School-Counselor Interventions: Cognitive Model
There is general consensus that cognitive therapy is the treatment of choice for school-age children who have been traumatized. 23, 25 The basic assumption of the cognitive model is that there is an interaction among thinking, feeling, and behavior. 26 Therefore, feelings and behavior can be controlled by altering dysfunctional cognitions such as
- black-and-white thinking—"I'm either all good or all bad"
- catastrophizing— "I'll never be safe again"
- overgeneralization— "Danger is everywhere"
- personalization— "It must have been my fault"
When applied to childhood trauma, the goals of cognitive therapy are to help school-age children
- understand the relationship between thoughts, feelings, and behavior
- recognize their own dysfunctional cognitions
- examine evidence for and against their irrational thoughts
- identify alternatives to distorted thinking
- adopt more realistic thoughts that will lead to more stable and positive emotions 23
By helping students articulate and explore the meaning of their trauma, they can begin to reality-test their irrational thoughts about the event. No matter the type of trauma, some students may blame themselves.
For example, victims of incest and rape often feel responsible for their abuse. Convinced that there is no safe place in the world, traumatized children may believe they have no future. Working through these distorted cognitions can help alleviate depression and, in turn, modify behavior problems caused by the trauma. 27
For students who have difficulty expressing their thoughts and feelings verbally, we recommend play therapy. Depending on the student's age and ability, play therapy utilizes board games, sports, and props, such as dollhouses, cars, ambulances, toy people, puppets, and sand trays. These devices allow children to address problem areas they cannot approach directly.
Again, depending on the age of the student, combining play therapy with other techniques, such as limited-exposure therapy, cognitive therapy, anxiety management, and psychoeducation can also be effective. By involving the family in the student's treatment, you reinforce the importance of their support to their child's recovery. In addition, families can provide feedback and insight about the child's family relationships and peer functioning outside the school environment.25