Any Piece of Media Can Be a CBT Intervention

I have talked before about what “makes” an activity have therapeutic value and how this description grows and changes over time. As I have said many times, in therapy sessions, I am not there to make a certain intervention happen; rather, my job is to take whatever happens and make that thing therapeutic.

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This is especially true when you work with kids. A six-year-old is not going to sit down and tell you in detail what is stressing them out right now. Even many pre-teens and teenagers would rather talk about their interests and things they enjoy rather than “doing therapy.” This leaves the therapist with two options: try to force and direct the session to go another way, or lean into what the client wants to share with you. Guess which option I prefer to go with.

In my clinical practice, I often pull from Cognitive Behavioral Therapy (CBT) as I conceptualize and treat my clients. In essence, CBT involves identifying how thoughts, feelings, and behaviors interact with each other. Sometimes we have thoughts without even realizing it, and those thoughts can trigger unpleasant feelings or problem behaviors. Sometimes the thoughts are not even based on reality. CBT helps clients identify these patterns and respond to them in a healthy way. You can learn more about CBT here.

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Sometimes when we feel uncomfortable talking about our own thoughts and feelings, it can be easier to talk about someone else’s. Fictional characters can feel particularly safe to talk about because they are not real, and so their feelings are not real either. But noticing connections between thoughts, emotions, and behaviors is helpful even if the child is not sharing a situation from their real life.

Ask your client to share a story from a movie or show that they enjoy watching. Explore with them what is happening for a particular character in the story. How does the character feel (and how can you tell that they are feeling that way)? What thoughts do you think they are having? What choices are they making, and how do their thoughts and feelings impact those behaviors?

Help your client identify cognitive distortions that the character is experiencing. (There is a great, FREE worksheet on cognitive distortions available here, or you can make your own based on the client’s developmental level.)

This gets the client thinking about situations from their own life and the thought patterns that contribute to difficulties they are having, without making them acknowledge or talk about “bad behavior” in their session. Media I have discussed in sessions using a CBT lens includes but is not limited to:

  • Clarence
  • We Bear Bears
  • Encanto
  • SpongeBob SquarePants
  • Animaniacs
  • Teen Titans
  • Cruella
  • Luca
  • Adventure Time

Introduce this activity by asking what they have been watching lately, and go from there. Let clients explore feelings in a way that is safe and interesting to them, and make therapy fun!

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. Her clinical interests are varied and include child and adolescent therapy, TF-CBT, rural psychology, telemental health, sexual and domestic violence, psychological assessment, and mental illness prevention. Dr. Marschall presently works in the Child and Adolescent Therapy Clinic at Sioux Falls Psychological Services in Sioux Falls, South Dakota, where she provides individual and family therapy and psychological assessment to children, adolescents, and college students. She also facilitates an art therapy group for adolescents and college students with anxiety and depression. Dr. Amy Marschall is certified in Trauma-Focused Cognitive Behavioral Therapy and Telemental Health.

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