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Should cognitive behavioral therapy be taught in school?
This modern therapy technique has been shown to be effective and easy to learn — could teaching it to students help cut off a growing mental health crisis?
- Adolescents are experiencing higher rates of mental disorders than ever before.
- One possible solution to this crisis would be to teach students cognitive behavioral therapy, an effective, modern therapeutic technique that focuses on addressing "distorted" thinking.
- What are the arguments for and against teaching cognitive behavioral therapy in school?
Nearly half of all young people aged 13 to 18 have experienced some form of mental disorder in their lifetime, whether that be depression, anxiety, substance abuse, or other disorders, with 27.6 percent experiencing severe impairment from that disorder. What's more, in the years between 2005 and 2017 (the most recent year for which data is available), the rates of major depression among teens aged 12 to 17 increased by 52 percent.
We could attribute this jump in mental health disorders as the result of a generation that's more aware of and comfortable talking about mental illness, but there's also been a corresponding increase in suicide attempts — presumably, a generation that is more open about their mental health would attempt suicide less or at the same rate, not more. A reasonable conclusion is that our young people are becoming more prone to mental disorders.
We could blame this on a toxic political environment, a dismal future threatened by climate change, too much screen time, too many participation trophies, or any number of things, but it's far more practical to focus instead on solutions. One such solution to this mental health crisis could be to teach cognitive behavioral therapy (CBT) in schools.
What is CBT?
CBT is the first-line treatment for a number of mental disorders, including PTSD, depression, and anxiety. In essence, CBT asserts that distorted thinking gives rise to changes in behavior and affect and that by changing our relationship with those distorted thoughts, we can change our behavior. In an interview with Big Think, New York University professor Jonathan Haidt said, "CBT is just a way of teaching people skills … to question their feelings, to look for evidence."
So in CBT you learn the names of these distortions, about 15 or so distortions. You can guess what they mean: catastrophizing; black-and-white thinking; labeling; mind reading. These are the things that depressed and anxious people do a lot. … All of us have had experience with these. One thing I like to think about is Homer Simpson saying, "Shut up, brain, or I'll stab you with a Q-tip!" Our brains do this. Our brains go on and on, and we're like stop it, stop it, stop it! Well, CBT is a way of stopping it.
Unlike psychoanalysis, where the therapist attempts to identify the issues in a patient's unconscious that gives rise to their mental disorder, CBT is very much a collaborative work between the therapist and the patient. In CBT, patient and therapist work together to identify instances of distorted thinking, what parts of that distorted thought can be changed, and how best to do so. In short, many of the skills used in CBT can be taught.
What are the benefits and downsides to CBT?
Half of all mental disorders arise before the mid-teens, so teaching young people the skills that CBT offers could be a powerful way of addressing mental health concerns before they become seriously problematic. CBT has been shown to be highly effective for depression, anxiety, and other disorders that commonly arise in young people. What's more, it's a very quick method of therapy that takes months rather than years.
That being said, CBT is not without its criticisms. For one, many psychologists criticize it as being too focused on treating the symptoms of mental illness rather than the underlying cause. As a result, some critics claim that CBT is only effective in the short-term. Additionally, evidence suggests that CBT can be more or less effective depending on the nature of the mental disorder. Ultimately, CBT is likely most effective when it is used as a component of a more comprehensive treatment plan.
Three ways to teach CBT in schools
However, there is some research to suggest that teaching CBT in schools could be beneficial, such as the Preventing Anxiety in Children through Education in Schools (PACES) randomized control trial. In this study, 1,257 students across 45 schools were tested for anxiety and depression. Then, all students (regardless of their mental status) were randomly assigned to receive either no treatment or a CBT intervention consisting of nine separate hour-long sessions administered by either trained teachers or mental health professionals. They found that when the CBT sessions were delivered by a mental health professional, students' anxiety and depression improved considerably, though this was not the case when trained teachers delivered the CBT lessons. Since the teachers were only given a two-day training seminar prior to delivering the CBT lessons, it could be argued that CBT simply requires more training to deliver effectively.
The PACES study implemented a universal CBT program, meaning that the curriculum was taught to all students regardless of their mental health status. While this would teach emotional management skills to all students and ensure that none fell through the cracks, it does raise the issue of how we could expect schools to implement a CBT curriculum when student schedules are already packed with core subjects and extracurriculars.
But a universal CBT program is just one of three possible paradigms. School systems could implement targeted interventions, where only at-risk students are provided CBT sessions, either in a class, a small group, or individually. While these have the advantage of being easier to fit into a busy school day, they also run the risk of encouraging stigmatization and failing to reach some students who could in fact benefit from CBT.
The third option would be an intensive CBT intervention, in which only those students with the greatest difficulties are offered CBT sessions and only in small groups or individually. Under this regime, outside agencies may also assist or oversee CBT sessions.
The evidence for all of these methods show that, in general, CBT is at least as effective as medication or other therapeutic techniques. A CBT curriculum in school could be set up in according to one of these paradigms, or it could use a combination of all three. But when we look at the statistics of mental health issues in children and adolescents, it's clear that we should consider whether we should start teaching students how to think well rather than merely what to think about.
Educators and administrators must build new supports for faculty and student success in a world where the classroom might become virtual in the blink of an eye.
- If you or someone you know is attending school remotely, you are more than likely learning through emergency remote instruction, which is not the same as online learning, write Rich DeMillo and Steve Harmon.
- Education institutions must properly define and understand the difference between a course that is designed from inception to be taught in an online format and a course that has been rapidly converted to be offered to remote students.
- In a future involving more online instruction than any of us ever imagined, it will be crucial to meticulously design factors like learner navigation, interactive recordings, feedback loops, exams and office hours in order to maximize learning potential within the virtual environment.
A leading British space scientist thinks there is life under the ice sheets of Europa.
- A British scientist named Professor Monica Grady recently came out in support of extraterrestrial life on Europa.
- Europa, the sixth largest moon in the solar system, may have favorable conditions for life under its miles of ice.
- The moon is one of Jupiter's 79.
Neil deGrasse Tyson wants to go ice fishing on Europa<div class="rm-shortcode" data-media_id="GLGsRX7e" data-player_id="FvQKszTI" data-rm-shortcode-id="f4790eb8f0515e036b24c4195299df28"> <div id="botr_GLGsRX7e_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/GLGsRX7e-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/GLGsRX7e-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/GLGsRX7e-FvQKszTI.js"></script> </div>
Water Vapor Above Europa’s Surface Deteced for First Time<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="9c4abc8473e1b89170cc8941beeb1f2d"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/WQ-E1lnSOzc?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
A study finds people are more influenced by what the other party says than their own. What gives?
- A new study has found evidence suggesting that conservative climate skepticism is driven by reactions to liberal support for science.
- This was determined both by comparing polling data to records of cues given by leaders, and through a survey.
- The findings could lead to new methods of influencing public opinion.
Mind the cues<div class="rm-shortcode" data-media_id="CabkeAzx" data-player_id="FvQKszTI" data-rm-shortcode-id="169377c88f392a86f6c42180b74820a5"> <div id="botr_CabkeAzx_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/CabkeAzx-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/CabkeAzx-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/CabkeAzx-FvQKszTI.js"></script> </div> <p>The gulf in accepting the science behind climate change also exists among party elites. It is well known to any American who is attentive to the news, as party leaders are often more than willing to discuss their take to journalists.</p><p>Using polling data going back to the 1980s, the researchers were able to create a chart showing the aggregate amount of climate skepticism among the general population. A similar diagram showing the Republicans' skepticism dating back to 2001 was sourced from a previous, similar study. It was shown to be highly correlated with the one produced for this study.</p><p>These charts were compared with media content from prominent newspapers that included implicit or explicit stances on climate change by significant political figures. These thousands of articles were classified by using key terms and which major political figures were quoted or referenced. The researchers compared the number of cues over time to measured skepticism and looked for "<a href="https://en.wikipedia.org/wiki/Granger_causality" target="_blank">Granger causality</a>," the tendency for one variable to predict the future value of another variable.</p><p>The model shows evidence of both in and out-group cue effects, though the repulsion to out-group cues was much more evident. A significant increase in Democratic cues in favor of climate science was followed by a rise in skepticism among Republican voters. Importantly, the cues lead, rather than follow opinion, and do so with consistency. Changes in view did not predict changes in the number or direction of cues. </p><p>The researchers also surveyed nearly 3000 adults to demonstrate the concept. This involved showing them a statement on the scientific consensus around climate change and a cue from either a Republican or a Democrat. This test confirmed the previous observation and provided further support for the notion that signals from leaders cause an increase in skepticism among some respondents.</p><p>Before my left-leaning and Democratic readers get too smug, this research references previous studies demonstrating a similar effect in the lead up to the Iraq War. However, in that case, the Democratic Party elites' mixed messages were countered by a Republican Party united behind the idea of invasion. The effect on the Democratic party rank and file was similar to that observed in this case. </p><p>Several other studies have examined effects similar to this for other issues. This study's importance is its focus on out-group cues and the effort placed into demonstrating a causal relationship between the statements of certain party elites and public opinion. Most previous studies focused purely on in-group cues or failed to differentiate between the two. </p>
Can thinking about the past really help us create a better present and future?
- There are two types of counterfactual thinking: upward and downward.
- Both upward and downward counterfactual thinking can be positive impacts on your current outlook - however, upward counterfactual thinking has been linked with depression.
- While counterfactual thinking is a very normal and natural process, experts suggest the best course is to focus on the present and future and allow counterfactual thinking to act as a motivator when possible.
“Upward” versus “downward” counterfactual thinking<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzQ1NDYxOS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NDM2MDY2OX0.njWs1qrV1vDBxU1V75tUduUW4TjJvEHglDWsK8ZF2l4/img.jpg?width=1245&coordinates=0%2C556%2C0%2C209&height=700" id="a15fa" class="rm-shortcode" data-rm-shortcode-id="98314d4d2b256ed08f42d369fe4ae080" data-rm-shortcode-name="rebelmouse-image" alt="concept of man thinking about the past one line drawing counterfactual thinking" />
What are upward and downward counterfactual thinking?
Image by one line man on Shutterstock<p><strong>What is upward counterfactual thinking?</strong></p><p>Upward counterfactual thinking happens when we look at a scenario and ask ourselves "what if" in terms of how our life could have turned out better. </p><p>Examples of upward counterfactual thinking are: </p><ul><li><em>"I wish I had taken that other job instead of this one 10 years ago - my life would be so much better if I had." </em></li><li><em>"I wish I would have gotten the part in that high school play, maybe I could have gotten into a theatre school and became an actor…"</em> </li></ul><p>Both of these examples have the ideology that if you had made different choices, your life right now would be improved. </p><p><strong>What is downward counterfactual thinking?</strong></p><p>Downward counterfactual thinking is, naturally, the opposite of upward counterfactual thinking in that we think about how things could have been worse if other decisions had been made. </p><p>Examples of downward counterfactual thinking are: </p><ul><li><em>"I'm so thankful I studied secondary education in university instead of psychology like I had originally planned - I love teaching high school kids and I never would have gotten to do that…" </em></li><li><em>"I'm so happy I left David when I got the chance, I can't imagine still being in an unhappy marriage with someone who doesn't support me…"</em> </li></ul><p>In these examples, we see the idea that if you had made different choices your life would not be as good as it is right now. </p>
How counterfactual thinking can impact your life<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzQ1NDYxNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNjI2MDQxOX0.DIVQ-Yk0d6yE3tc743MH1Fz2pOg1TGHLmhp8dPp9UdY/img.jpg?width=1245&coordinates=0%2C0%2C0%2C0&height=700" id="522d7" class="rm-shortcode" data-rm-shortcode-id="da7df6ad916b043e3610223900d0f8df" data-rm-shortcode-name="rebelmouse-image" alt="man thinking what if written on chalkboard" />
How do upward and downward counterfactual thinking impact your life?
Photo by Brasil Creativo on Shutterstock<p>While many people don't see the point in "what if" scenarios, various studies have found that downward counterfactual thinking can be more associated with psychological health compared with upward counterfactual thinking. Not only that, but research has also shown upward counterfactual thinking can be linked with current and future depression.</p> <p><strong>Downward counterfactual thinking tends to be more associated with psychological health </strong></p><p>According to a <a href="http://journal.sjdm.org/jdm06136.pdf" target="_blank">2000 study</a>, downward counterfactual thinking can be linked with better psychological health compared to upward counterfactual thinking. More importantly, in cases where downward counterfactual thinking did lead to negative feelings, those feelings acted as something of a motivator for people to take productive actions to better their current situation. </p> <p><strong>Upward counterfactual thinking tends to be more associated with depression </strong></p><p><a href="https://www.sciencedirect.com/science/article/abs/pii/S0272735816301714#:~:text=An%20upward%20counterfactual%20(as%20opposed,Markman%20and%20McMullen%2C%202003)." target="_blank">According to a 2017 study</a> that pooled a sample of over 13,000 respondents, thoughts about "better outcomes" and regret (upward counterfactual thinking) were associated with current and future depression. </p> <p><strong>Downward counterfactual thinking can actually improve your relationships and is more often engaged in by women than men.</strong></p><p>In a <a href="https://dspace.sunyconnect.suny.edu/bitstream/handle/1951/67589/Studer_Thesis.pdf?sequence=1&isAllowed=y" target="_blank">2016 research paper submitted</a> to the Department of Psychology at the State University of New York at New Paltz, downward counterfactual thinking in regards to romantic relationships was associated with relatively positive relationship outcomes. Interestingly, women were more likely than men to engage in downward counterfactual thinking about their romantic life. </p> <p><strong>Upward counterfactual thinking can have some benefits in certain scenarios. </strong></p><p>When we look back after a failed test and think "I wish I would have studied more" - this motivates us to study harder the next time a test comes up. In this way, upward counterfactual thinking (or the negative version of "what if") can actually benefit us. </p> <p><strong>This can be difficult, though, because much of the time upward counterfactual thinking is more associated with a pessimistic outlook that can be unmotivating. </strong></p> <p>Thinking in the past tense can be motivational (and even healthy) at times, but the best thing to do is look forward. </p><p>While counterfactual thinking as a whole can be used to motivate us to make better choices or appreciate where we are in life, <a href="https://www.psychologytoday.com/us/blog/darwins-subterranean-world/201809/the-psychology-what-if" target="_blank">this Psychology Today</a> article suggests that we should come up with ways to move on and focus on the present and the future instead of the past. Using counterfactual thinking as a motivational tool can be very helpful if we don't get stuck in the "what if" mindset that tends to pull us out of the present and back into the past, where things will always remain the same. </p>