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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.
Evolution doesn't clean up after itself very well.
- An evolutionary biologist got people swapping ideas about our lingering vestigia.
- Basically, this is the stuff that served some evolutionary purpose at some point, but now is kind of, well, extra.
- Here are the six traits that inaugurated the fun.
The plica semilunaris<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgwMS9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY3NDg5NTg1NX0.kdBYMvaEzvCiJjcLEPgnjII_KVtT9RMEwJFuXB68D8Q/img.png?width=980" id="59914" width="429" height="350" data-rm-shortcode-id="b11e4be64c5e1f58bf4417d8548bedc7" data-rm-shortcode-name="rebelmouse-image" />
The human eye in alarming detail. Image source: Henry Gray / Wikimedia commons<p>At the inner corner of our eyes, closest to the nasal ridge, is that little pink thing, which is probably what most of us call it, called the caruncula. Next to it is the plica semilunairs, and it's what's left of a third eyelid that used to — ready for this? — blink horizontally. It's supposed to have offered protection for our eyes, and some birds, reptiles, and fish have such a thing.</p>
Palmaris longus<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgwNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzMzQ1NjUwMn0.dVor41tO_NeLkGY9Tx46SwqhSVaA8HZQmQAp532xLxA/img.jpg?width=980" id="879be" width="1920" height="2560" data-rm-shortcode-id="4089a32ea9fbb1a0281db14332583ccd" data-rm-shortcode-name="rebelmouse-image" />
Palmaris longus muscle. Image source: Wikimedia commons<p> We don't have much need these days, at least most of us, to navigate from tree branch to tree branch. Still, about 86 percent of us still have the wrist muscle that used to help us do it. To see if you have it, place the back of you hand on a flat surface and touch your thumb to your pinkie. If you have a muscle that becomes visible in your wrist, that's the palmaris longus. If you don't, consider yourself more evolved (just joking).</p>
Darwin's tubercle<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgxMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0ODUyNjA1MX0.8RuU-OSRf92wQpaPPJtvFreOVvicEwn39_jnbegiUOk/img.jpg?width=980" id="687a0" width="819" height="1072" data-rm-shortcode-id="ff5edf0a698e0681d11efde1d7872958" data-rm-shortcode-name="rebelmouse-image" />
Darwin's tubercle. Image source: Wikimedia commons<p> Yes, maybe the shell of you ear does feel like a dried apricot. Maybe not. But there's a ridge in that swirly structure that's a muscle which allowed us, at one point, to move our ears in the direction of interesting sounds. These days, we just turn our heads, but there it is.</p>
Goosebumps<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMxNC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNzEyNTc2Nn0.aVMa5fsKgiabW5vkr7BOvm2pmNKbLJF_50bwvd4aRo4/img.jpg?width=980" id="d8420" width="1440" height="960" data-rm-shortcode-id="8827e55511c8c3aed8c36d21b6541dbd" data-rm-shortcode-name="rebelmouse-image" />
Goosebumps. Photo credit: Tyler Olson via Shutterstock<p>It's not entirely clear what purpose made goosebumps worth retaining evolutionarily, but there are two circumstances in which they appear: fear and cold. For fear, they may have been a way of making body hair stand up so we'd appear larger to predators, much the way a cat's tail puffs up — numerous creatures exaggerate their size when threatened. In the cold, they may have trapped additional heat for warmth.</p>
Tailbone<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMxNi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY3MzQwMjc3N30.nBGAfc_O9sgyK_lOUo_MHzP1vK-9kJpohLlj9ax1P8s/img.jpg?width=980" id="9a2f6" width="1440" height="1440" data-rm-shortcode-id="4fe28368d2ed6a91a4c928d4254cc02a" data-rm-shortcode-name="rebelmouse-image" />
Image source: Decade3d-anatomy online via Shutterstock<p>Way back, we had tails that probably helped us balance upright, and was useful moving through trees. We still have the stump of one when we're embryos, from 4–6 weeks, and then the body mostly dissolves it during Weeks 6–8. What's left is the coccyx.</p>
The palmar grasp reflex<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMyMC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjY0MDY5NX0.OSwReKLmNZkbAS12-AvRaxgCM7zyukjQUaG4vmhxTtM/img.jpg?width=980" id="8804c" width="1440" height="960" data-rm-shortcode-id="67542ee1c5a85807b0a7e63399e44575" data-rm-shortcode-name="rebelmouse-image" />
Palmar reflex activated! Photo credit: Raul Luna on Flickr<p> You've probably seen how non-human primate babies grab onto their parents' hands to be carried around. We used to do this, too. So still, if you touch your finger to a baby's palm, or if you touch the sole of their foot, the palmar grasp reflex will cause the hand or foot to try and close around your finger.</p>
Other people's suggestions<p>Amir's followers dove right in, offering both cool and questionable additions to her list. </p>
Fangs?<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Lower mouth plate behind your teeth. Some have protruding bone under the skin which is a throw back to large fangs. Almost like an upsidedown Sabre Tooth.</p>— neil crud (@neilcrud66) <a href="https://twitter.com/neilcrud66/status/1085606005000601600?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Hiccups<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Sure: <a href="https://t.co/DjMZB1XidG">https://t.co/DjMZB1XidG</a></p>— Stephen Roughley (@SteBobRoughley) <a href="https://twitter.com/SteBobRoughley/status/1085529239556968448?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Hypnic jerk as you fall asleep<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">What about when you “jump” just as you’re drifting off to sleep, I heard that was a reflex to prevent falling from heights.</p>— Bann face (@thebanns) <a href="https://twitter.com/thebanns/status/1085554171879788545?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script> <p> This thing, often called the "alpha jerk" as you drop into alpha sleep, is properly called the hypnic jerk,. It may actually be a carryover from our arboreal days. The <a href="https://www.livescience.com/39225-why-people-twitch-falling-asleep.html" target="_blank" data-vivaldi-spatnav-clickable="1">hypothesis</a> is that you suddenly jerk awake to avoid falling out of your tree.</p>
Nails screeching on a blackboard response?<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Everyone hate the sound of fingernails on a blackboard. It's _speculated_ that this is a vestigial wiring in our head, because the sound is similar to the shrill warning call of a chimp. <a href="https://t.co/ReyZBy6XNN">https://t.co/ReyZBy6XNN</a></p>— Pet Rock (@eclogiter) <a href="https://twitter.com/eclogiter/status/1085587006258888706?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Ear hair<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Ok what is Hair in the ears for? I think cuz as we get older it filters out the BS.</p>— Sarah21 (@mimix3) <a href="https://twitter.com/mimix3/status/1085684393593561088?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Nervous laughter<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">You may be onto something. Tooth-bearing with the jaw clenched is generally recognized as a signal of submission or non-threatening in primates. Involuntary smiling or laughing in tense situations might have signaled that you weren’t a threat.</p>— Jager Tusk (@JagerTusk) <a href="https://twitter.com/JagerTusk/status/1085316201104912384?ref_src=twsrc%5Etfw">January 15, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Um, yipes.<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Sometimes it feels like my big toe should be on the side of my foot, was that ever a thing?</p>— B033? K@($ (@whimbrel17) <a href="https://twitter.com/whimbrel17/status/1085559016011563009?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
A new study looks at how images of coffee's origins affect the perception of its premiumness and quality.
Research has shown how important empathy is to relationships, but there are limits to its power.
- Empathy is a useful tool that allows humans (and other species) to connect and form mutually beneficial bonds, but knowing how and when to be empathic is just as important as having empathy.
- Filmmaker Danfung Dennis, Bill Nye, and actor Alan Alda discuss the science of empathy and the ways that the ability can be cultivated and practiced to affect meaningful change, both on a personal and community level.
- But empathy is not a cure all. Paul Bloom explains the psychological differences between empathy and compassion, and how the former can "get in the way" of some of life's crucial relationships.