Acceptance and Commitment Therapy (ACT): ACT is a type of therapy based on the idea that much human suffering comes from struggling against our feelings, avoiding them, etc. and that if we can accept our feelings and commit to our values (i.e., acting in ways that are in line with what we care about) we will feel better and move towards a life that is fulfilling. ACT is an evidence-based treatment for many mental health concerns, including depression and anxiety.
Behavior Therapy: Behavior Therapy (BT) is a type of therapy based on behavioral principles (e.g., rewards, reinforcement, consequences, shaping). Some classic examples of these principles that many people are familiar with are Pavlov’s dogs who were trained to salivate at the sound of a bell and Skinner’s pigeons who developed superstitious behaviors. With humans, behavior therapy is used to make changes to an environment or interaction with goals like reinforcing behaviors that we want to increase and reducing reinforcement of behaviors that we want to decrease. For example, if a child is biting their nails when they are nervous, behavior therapy might help a child to develop alternative coping strategies that would result in a reduction of anxiety (e.g., playing with a fidget toy) without causing damage to their body.
Behavioral Activation: Behavioral activation refers to doing something actively rewarding (e.g., going for a walk, cleaning one’s room, playing a game) in order to address fatigue and low mood that are a part of many people’s experience of depression. It is an evidence-based component of cognitive-behavioral depression treatment. The idea is that if we can get ourselves to do something active or productive, even if it doesn’t sound good in the moment, it often results in improved mood.
Cognitive Behavioral Therapy (CBT): CBT is based on the idea that our thoughts (cognitions) and behaviors contribute to our feelings and that if we shift our thinking and behaviors to be more accurate and helpful, we’ll feel better. For example, if I make a mistake, and I think, “I never do things right,” I’ll feel pretty bad about myself, but if I recognize that this is probably an overgeneralization, and I think instead, “well, that’s embarrassing, I’ll try to be more careful next time,” I’ll probably feel a little better. CBT is a widely-used evidence-based treatment for many mental health concerns, including depression and anxiety.
Cognitive Restructuring: This is a core aspect of Cognitive Behavioral Therapy (CBT). It refers to the skill of recognizing patterns in thinking that are unhelpful and/or inaccurate (e.g., black-and-white thinking, catastrophizing) and learning to shift those thoughts to be more accurate and more helpful.
Diaphragmatic Breathing: Also known as belly breathing or taking deep breaths. It’s a major tool in emotion regulation (anger management, anxiety reduction, etc) and helps to down-regulate our nervous systems.
Effective Communication: This refers to a set of skills required to effectively communicate with others. It includes skills such as expressing one’s feelings and needs, requesting changes, conveying empathy, and resolving conflicts.
Emotional Literacy: This refers to the skills of being able to identify, name, and understand one’s own feelings as well as others'. There’s a saying in the child therapy world, “To name it is to tame it.” Being able to recognize and name and understand feelings is an important strategy for emotion regulation and for effective communication with others.
Emotional Processing: This refers to the process of feeling, understanding, and expressing one’s emotions. Emotional processing can occur via play, art, writing, speaking, or any other modality that resonates with a person. Emotional processing often helps people to cope with difficult or uncomfortable emotions, such as sadness and grief.
Emotion Regulation: When we feel a strong emotion (e.g., angry, frightened), our bodies react in kind by engaging our fight, flight, or freeze response (e.g., by speeding up our heart rate and breathing, tensing up our bodies, putting our senses on high alert). Emotional dysregulation occurs when this response doesn’t fit the situation or gets in the way of our ability to react in a useful way. Emotion regulation refers to the process of calming our brains and/or bodies (e.g., by taking deep breaths, talking with a trusted person).
Evidence-Based Practice (EBP): This refers to a treatment component that has been standardized and studied in large groups of people, usually in clinical trials comparing it to a control group, and has been determined to be effective at significantly reducing symptoms in many people.
Expectancy Violation: This is a component of evidence-based treatment for anxiety. Expectancy refers to one’s prediction (e.g., that if I ask for help, the teacher will seem annoyed), and violation refers to the outcome going differently than predicted (e.g., I ask for help, and the teacher is actually really nice about it). Our brains learn really well with this type of experience–much better than just thinking through a hypothetical. Other types of important expectancy violations are something being less bad than one thinks it will be, and finding oneself to be more resilient or able to cope than one predicted.
Exposure and Response Prevention (ERP): This is the gold-standard evidence-based treatment for OCD. It consists of exposure to a feared thought, feeling, or situation (e.g., touching a surface feared to be contaminated) and prevention of a compulsive response (e.g., not engaging in a hand washing ritual). In OCD our brains believe that a compulsive behavior is keeping us safe from a feared thought/ uncomfortable feeling/ bad outcome (even if it really isn’t!). The idea of ERP is essentially to prove that connection wrong by delaying or eliminating the compulsion so the person with OCD is able to experience a lack of feared outcome (e.g., not getting sick) despite exposure to the feared thought or feeling (e.g., touching a surface that the person fears is contaminated). In ERP, we create a hierarchy of challenges (i.e., feared thoughts, situations, feelings) from easiest to most difficult, and we start with something that feels a little scary but doable. The child (or adult) “levels up” as they adjust to different challenges.
Exposure: Exposure is foundational in the evidence-based treatment of anxiety. It refers to the process of a person gradually exposing themselves to the object/activity/situation/feeling that makes them anxious so that their brain and body have a chance to react and then realize that the feared outcome did not occur or that they are able to cope. For example, if a person is afraid of dogs biting and avoids them, this person will continue to believe that if they get close to a dog, the dog will bite. If, one day while they are engaging in exposure therapy, instead of avoiding dogs, they approach a dog (ideally a friendly one), they are very likely to feel quite anxious! But if that dog then nuzzles their leg and wags her tail, over the next few minutes, it is likely that the person’s anxiety will go down as they realize the feared outcome isn’t likely to occur. Even if their anxiety doesn’t go down over the course of their interaction with the dog, they will still realize that they were able to tolerate the anxiety, and their brains still experienced a potent expectancy violation (see definition above). If they repeat this exposure enough times, they are likely to get to a point where they are only a bit nervous around dogs, or maybe not scared at all! In Exposure Therapy, we create a hierarchy of challenges (e.g., watching YouTube videos of dogs, walking past dogs on leashes at a distance, getting close to a dog but not touching, giving a dog a treat) from easiest to most difficult, and we start with something that feels a little scary but doable. The child “levels up” as they adjust to different challenges.
Growth Mindset: Growth mindset is a concept popularized by psychologist Carol Dweck, Ph.D. It has been very influential in educational systems as a means of supporting children’s attitude toward learning. Growth mindset refers to the belief that one’s skills can be developed with effort and practice, in contrast to a fixed mindset which refers to the belief that one’s skills are based on talent or innate intelligence. The more of a growth mindset a child has, the more likely they are to see mistakes and failures as stepping stones to success rather than indicators of their incompetence, and the more likely they are to keep trying and to take on challenges, rather than giving up when they aren’t immediately successful or sticking to tasks they already know how to do.
Medication: Many children and adults with mental health diagnoses benefit from taking medication to reduce their symptoms (e.g., to improve mood, reduce anxiety, improve attention). In fact, many studies have shown that a combination of medication and therapy is most effective at reducing symptoms for many people. Every person is different, though, and there is no one-size-fits-all recommendation here. Psychiatrists, pediatricians/physicians, and psychiatric nurse practitioners can prescribe these medications.
Mindfulness: Mindfulness refers to different techniques for focusing on the present (rather than the past, as in rumination, or the future, as in worrying). It can be a useful relaxation and regulation strategy. It’s also really important in getting in touch with our feelings in order to listen to them, as well as developing a sense of which thoughts are worth listening to and acting on and which are not. Mindfulness can help us to realize that our thoughts and feelings are not always the absolute truth (sometimes our brains play tricks on us!) and that we can make choices about how we react to a thought or feeling.
Progressive Muscle Relaxation: This is a technique that is used to relax one’s muscles. When we are angry or anxious, our muscles often tighten up, and it can be difficult to relax them on demand. In addition to reducing muscle pains and headaches, relaxing one’s body can cause one’s brain to be more relaxed too (i.e., less anxious, fewer worries, less agitated). In Progressive Muscle Relaxation (PMR) a child (or adult) squeezes different muscle groups (e.g., feet and calves, stomach and buttocks, chest and shoulders, etc.) for five to ten seconds and then relaxes them, often starting with feet muscles and moving up to face muscles. Here’s a YouTube video by GoZen that walks a child through this skill. PMR can be particularly helpful in facilitating relaxation before bedtime, but it works at any time of day!
Psychoeducation: Knowledge is power! Psychoeducation is the provision of psychologically-relevant factual information (e.g., many people with depression feel more tired than usual, even if they get a full night’s sleep). Psychoeducation can correct misconceptions children have about themselves or others, help children know what to expect, and reduce the unknowns of a situation.
Relaxation: Relaxation generally refers to anything that reduces activation (e.g., as in anger, agitation, frustration, anxiety, stress). There are relaxation strategies that relax a child’s mind , such as mindfulness, “imagination vacations,” and listening to calming music, and body, such as taking deep breaths, progressive muscle relaxation (described above), drinking a cup of tea, playing with putty, and going for a walk. When our minds are more relaxed, our bodies follow, and when our bodies are more relaxed, our minds follow. Children often benefit from having a relaxation “toolkit” that they can turn to when they need to calm their bodies and minds.
Self-Soothing: This refers to a set of skills to help children to cope with and tolerate uncomfortable feelings (e.g., sadness, grief, frustration) in a safe, healthy way. What counts as Self-Soothing varies from person to person, but it can include activities like drawing or art, hugging a stuffed animal, snuggling with a pet, and asking for a hug.
Sleep Hygiene: This term refers to a set of best practices to increase sleep quality. It includes things like going to bed at a regular time and removing electronic devices from the bedroom.
Specific Praise: This refers to a style of praising a child’s specific behaviors, rather than general traits. For example, rather than saying to a child, “You’re so helpful,” a specific praise might be, “I love how you held the door open for me when my hands were full!” Psychological research suggests that specific praise is particularly useful when a behavior change is desired. It is often more effective for parents and caregivers to use specific praise to reinforce moments when a child engages in a desired behavior, no matter how briefly (e.g., “Wow! I just noticed that you gave your sister a turn even though I could tell you were really having fun with that toy!"), rather than using criticsm to punish non-desired behaviors (“Amelia, you’re being greedy!"). Specific praise is more pleasant for everyone, better for relationships, and actually more likely to result in positive behavior change!
Visualization: This refers to the practice of picturing something in as much detail as possible, often including other sensory details in addition to visuals (e.g., sounds, smells). It is used as an aspect of exposure therapy (see above), sports/performance psychology, and relaxation. When we visualize something, our brains are activated in ways that are surprisingly similar to when we actually experience something.