CBT triangle for kids

If you’re a therapist looking for a CBT triangle for kids to help them understand their thoughts, feelings, and actions, these free CBT worksheets for kids can be helpful.

Cognitive behavioral therapy (CBT) is one of the most widely used interventions that therapists use to treat a broad range of mental health issues, and CBT worksheets for kids can be helpful tools for younger clients. 

This guide provides an overview of the CBT triangle for kids, how to use CBT in your practice, and includes a free CBT worksheet for kids to save to your electronic health record (EHR) and use in your practice. 

What is the CBT triangle for kids?

Cognitive behavioral therapy is an evidence-based intervention used for a wide range of clients, including children and adolescents. It’s effective at treating multiple mental health conditions, from anxiety to behavioral problems. 

The CBT triangle, also known as the cognitive triangle, depicts the central concept of cognitive behavioral therapy: the connection between our thoughts, feelings, and actions or behaviors. 

Specifically, the CBT triangle for kids illustrates the following:

1. Thoughts: What we think influences our emotions
2. Feelings: What we feel shapes our thoughts and impacts our behaviors
3. Behaviors: What we do is driven by our thoughts and feelings, which can be a reinforcing pattern

Understanding the relationship between thoughts, feelings, and behaviors helps individuals  modify negative thoughts into more adaptive thoughts and behaviors, leading to a positive impact on their emotions and overall well-being.

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Example techniques and CBT worksheets for kids

When working with children, clinicians may adapt the cognitive triangle for kids, depending on their age. 

Examples of different types of CBT worksheets for kids that may be helpful include:

Cognitive triangle for preschool children 

Instead of using a thoughts, actions, and feelings circle worksheet, therapists might use a worksheet with pictures of people and thought bubbles. 

These illustrations can help children understand their thoughts by asking prompts like “What are you saying to yourself?” or “What is your brain saying?” 

Clinicians might also use images of people involved in different scenarios to help children learn how thoughts, feelings, and actions may change. Alternatively, shapes and arrows can help describe how thoughts influence feelings and behaviors. 

CBT worksheet for school-aged children 

For school-aged children and older, therapists can use a CBT triangle for kids worksheet to describe the interrelationship between thoughts, feelings, and behaviors. 

Clinicians could also use a book and ask the child to identify unhelpful thoughts in the story and think of more helpful ones. Kids may then describe how those thoughts impact their feelings. 

CBT child anxiety worksheets 

These anxiety worksheets for kids help children understand anxiety, identify anxiety triggers and unhelpful thoughts, and reduce their worry.

CBT for older children and youth

CBT interventions for youth-aged children may involve using a catch it, check it, and change it worksheet. 

This three-step process helps to cognitively restructure unhelpful thoughts:

• Catch it: When children feel anxious, they are prompted to identify their thoughts, which can be captured in a thought bubble. Younger children may also want to externalize the thought into a character, like a “worry monster.”
• Check it: Examine the accuracy of the thought to identify thinking traps. Youth might be provided with a list of common thought distortions to help them compare these against their thoughts and determine if they are helpful. 
• Change it: Helps youth change their thinking into more helpful thoughts.

You’ll find some CBT triangle examples in our printable thoughts, feelings, behavior worksheet that you can download for free at the top of this article.

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How therapists can use the CBT triangle for kids

Therapists may find it helpful to use the CBT triangle for kids worksheet in the following ways: 

• In session to provide psychoeducation to kids and families about the relationship between thoughts, feelings, and actions
• To support kids and families in identifying unhelpful thought patterns and demonstrate ways to restructure their thoughts cognitively
• As a handout, the CBT triangle for kids worksheet could be a helpful reminder for clients, prompting them to notice when they’re having unhelpful thought patterns 
• To help clients practice noticing and restructuring their thoughts between therapy appointments using the CBT worksheets for kids, and then following up on their progress at the next appointment  

Sources

• Halder, S., & Mahato, A. K. (2019). Cognitive Behavior Therapy for Children and Adolescents: Challenges and Gaps in Practice.
• Kendall, P. C., Ney, J. S., Maxwell, C. A., Lehrbach, K. R., Jakubovic, R. J., et al. (2023). Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings. 
• Pollio, E., & Deblinger, E. (2018). Trauma-focused cognitive behavioural therapy for young children: clinical considerations. 

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