Cognitive behavioural therapy (CBT) for young people (Cognitive behavioural therapy for children and adolescents)
A practical, evidence-based talking therapy that helps a child or young person understand the links between thoughts, feelings and behaviour, and learn skills to manage problems like anxiety and low mood.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- CBT is a practical, NICE-recommended talking therapy that helps a young person change unhelpful links between thoughts, feelings and behaviour, used for anxiety, low mood, OCD and PTSD.
- It is active and gradual: most progress comes from practising skills between sessions, so it takes effort and is not an instant fix.
- Look for a properly trained, accredited therapist (for example BABCP) experienced with young people; CBT is available on the NHS via GP and CAMHS, and privately.
- If a young person talks about self-harm or not wanting to be here, get help: 999 or A&E in an emergency; Samaritans 116 123; Papyrus HOPELINE247 0800 068 4141; text SHOUT to 85258. For urgent mental-health support, call 111 and choose the mental-health option where it is offered in England, Scotland or Wales; in Northern Ireland call Lifeline on 0808 808 8000.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your psychiatrist will give you advice for your situation.
An evidence-based, NICE-recommended treatment for anxiety, low mood, OCD and PTSD in young people
In an emergency or where there is immediate risk, which needs urgent help rather than routine therapy.
Understanding the difficulty, setting goals, and building a shared picture of what keeps the problem going. Skills work begins.
Regular review of progress, safety and goals during therapy.
Understanding the difficulty, setting goals, and building a shared picture of what keeps the problem going. Skills...
Most progress comes from home practice and small real-life experiments. Difficult feelings may rise at first...
Skills build and symptoms usually ease. Goals are reviewed and adjusted as things improve.
Any medication works alongside therapy under appropriate care, is monitored, and is never stopped abruptly.
What is cognitive behavioural therapy (CBT) for young people?
Cognitive behavioural therapy (CBT) is a practical talking therapy. It helps a child or young person notice the links between their thoughts, feelings, body sensations and what they do, and to learn skills to change unhelpful patterns.
CBT is recommended by NICE as a first-line treatment for a range of common difficulties in young people, including anxiety, low mood and depression, obsessive-compulsive disorder (OCD), and post-traumatic stress. Rather than just talking about the past, it focuses on understanding what keeps a problem going now and on practical steps to feel and cope better.
It is important to set realistic expectations. CBT is an active therapy: most of the progress comes from practising new skills between sessions, not from the sessions alone. It is not an instant fix, it takes effort, and a young person usually needs to be reasonably ready to take part. It is also not the right answer for every problem or every child.
For children, parents or carers are often involved, especially with younger ones. The therapy is adapted to a young person's age and stage, often using games, drawings, stories and everyday examples.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Low-intensity, guided CBT
Shorter, guided self-help or digital CBT for milder anxiety or low mood, often delivered by trained wellbeing practitioners with support.
Standard (high-intensity) CBT
Regular one-to-one sessions with a CBT therapist for moderate difficulties such as anxiety disorders, depression, OCD or PTSD.
Group CBT
CBT delivered in a group of young people with similar difficulties, which NICE recommends as an option, for example for social anxiety.
Family-involved CBT
CBT that actively involves parents or carers, particularly for younger children or where family responses affect the problem.
Preparing for your programme
- If a young person is in crisis or unsafe, treat that first with 999 or A&E; therapy is not for emergencies.
- Start with the GP, who can assess and refer to therapy or CAMHS, or you can explore private therapy.
- Check the therapist is properly trained and accredited (for example BABCP accreditation for CBT) and experienced with young people.
- Note the main difficulties, how long they have lasted, and what makes them better or worse.
- Bring a list of any medicines, other professionals involved, and previous reports or therapy.
- Involve your child in the decision; CBT works best when they are reasonably willing to take part.
- Be ready to support home practice between sessions, which is where most progress happens.
What happens
CBT usually starts with an assessment to understand the difficulty, set goals, and check it is the right therapy. The therapist and young person then build a shared picture of what keeps the problem going: the thoughts, feelings, body sensations and behaviours that feed into each other.
From there, the work is practical and structured. For anxiety, this often means gradually facing feared situations with support (exposure) and learning to manage worried thoughts and physical symptoms. For low mood, it may mean gently rebuilding activity and rewarding routines, and challenging harsh or hopeless thinking. For OCD, it often involves resisting compulsions step by step. Sessions are adapted to a young person's age, often using drawings, examples and everyday language.
Between sessions, the young person practises new skills and tries small experiments in real life. This home practice is where most progress comes from. Parents and carers are often involved, especially with younger children, to support practice and changes at home.
Progress is reviewed regularly, with goals adjusted as things improve. Where CBT is combined with medication, the two work alongside each other under appropriate care, and any medication is reviewed and never stopped abruptly.
Is this programme right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- In an emergency or where there is immediate risk, which needs urgent help rather than routine therapy.
- Where a young person is not ready or willing to engage, so the timing or approach needs rethinking.
- As the right therapy for every problem; some difficulties need a different psychological approach or a different kind of help.
- Where an untreated problem driving the difficulty (such as bullying, abuse or a physical illness) needs addressing too.
Delay or rearrange if…
- There is an immediate safety emergency; deal with that first.
- A young person is too unwell or distressed to take part and needs stabilising support first.
- Important information, such as safeguarding concerns or other diagnoses, has not yet been gathered.
- Major upheaval or crisis means a young person cannot engage in active therapy right now.
Alternatives to discuss
- Guided self-help or digital CBT for milder difficulties.
- Other evidence-based psychological therapies (such as family therapy or, for some difficulties, other approaches).
- Medication under specialist care where appropriate, usually alongside therapy.
- Support at school, and help with sleep, routine and activity.
- Watchful waiting with support for mild, recent difficulties.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- An evidence-based, NICE-recommended treatment for anxiety, low mood, OCD and PTSD in young people
- Teaches practical, lasting skills a young person can keep using
- Helps a young person face fears, lift mood, and get back to school, friendships and activities
- Can be delivered individually, in groups, or with family involvement
- Often the first-line option, avoiding or delaying the need for medication
- Gives young people a sense of understanding and control over their difficulties
Risks & complications
- It takes effort and consistent practice between sessions; it is not an instant fix
- Facing fears or difficult feelings can feel uncomfortable before it gets easier
- Symptoms can temporarily rise, for example anxiety when first facing avoided situations
- Sessions and home practice take time and energy
- Not enough benefit from the first approach, needing a change of plan or therapist
- A young person not feeling ready or willing to engage, so timing needs rethinking
- Waiting for therapy where local services are stretched
- Difficult memories or feelings surfacing that need extra support
- Discovery that the problem is more serious or different than first thought, needing other help
The main thing to understand is that CBT is active and gradual: it works through practice, not by talking alone, and feelings can briefly intensify when facing avoided situations, which is part of the process rather than a sign it is failing. Make sure the therapist is properly trained and experienced with young people, that the approach is evidence-based, and ask how progress is measured and what happens if it is not working. If there is any concern about safety, that takes priority over therapy.
Published figures to discuss
Precise success percentages for an individual young person would be misleading, because outcomes depend on the type and severity of the difficulty, how ready a young person is to take part, what else is going on, and how consistently skills are practised. CBT has a strong evidence base and is NICE-recommended for several conditions, but it does not work for everyone and is not guaranteed. A short-term rise in anxiety or difficult feelings when facing avoided situations is expected and is part of effective therapy. Where an SSRI is used alongside, a small number of young people can have an early increase in agitation or suicidal thoughts, which is why monitoring is close.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Temporary distress during therapy tasks | Common | Talking about fears, mood or trauma and practising exposure can feel harder before it feels easier. | Guide sourcesClinical context |
| CBT not matched to diagnosis or development | Recognised | Younger, neurodivergent or traumatised young people may need adapted CBT or a different therapy. | Guide sourcesClinical context |
| Risk escalation missed between sessions | Must be monitored | Self-harm, suicidal thoughts, eating risk or safeguarding concerns need clear crisis routes. | NICE NG134 — Depression in children and young people: identification and managementnice.org.ukSource-linked context |
| No change because practice is not supported | Common practical barrier | CBT usually needs between-session practice and involvement from parents or school when appropriate. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery. 'Afterwards' means putting CBT skills into practice between and after sessions, the gradual progress that builds over weeks, and reviews that keep the therapy on track.
- A temporary rise in anxiety or difficult feelings when first facing avoided situations
- Gradual, uneven progress with better and harder days
- Tiredness after challenging sessions or home tasks
- Needing to repeat and practise skills before they feel natural
- Mixed motivation at times, which the therapist can help with
Aftercare
- Keep practising CBT skills and home tasks between sessions; this is where most progress happens.
- Support gentle, gradual steps rather than removing every challenge for an anxious child.
- If medication is also used, take it as directed, never stop suddenly, and report any early increase in agitation or self-harm thoughts.
- Support good sleep, routine and activity, which all help mood and anxiety.
- Work with school on any practical support that would help.
- Use the relapse-prevention plan and a clear route back to help if difficulties return.
- Keep crisis numbers handy: 999 or A&E for emergencies; Samaritans 116 123; Papyrus HOPELINE247 0800 068 4141; text SHOUT to 85258. For urgent mental-health support, call 111 and choose the mental-health option where it is offered in England, Scotland or Wales; in Northern Ireland call Lifeline on 0808 808 8000, or your GP out-of-hours service.
- Therapy appointments and home practice planned
- Therapist's training and accreditation checked (for example BABCP)
- A few small, agreed steps or tasks to practise
- Medication routine clear, with no sudden stopping, if used
- Warning signs to watch for agreed
- Crisis numbers saved in phones
- A relapse-prevention plan and a route back to help
⚠ Get urgent help if…
- Any talk of suicide, feeling hopeless, or wanting to escape life: call 999 or go to A&E now
- A new or increasing urge to self-harm, especially if also taking medication
- Becoming much more agitated or restless soon after starting or changing an SSRI
- Symptoms getting much worse rather than gradually better over the course of therapy
- Difficult memories or feelings surfacing that feel unmanageable
- Complete withdrawal from friends, school and activities
- For urgent but non-emergency support: Samaritans 116 123, Papyrus HOPELINE247 0800 068 4141 (under 35s), or text SHOUT to 85258. For urgent mental-health help, call 111 and choose the mental-health option where it is offered in England, Scotland or Wales; in Northern Ireland call Lifeline on 0808 808 8000, or your GP out-of-hours service
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your psychiatrist gives you.
Results & realistic expectations
With CBT, many young people see a real reduction in anxiety, low mood or other difficulties, and gain skills they can keep using. A good outcome is meeting the goals set at the start, getting back to school, friendships and activities, and feeling more able to handle worries or low moods in future.
CBT does not work for everyone, and it is not an instant or guaranteed fix. Progress depends on the difficulty, its severity, how ready a young person is to take part, and how consistently skills are practised. Some young people need a different therapy, more sessions, family work, or medication alongside, and difficulties can return at stressful times, which is why a relapse-prevention plan matters.
One of the strengths of CBT is that it teaches lasting skills, so benefits can continue after therapy ends. Even so, anxiety and low mood can return at times of change or stress, such as exams, new schools or family difficulties. A young person who knows their early warning signs and how to use the skills that helped, with a clear route back to support, copes better with future episodes. A short course of further sessions can help if needed.
Related tests, treatments or support
CBT is often used alongside other support: family involvement, work with school, help with sleep and routine, and, for some young people, medication under specialist care. It can be adapted for young people with additional needs such as autism or ADHD, where the pace and style may need adjusting. Where difficulties are severe or there is risk, CBT is one part of a wider plan rather than the only treatment.
Follow-up & long-term care
Young people are reviewed during therapy to check progress, safety and goals, with closer attention if there are any safety concerns or if medication is also used. As things improve, sessions are usually spaced out and ended with a relapse-prevention plan, clear advice on when and how to seek help again, and any onward referral that is needed.
- Keep using CBT skills and facing situations rather than avoiding them
- Brush up skills at known stressful times, such as exams or transitions
- Continue and review any medication as advised, never stopping abruptly
- Maintain sleep, routine and activity
- Use the relapse-prevention plan and a clear route back to help if needed
Repeat, follow-on and what comes next
- If the first approach does not help enough, the plan, format or therapist may be changed.
- Therapy may be combined with family work or medication, or stepped up in intensity.
- Difficulties can return at stressful times, so a relapse-prevention plan and a route back to help are part of care.
- Care is reviewed as a young person grows and may transfer to adult services.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Regular review of progress, safety and goals during therapy.
- A clear home-practice plan, since most progress happens between sessions.
- A named contact and crisis numbers for out of hours.
- A relapse-prevention plan and a clear route back to help.
- School liaison and, where relevant, coordination with any medication and monitoring.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The therapist's training, accreditation and experience with young people
- The number and length of sessions and how often they are held
- Whether therapy is individual, group, or family-involved, and in person or online
- The depth of the initial assessment and any reports
- Whether a psychiatrist is also involved if medication may be needed
- Follow-up sessions and any relapse-prevention work
- The therapist's qualifications and accreditation (for example BABCP) and experience with young people
- How many sessions are recommended, at what frequency, and over what period
- Whether sessions are individual, group or family-involved
- Whether a psychiatrist is involved if medication may be needed
- What assessment, monitoring and review are included
- How urgent concerns are handled out of hours, and the cancellation policy
On the NHS? CBT for young people is available on the NHS through GP and CAMHS routes when clinically indicated; private therapy may be used for choice or speed, with the same evidence-based approach.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that CBT is active and works through practice, not talking alone.
- Not warning that difficult feelings may rise at first when facing avoided situations.
- Not checking the therapist's training, accreditation and experience with young people.
- Failing to mention the early risks of any SSRI used alongside.
- No clear plan for monitoring, review, relapse prevention or who to contact if things worsen.
Marketing red flags
- Promising to 'cure' anxiety or depression, or guaranteeing results.
- Offering CBT from unqualified or unaccredited practitioners.
- One-size-fits-all packages without proper assessment.
- Offering medication to under-18s without specialist assessment and monitoring.
- Discouraging NHS or GP involvement, or downplaying the effort therapy takes.
Choosing a specialist safely
- Check the psychiatrist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good psychiatrist will welcome every one of these.
- Is CBT the right therapy for my child's difficulty, and why?
- What are your qualifications and accreditation, and your experience with young people?
- How many sessions, how often, and how much home practice is involved?
- How and how much will I be involved as a parent?
- How will we know if it is working, and what happens if it is not?
- If medication is considered alongside, what are the benefits, side effects and monitoring?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the psychiatrist who carries out my programme, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this programme not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
What is CBT and how does it work?
What problems is CBT used for in young people?
How long does CBT take to work?
Will my child have to take medication too?
Can we get CBT on the NHS?
Will I be involved as a parent?
What if CBT does not help my child?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE NG134 — Depression in children and young people: identification and management NHS — Cognitive behavioural therapy (CBT) BABCP — What is CBT and finding an accredited therapist YoungMinds — Talking therapies Samaritans — call 116 123 free, any time nidirect — urgent and emergency care services nidirect — GP out-of-hours service NHS England — NHS 111 mental-health crisis support NHS inform (Scotland) — urgent mental-health help NHS 111 Wales — mental health and wellbeing nidirect — mental health emergency / Lifeline (Northern Ireland)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Cognitive behavioural therapy (CBT) referral · Anxiety in children and teenagers · Depression in children and teenagers · Obsessive-compulsive disorder (OCD) in young people · Psychotherapy / talking therapy