents
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!II, Introduction ..... . ...... . .. . .... . ... . . . . . . . . . ........ xi Pro-social Skills
I What Do You See~ . .. ... .... .. . .... . .... .. --. . -. 2.;
I I. Childhood Trauma Cycles of Re\ationships . . . . . . . . . . . . . . . .. . . .. 2.4
I Triggers and Shie\ds, Introduction . . . . . . . . . . . 2.5
I Cognitive Skills
Triggers and Shields . . . . . . . . . . . . . . . . . . . . . . . . . 2.6
I Thinking Competency Skills
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Cognitive Behavioral Triangle ..... . ... ..... . .... 2
My Ouch Story ... . .. . . . ........... . ...... .. . . ... 3
Safety Planning . .... . .. . .............. . . . .... ..... 4

Resilience
Power Poster, Introduction . . ... ... . ... ... ...... 2.7
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Power Poster: Part 1 .. ... . .... . . .... . ... ... .. . ... 2.8
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• Memory Power Poster: Part 2 . . ......... .. . ..... ... . . . . ... 2.9
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Memory Cloud Walk .... . ... . ............... .... S My Positive Thought Journal . . . . . . . . . . . . . . . .. 30
Memory Land . .... . . . ....... ..... ... ......... .. .. 6 Symptom Relief
Creating a Schedule .. . ... . ....... . .. . . . ... . . ..... 7 Boo Boos and Bandages ...... .. . . .... . . .. . .. . .. . , 1
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• Language Coping Skills . ..... . .. . ... . .. . ....... . . ... . .... .. 32.
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Communicati on Rules ........ . ... . ........... . .. 8 Thermometer ..... ............ . .... . .. . .... ... . . 33
This vs. That, Introduction ........ . .. . . .. ... . .... 9 Emotional Regulation
This vs. That .. . ........ . .. . ...... . .......... . . . . . 10 Feeling Faces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
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Say It Strong .... . ............... ...... . ... . .... . . 14 Feeling Pie ........... . ... . ............... ...... . . 35
Comfort Levels ............... .. . .. . . . . . . . . . .... 36
Relationship Coaching
I Alliance Building Brain-Based Leaming
' Building a Bridge, Introduction .. . ............ .. 15 Connecting with the Present
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Building a Bridge, Part 1: Present ........ . . . . . .. 16 Cleaning Up Negative Thoughts . . . .. . . . . ...... . ,7
Building a Bridge, Part 2: Past . . . ........... .. . . 17 Grounding Exercises ..... . ...... . ........ . .... . . ,8
Building a Bridge, Part 3: Collaboratio n .. . . .... 18
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Reciprocal Relationships
Balloon Breathing ........... . .. . ...... . ....... . . ,9
Quieting the Body
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Moods and Relationships ......... ... .... . . . .... 19 Calm Images ...... . ............... . ..... . . . . .. . 40
Relationship Balance, Introduction ............ 2.0 Calm Down Plan . . . . . . . . . . ............. . . . . . . . . . 41
• Relationship Balance . . ........... . ...... . ....... 2.1 Roll a Brain Break! ......... . ... . ...... .. . . ... . . 42.
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• Relationship Roadblocks .... . . ............ . .... 2.2.
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A/ind and Body
Mind and Body Wellness Plan .. · · · · · · · · · .... 43
Connecting the Body with Emotions,
Introduction . ·, . . ...... • . • . ..... . .... .... .... 4 4
Connecting the Body with Emotions . . . . . . . . . . 45
Exercise Diary . . . . . . .... • • . • . . • . . .... .. ...... . . 46
II. Attention Deficit
Hyperactivi ty Disorder
Cognitive Skills
Concentrarion
Examining Inattention . . .. ....... ............ . . 48
Distraction •ro Do"' List . · ·· ··· · ·· ··· . ......... 49
.
Ttmcs of Inattention . .. ... ......... ............. 50
Impulse Control
Examining lmpulsiviry ... ... ..... . . ... . .. . ...... 51
Internal vs. Enemal Distractions ........ . . ..... 52
Back on Track! Coping with Distractions ...... 53
Creating a Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Metacognition
Finding a Solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Thinking About My Warning Signs .. . .......... 55
Re.framing Thoughts ... .......... .. .. ..... . ..... 56
Relationship Coaching
Alliance Building
Family Rules ............. . ... . . . . ... .. .......... 57
End on a Good Nore ........ ... . ..... ....... .. . . 58
All or Nothing and Everything in Between ..... 59
Reciprocal Relationships
Say It or Swallow It .. ................ ... . ....... 60
Being a Good Friend ...... ...... . . ..... . . ....... 61
Staying on Topic, Introduction . . . . . . . . . . . . . . . . 62
Staying on Topic ...... . ........... . . • • .. • • • • · · · · 63
Pro-social Skills
.,.,, . . . . . . . . . . . . . . . . 64
Boundan~ -· · · ·················
How Big Is My Problem? ... . .. . ...... • • • • · · · · · · 65
Does My Reaction March My Problem?.• •• ••· 66
Competency Skills
Time Management
Estimating Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Goal Setting Worksheet .... . ............. .. .. . 68
Visualization of Distant Rewards .... . .. ..... .. 69
Self-Regulation
Attention Regulator .... . .. .. .... ...... .. ...... 70
Action Regulator .. . ........ . ........ .......... .. 71
Stop and Think! Managing lrnpulsivity . ....... 71
Memory
Breaking It Down .................. . .... . ....... 73
Cues on Cards ... . .... .............. .. .. .. ...... 74
Cognitive Flexibility, Introduction ... . ......... 75
Cognitive Flexibility ....................... .. . . 76
Brain-Based Leaming
Brain Breaks
Calm Down Bingo, Introduction . . . . . . . . . . . . . . 77
Calm Down Bingo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Animal Break Ladder . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Whole-Body Games ..... . . .. . ..... .. .......... So
Healthy Habits
Healthy Plate, Introduction ....... .. ............ 81
Healthy Plate ..... .. .. . ........... ... ........ .... 81
Exercise Routine ................... . ........ . ... 83
Time for Bed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Positive Mindset
Positive Self-Reflection Log ....... ...... ... . .. •. 85
Positive Imagery Practice: In Control
and Focused . . . .... ... ..................... ••• 86
Look at What I Accomplished! .. .. .. ... . .. •••• 87
III. Autism Spectrum Disorder
Cognitive Skills
Facilitating Conversation
Allow Me to Introduce Myself.
Introduction ...................... .... . ........ 90
Allow Me to Introduce Myself .. . ...... . ........ 91
Conversation Map ..... . .. ..... .. . .... .... -----
---- 92.
Conversation Toolkit .... .. ..... .. ---.. -. -•----•
Brain-Based Lea min g
93
Rela xatio n
Flexible Thinking
Coo l Dow n Checklist .... . . -. -- . 12.0
Flexible: vs. Rigid Thinking ... .. ..... --. -----
. -- 94 Race Track Breathing: Wa m\ Up qr
Dealing with Detours .... .. .. . . .. ---. --... .
-.. . -95 Coo l Dow n .... .... .... . .... .... .... . . . .
Embracing Change .. .. .. . .. ..... .. . . .... -. --. . .. .. 12.1
. . 96 Visual Breathing . . . . . . . . . . . . . . . . • --• --- - u.2.
Sensory Integration
Social Thin king
Sensory Profile .... ..... . . . .. . . .. . ..... .... ----.
Sensory Awareness ..... . ... . ..... ... .. .. . . ..
97
. . . 98
How Can I Help? .... .... .... ... ---- -. . -.
I CA N Make a Cho ice . . . . . . . . . . . . . . . . . . .
--- - u.,
Sensory Escape: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . l 2.5
. . . . 99 Reaching Out for Hel p . . . . . . . . . .. . . ... ..
.... .12.6
Relationship Coaching Brai n Gam es
Perspective Emo tion al Con nec tion Gam e . . . . . . . . .
. . . . . 12.7
Perceptive Taking . . ..... .. . .. .. ..... . ..... Find a Frie nd . . . . . . . . . . . . . . . . . .... . . .. . .
.... 100 . . . .. .. 12.8
Looking at All Sides ..... . .... .. .. .. . . . . .. ..... Con versatio n Cub e .. . . . . ..... ... . ..... .
. 101 .... .. . 12.9
Com mon Gro und . ..... ... . ... ... . ..... .....
.. 102.
Emo tion al Expression IV. Conduct Disorder
Emotions Che at She et .... .... .... ... . .. ..
..... 103
Und erst and ing Emo tion s . .. . . ..... . ..... . Cognitive Sk ills
. ... 104
Wh at's My Emo tion al Temperature? .....
. . ... 105 Ang er
Pro- soda / Skill s
Get ting to Kno w You r Ang er ... . .. ....
.... . . . . 131.
Min dful Com mun icat ion ..... ... .. . .. ... Tac klin g Ang er Mo unt ain .. .. ... .. ....
.. ... 106 . . . . . . .. r,;
"I" Stat eme nt 101 ..... . . .. .... .... .. . .... Wee kly Ang er Dia ry ... .. .... .... . ... .
.... . 107 . . .... . .. 1,4
"I" Statements vs. "You" Stat eme nts .. ...
. ... . 108 Aggression
Competency Skills Tim es of Act ing Out : Intr odu ctio n ....
. .. ... .. 1,
Man agin g Expectations Tim es of Act ing Out : Clie nt .... .. .. ....
Tim es of Act ing Ou t: Car egiv er .. ... ..
.... . .. 1,
Is it an Emergency? ... .... .... . . ... . . . . ....
. . . 109 .. .. . .. . 1:
Exp ecte d vs. Une xpe cted ..... .... .. . .. .... Tim es of Act ing Out : Plan of Act ion .
.... . 110 ...... ..1
Exa min ing Exp ecta tion s ..... . .. . . .. . . . . Dys regu latio n
.. .... . 112.
Functional Interactions Goi ng Bac k in Tim e .... .. .... .. _. . _. .
_. .. . . . . .
My Personal Bub ble .... ..... . . .... .. .. .. Rec ogn izin g Em otio nal Lim its .... ....
... .... 113 . . _. . .. 1
Con trol My Vol ume . .... .... .... .... .. . Bod y Rea ctio ns . .. .. .. . _.... ... . _... ..
. . . ..... 114 . . . . .... .
App ropr iate Tou chin g ... .... .. . .. . ... ..
. .... .. 115 Relationship Coaching
Thought Challenging
Com mun icat ion
Perseveration Log .. . .. .... .... .... . . .. ....
. . . .. 116 l Feel . . . ... .. . . .... .... .... .... . .. . . . . . -...
Pers ever atio n Info rma tion . . .... .... .... .. .
. .... . . 117 Wa tch You r Wo rds . . .... .... .. . .. .. -...
Pers ever atio n Act ion Plan , Intr odu ctio . -- -- •
n .. . ... . 118 Com mun icat ing wit h Oth ers .... .. .....
Pers ever atio n Act ion Plan .... .... .. . .... . .. . .
... ... . 119
Alliance Bui ldin g
Und erst and ing Fam ily Rul es . . . .. . . . .
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Frie nds and Fam ily .. . .. . . .. .... ... . ...
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 Respecting Mysdf and Others
... .. .. . ....... 147
Pro-social Skills
Pro-social Behaviors . . ... . .. . ...... . ....... 148
HclpfuJ Behaviors . . . . . . . . . . . . ... . . . .. .. . .. .. . 49
1 Thought Distortion
HclpfuJ Self . . . . . . . ...... .... ..... ___ . __ . ___ . _.
150
Competency Skills
Sequencing
Behavior Sequencing, Introduction .... .... __.. 151
Behavior Sequencing: Pan 1 .............. ___ .. 152
Tipping Point: Pare 2 ....... ... ...... .... . .. _.. 153
Behavior Sequencing Redo: Pan 3. . . . . . . . .... 154
Emotion Regulation
Control Cards ... ... ........ ....... .... .. .... ... 155
Reframing Thoughts ........ ..... ... .... ... .... 15 6
Change of Mind .... ....... .... ............... 157
Emotional Vocabulary
Building Emotional Vocabulary .... ......... .. 158
Linking Emotions, Thoughts, and Feelings .... 159
Feeling States ..... .... .. ..... ..... ....... .. ... . 160
Brain-Based Leaming
Creating Peaet
Peace Chain ... .. ........ .............. ..... .... 161
Peaceful Actions .. ........ .. .... ..... . ..... .... 162.
Thinking Peace ... .. .. .. ... ......... .......... .. 163
Body Control
Recipe for Success ....... ... .... .. .. ........... 164
Yell It from the Mountaintop .. ... .. ...... ... .. 165
10-Point Check-In ..... .... ..... ........ ... ... 166
Gratitude
Letter of Thanks .. .. ........... .... ..... ...... 167
Little Victories .. ... .. ...... .... .. .. ...... ..... 168
Grateful Feelings .. ... .. .. .... ...... .. .... ..... 169
V. Anxiety
Cognitive Skills
Defining Anxiety
Getting to Know Your Worry .. ... . . .. .... .... 172.
Anxiety Hierarchy, lntrodu·ction . . ..... .. ... . 173
Anxiety Hierarchy ................. ..... ...... 174
Your Worry .... ... ... ... .... _.. . _.. .. _.... _.. __ . 175
"Good" Worry vs. "Bad" Worry ... ..... ...... . 176
Detective .. . . . . ............ . . . . . ...... · · ·· ·•· .. 177
Weighing Your Worries ..... .. ........ .... ....178
Physical Reactions/Somatization
Responses, Reactions, and Feelings .. ..... .... 179
How Do You Respond to Your Worry? ....... 180
Thoughts and Feelings Log ............. ...... 181
Relationship Coaching
Allianet Building
Talking with Others ........ ..... .... .. .... ..... 182.
Helpful Thinking .... ..... ....... ...... ....... . 183
Trust Bubble . .. . . .. ... .. .................... 184
Assertiveness
Assertiveness Regulator ..... ...... .. ..... ..... . 185 \
Three Wishes .. .... ... .... ........ ... ..... .... . 186 (
II,
To Do, Won't Do List ..... ........... ... ...... 187
Pro-social Skills
Pro-social Behaviors ... .. ....... ..... ........... 188
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Stressed Out! ... .... ......... ..... .. ... ... ... .. 189
Fear/ Anxiety Self-Statements ........... .... .. 190
Competency Skills
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Problem Solving
Red Light, Yellow Light, Green Light .... ... .. 191
Creating Your Own Coping Kit ......... ...... 192.
Stay Calm Checklist ........... ..... ...... .... . 193
Control
Circle of Control ......... ..... ........... .... . 194
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Managing Expectations of Control ..... ... ... . 195
Controlling Your Thoughts .............. ... .. 196 ••
Thought Challenging
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What Will Work? .. .. ... .... ....... ... ........ 197
How Do We Get There? .. .. ... ........ . .. ..... 198
Stop, Rewind, Rethink, Introduction ......... 199
Stop, Rewind, Rethink .......... ...... ... .. .. . 2.00
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Brain-Based Leaming
Positive Changes
Within Reach! ... . . .. ......... . .... . . . .... .... 2.01
26 Positive Traits .. .. ... . .......... . .. . . .. .. . .. 2.0 2.
Self-Care Routine .... .... . ............... . .... 2.0 3
Perspective Changing
Staying in the Present, Introduction ... . ...... 2.0 4
Staying in the Present .................... . .... 2.05
Let's Box It Away . ...................... . . .. .. . 2.06
You're Not Alone . ...... ... .... . ......... . ..... 2.07
Brain Games
Relaxation Rolls ........ .. ..................... 2.0 8
Mandala ..... . .................... .. ......... . . 2.09
Anxiety the Alien, Introduction ....... ... .... 2.10
Anxiety the Alien . .. ........................... 2.11
VI. Depression
Cognitive Skills
Mood
Understanding Your Mood ................... 2.14
Mood Tracking . . . . . ....... ...... ............... 2.15
Building Your Defense, Intro duction .. ....... 2.16
Building Your Defense ........ ...... ........... 2.17
Isolation
Social Interaction and Mood ........ . . . ....... 2.18
People Around Me ......... ... . . ............... 2.19
Support Chain ........ . ...... . ................
Emotional Expression
M y Feelings ... . . . . ........................ . .... 2.2.1
Uncut Diamond .......... . ... ..... .... .... ...
Inside Out ........................ .. .... .... ... . 2.2.3
Relationship Coaching
Confidence
I Am ... ............... . ...................... . . 2.2.4
Your Inner You ... . ............. . ....... . . ...... 2.2.5
Self-Portrait ........................ . .......... 2.2.6
Supportive Alliance
Supportive Responses .............. . .. . .. . . .. . 227
Understanding Stress and Support . . . . . . . . . . . . 228
Support Constellation . . . . . . . . . . . . . . . . . . . . . . . . 229
SelfEsteem
I Like Me! ..... .. ........ .. .. .. .. .... .......... 2.30
Awards, Introduction....... .............. ... . . . 2.31
Awards ... . ........... . .. .. .. . . . .. . . . . ------• • • -2 32
I Am Valuable ..... .. . ... .. . . .. ... ...... -.. .. · · · 2 3 3
Competency Skills
Realistic Thinking
Reframing Sad Thoughts .......... . . . . . . ...... 2.34
Optimistic Views ... . . .. ..................... . -2.35
Test Your Thinking .. .. .... . . .. . . . . . ... ... . . .. . 2.36
Coping
Positive Self-Talk, Introduction ....... . ....... 2.37
Positive Self-Talk .. ............................ 2.38
The Four ~estions . ... ......... . . . ........... 2.39
Coping Skills Tree . . . . ............. .. .... . ..... 2.40
Problem Solving
Stoplight Problem Solving .. . ... . . . .. ...... .. . 2.41
Finding Another Solution ......... . ..... ..... 2.42.
Reaching Out ... . ............ .. .. ....... ...... 2.43
Brain-Based Leaming
Fostering Motivation
What Drives You? .................. ... ... . .... 2.44
2.2.0 Positive Goal Setting ........... . .......... . . . . 2.45
Self-Improvement Plan ..... ........ .. .... .... 2.46
Positive Changes
2.2.2.
Connecting with Your Body ........ .. . ....... 2.47
Making Positive Changes .......... . .. .... . ... 2.48
Self-Care Plan ................. .. ....... . . ... .. 2.45
Healthy Body
Get Moving! ............. ... ....... .. . . . ..... . 2.5 c
Sleep Schedule . .......... .. .... .. ....... .... . .. 2.5
Emotional Eating ...... ..... .. .............. . --2.5
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- Introduction
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-• C BT Toolboxfor Children and Adolescents was designed with therapists in mind to provide
tar~c.t~d s.oluti~ns to a myriad of mental .h~alth issues that arc frequently present
act1V1t1cs m th,s workbo ok enhance tradmon al CBT by promoting the develop
executive functioning, developing social skills, and prompt ing whole brun approac
therapy rdic:s heavily on language and the activities in this book accompany languag

brief.
in children. The
ment of a child's
h. Traditional
e with nonverbal activities
!I to help facilitate growth with individuals who have difficulties reflecting and changin
g their own negative
'!!II thinkin g. This book used a multidisciplinary approach relying on the expertis
e of school psychologists, social
•
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workers and therapists. We have put togethe r an abundance of creative ideas that
allowing clients to express themselves, communicate with others and create positive
can engage and inspire
change.
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The workbo ok covers si..x clinical areas: Childh ood Trauma, Attentio n Deficit
Hyperactivity Disorder, Autism
~ Spectru m Disorder, Condu ct Disorde r, Anxiety, and Depression. The activitie
s arc tailored to specific disorders
~ and sympto mology and can be combin ed to meet the client's needs in regards
to interrup ting negative thought
~ patterns, developing healthy relationships. and creating a mind-b ody connect
ion. Within each chapter arc four
,"
content areas tailored to the specific disorder.
~
1. Cognitive Skills
These activities focus on recognizing symptoms, determi ning the impact of negative
thinkin g patterns,
". 2.

and enhanc ing memor y strategies.

Relatio nship Coachi ng
"
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These activities focus on the develop ment of pro-social behavior, buildin g alliance
s, and improving
• interpe rsonal relationships.
••
3. Compe tency Buildin g
These activities target emotio nal regulation, realistic thinkin g, coping, and problem
solving.
II 4. Brain-B ased Learning
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These activities focus on developing a mind-b ody connec tion, finding motivat
ion, and developing
![I healthy mental and physical habits.
'
~ How to Use this Book
I This workbo ok provides activities to address countless sympto ms with skill-bu
ilding exercises. You will notice
,
I three types of worksh eets: In-sessi on Exercise, Client Activity and Caregiver
differen t uses and each one is written from a different perspective.
Worksheet. These handou ts have
' In-session Exercises are designed for the therapi st to use as a tool while in-session. Includi
ng the client,
,',
caregiver and therapi st in one setting, they are made to spark conversation and
make the client comfortable.
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 xii ■ CBT Toolbox f or Children & Adole sc ents
Client Activities arc created for the child to do themselves either in-session or as homework. Whether
supervised by the therapist or their caregiver, they will be able to do the activity at any age or stage in the
treatment process.
Caregiver Worksheets arc for the parent or caregiver-to help them cope and work with the therapist, and also
allow them to become: part of the therapy process and reinforce: strategics being taught in-session.
Although suggestions, ideas, and specific instructions are given, we encourage creativity within your own setting
and specialty. These activities can be used to engage children dfreccly in therapy, used in a group format for at-
risk children, or as a strength building competency activity. As every therapist knows, skills chat are repetitively
practiced outside: of therapy have: a greater chance of being retained and used when faced with challenges.
Think Outside the PAGE
Lee these activities act as a springboard co your own creativity. All these activities can be adapted to meet your
client's age:,. developmental capacity, or current stage in treatment. It is important to let the client dictate when a
piece is completed and how much they would like to expand the given directive. If a client is invested in a certain
activity, you may consider letting him or her work on it over several sessions to maximize your information
gathering. A loosc:ly structured approach allows more opportunities for your client to encounter challenges in
the process, which will result in opportunities for problem solving, skill building, and relationship building.
Keep in mind that once an activity is completed, the client's processing of those skills continues.
Go Beyond the Activity Itself!
The activity or art piece is significantly important to the therapeutic process, the dialogue about the activity is
equally important. Consider having the client title each activity and journal about it. Engage in discussions with
the client regarding his or her feelings about this process of creating by using nonjudgmental commentary and
open-ended questioning.
The artwork is an extension of self co be honored; therefore, it is important to have a plan for what to do with
completed pieces co honor them and protect them. This ritual offers closure to the creative process. Options co
consider include creating a portfolio to keep in the office until treatment is ended or for the client to take home.
You may also find a safe place for the artwork to be on display in the office or use the artwork in other treatment
activities; for example, many of the pieces created in session would double nicely as a focal point for guided
imagery activities. The artwork could also be used in the client's home as a daily reminder of skills to practice or
as a banner ofpride and accomplishment. Process these options with the client ahead of time and come to an
agreed plan.
Keep in mind that once an activity is completed, the client's processing of those skills continues. There are
therapeutic advantages to repeating activities at different points in the therapeutic process. You might consider
having the client do the activity again in the same way it was done before and then process the differences.
Anocl1er option would be co complete a similar version of the activity co better meet where the client is at that
particular point in crcarment. Both options offer the client opportunity for repetition and mastery.
 SEC TIO N
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Childhood Trauma
his chap ter will assist with developing a person's
T
ability to be resilient and overc ome adverse
experiences, intro ducin g the conc ept chat the job
of the caregiver, child and thera pist is to impa ct
the subjective mean ing of events that enables a
child to move from bein g over whel med by an even
to having an even t empo wer them into resilience t
and grow th. These exercises focus on deali ng with
feelings of guilt , blam e and loss, the abili ty co use
emot iona l energy in a positive way, and impr ove
so they can feel accepted. (Every child's response relationships
to these activities will differ; some times a perso
differs from what you chink it shou ld be.) n's respo nse
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Cognitive Behavioral Triangle
This activity will bri ng awareness of how our thoughts, feelings, and behaviors are connected, and
identify how negative events can change our thinking patterns. Identify two positive events and two
negative events and complete the spaces below. Discuss this with your therapist; your thoughts about it,
your feelings related to it, and how these both may affect your behaviors.
Feelings
I
Event
Thoughts Behaviors
Negative
Negative
Positive
Positive
'2. • Copynght © L Ph,fer, A Crowder. T. Elsenratt. R Hull. CBT Toolbox For Children&. Adolescents. All R,ghts Reserved
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My Ouch Story
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Iii Everyone has a story to tell. When bad things happen, it makes it much harder to tell the story. When
bad things happen to us, there is typically a lot of shame, guilt, and embarrassment. This activity provides
•...-
guidance to achieve the goal of telling your story without the shame, guilt, and embarrassment. To get
Iii
the story out, so that someone else can hear it and read it. Complete the sentences below with your
story. Please use additional pages as needed.
-
I remember a time when
ti ---- ---- ---- ---- ---- ---- -
First.
------------------------------
Next I remember
--------------------------
Then. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
I Last.
\
I I remember feeling
I
I wou1d like to feel
I need because
I feel safe when _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
These are the people in my life who support me _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
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When I get upset can to feel safe again
Copyright © L Ph,ler. A Crowder, T E15enratt, R Hull, CBT Toolbox For Children & Adolescents. All Rights Reserved.
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Safety Planning
1. What are your trauma reminders or triggers? (Please circle all that apply)
Being touched Being isolated Specific person (Who)
Time of year (When) People in uniform Anniversaries (What)
Particular time of day Yelling/fighting People being too close
(When) Being forced to talk Other: _ _ _ _ _ _ __
Not having input Being around men/women
Bedroom door open or closed Seeing others out of control
2. Please describe your warning signs; for example, what your body feels when you are losing control,
and what other people can see changing? (Please circle all that apply)
Sweating Isolating self Being agitated
Red faced Eating less Clenching fists
Rocking Racing heart Bouncing legs Swearing
Crying Loud voice Nauseous
Sleeping less Eating more Short of breath
Breathing hard Clenching teeth Other:
Wringing hands Sleeping a lot
Pacing Can't sit still
3. What helps you feel or stay safe? (Please circle all that apply)
Writing Walking Exercise/sports
TV/ movie Reading Drawing/coloring
Listening to music Video games Taking a shower
Support from peers Talking with adults Other: _ _ _ _ _ _ __
4. What helps you stay in control? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _
5. What helped you stay in control in the past? _ __ __ _ __ _ _ _ _ _ _ _ __
6. What kind of space is most comfortable when you need it? _ __ __ _ _ _ _ _ _ __
L .. Copyright © L Phifer, A Crowder, T Elsenratt, R Hull, CBTToolbox For Chddren & Adolescents. All R,ghts Reserved
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• Memory Cloud Walk
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j Write down past challenges and how you solved them. Questions to think about: What happened? What
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did you do? Did anyone help you? Are there any similarities? What did you learn? Has anything changed
over time? W hat does this say about you?
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Memory#l: Memory#2:
Solution: Solution:
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Support Support
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i Memory#3: Memory#4:
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•• Copyright (£) L Phifer. A Crowder. T. Elsenratt. R Hull, CBT Toolbox For Children & Adolescents. All Rights Reserved. ■ 5
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Memory Land
Mem ories can be hard but are useful in helpi
ng us understand and battle our fears. Sometimes
we may
tend to ignor e thing s that are painful and
other times it may be hard to stop thinking abou
t them . Use the
organ izer below to recal l detai ls of mem ories
so you can ident ify your feelings and move towa rd
healing.
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Feelings During 1
i Feelings After
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Memory
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Details
Details
Environment
Environment
Events
Events
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6 • Copyri ght © L Ph,fer, A Crowd er, T Elsen
ran, R. Hull, CBT Toolbox For Children&. Adolescents All Rights Reserved.
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••It Caregiver
~a,kahact
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Creating a Schedule
••
j Consistency and structure are very important for children and adolescents, especially when a trauma has
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occurred. Typically, when a trauma occurs, the person is left feeling out of control. Creating a schedule is
a helpful way to increase structure and predictability. Work with your child to create a schedule for daily
activities and discuss alternatives to handling changes in routine.
• Monday Tuesday Wednesday Thursday Friday Saturday Sunday
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6AM-
8AM
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10AM
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12PM-
2 PM
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2PM-
i 4PM
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6PM
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i 8PM
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8PM-
10PM
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I Copyr,ght (0 L. Phifer. A. Crowder. T. Elsenratt. R. Hull, CBT Toolbox For Chddren &. Adolescents. All Rights Reserved • 7
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Conunllnication Rules
Ma ke cop;es of the scroll below fo, both ca,eg;ve, and ch;ld to complete
Make a 1;s1 of mies lo, the othe, pe,son to keep ;n m;nd when communkat;ng o, settling d;sputes.
Th;nk of behavoo,s o, ph,ases that the othe, pe,son can utn;,e to help you feel ,espected and vaHdated.
Be specific. Share your list once completed.
Therapist Note: When discussing the list. point out similarities and differences among the rules. How
realistic are the requests? If something is not realistic, help client revise to make it more appropriate.
8 • Copyright Cf, L Phifer, A Crow der, T Elsenratl R. H ull, CBT Toolbox For Children & Adolescents. All RiRnts
_ Reserved.
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This vs. That
Communication between family members, especially parent and child, can be difficult particularly when
dealing with trauma. This vs. That is a guided activity designed to help facilitate communication between the
caregiver and child. The caregiver and the child will have an opportunity to reflect on each other's strengths
as well as problematic behaviors. The caregiver and child questionnaire on pages 10-13 can be completed by
the individual or can be completed as an interview. When both are finished filling out the forms, discuss the
similarities and differences in both surveys. Recognize the strengths of both and acknowledge behaviors that
need to be changed.
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This vs. That
Caregiver Perspective
1 . What aro soma positives you can identify about your child?
2 . Why are theoo positives or things that you like to see?
3. What are the negative behaviors you can identify?
4. Why are these negatives or things that you do not like to see?
5. What is the biggest change that you would like to see as it relates to your child?
10 • COO')~ ,t: L Ph,te,. A Crowder T Elsenratl R Hull. CST Tooloox Fo, ChJdren & Adolescents A'I Rgnts Reser.ed
 6. What are some things that you think you can improve on as a caregiver?
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7. What are some things that you think you do well as a caregiver?
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This vs. That I~
Client Perspective
1. What are some pos1t1ves that you can identify about your parent/caregiver?
2. Why do you like these things?
3. What are some things that you do not hke your parent/caregiver doing')
4. Why don't you like these things'!
Adolescents. All R,ghts Reserved
12 c:, Copyright 1£> L Ph,ler, A Crowder. T Elsenratt. R Hull, CBT Toolbox For Children &
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5. What is the biggest change that yo.J. would like to ~
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6. What behav10rs would 'Pl 1dent1ry as negatwe w\1.hm yourselP
7 • Why do you think these are negative behaV10rs'?
8. What do you think you do well?
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Cop~11ght s.C' l Ph,ler. A Crowder.1 t.lsenratt, R. Hull, CBT Toolbox For Children & Ado!escents All R,6hts Reser-,ed
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Say It Strong
Mirror, mirror on the wall. Saying positive things will help you feel tall. Write statements of praise and
encouragement in the mirror below. Recite these phrases daily to help set a positive mindset.
14 ■ Copyright © L Ph,fer, A Crowder, T Elsenratt. R Hull. CBT Toolbox For Children & Adolescents All Rights Reserved