Cognitive Behavior Therapy as Cure of Psychological Distress among School Children Sidra Liaquat Department of Psychology Institute of Southern Punjab, Multan

Introduction Mental well-being of children’s has emerged as a priority for education due to increased numbers of children experiencing learning problems, conduct and behavioral problems, family crisis, anxiety, depression, anger, stress and attention difficulties. School life is most effecting and personality shaping phase in a person’s life and affect a person in their later life. Unresolved conflicts and behavioral defects can result into stress, low self-esteem, fear are causing psychological distress.

Objective of the study Present study is aimed to explore the mental wellbeing of school children and outcomes of cognitive behavior therapy. To explore the effectiveness of CBT To observe Gender differences throughout the therapeutic session

Psychological Distress Psychological distress is a general term that is used to describe unpleasant feelings or emotions that impact human functioning level, a range of symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary anger, depression, stress, self esteem, and anxiety

Cognitive Behavioral Therapy CBT treatments have been found to be effective for depression, anger, and PTSD(Beck& Fernandez, 1998) Cognitive interventions target cognitive processes such as hostile appraisals and attributions, irrational beliefs & thinking(Trafate, 1995) Relaxation interventions, which target emotional and physiological components of anger among youngers students (Deffenbacher, 1996)

Literature Review Common psychiatric sysmptoms among children are acute stress reactions, adjustment disorder, depression, panic disorder, post traumatic stress disorder, anxiety disorders specific to childhood, and phobias(KarN, Bastia , 2006) Depression, disruptive behavior and anger are the most common disorders associated with school children (Kannan et al. ,2006) Cognitive behavior therapy (CBT) is considered by many to be the mainstay of treatment of children and adolescents. The efficacy of CBT in alleviating mental distress (Silva et al., 2003)

Hypothesis Cognitive Behavioral Therapy will significantly affect psychological distress of school children

Method Experimental Design (with double blind ) Participant 40 children Age of 7-11 randomly selected from “City School Multan”

Instruments Psychological distress was measured through Beck Youth Inventory Five self-report inventories, Depression, Anxiety, Anger, Self-Concept and Disruptive Behavior Each inventory has 20 items Item responses are 0-3 point Likert scale

Ranges for Depression, Anxiety, Anger and Disruptive Behavior T Clinical Range 70+ Extremely Elevated 60-69 Moderately Elevated 55-59 Mildly Elevated <55 Average Range for Ranges for Self-Concept T Clinical Range >55 Above Average 45-55 Average 40-44 Lower than average <40 Much lower than average

Procedure all confidentiality and ethical considerations were followed Randomly selected sample of 40 children completed the questionnaire Children were identified by their teachers who have disrupt attitude in class and have behavioral changes within last few months Pre and Post testing was done on Beck Youth Inventory CBT treatment consisted of 16, 45minute weekly sessions, in a group of four children, conducted by two therapist Within CBT sessions role play, behavioral rehearsal, group discussions & self releasing

CBT with Children Understanding to the developmental stage of the young person (think about psychological, cognitive and emotional development). •Involve family. •Make it interesting and engaging: –Use of cartoons. –Use of favourite super heroes. –Role plays. –Use age-appropriate language. –Use of worksheets –make them fun and colorful, use of reminders at home.

CBT management Plan Consist of three main section used on the 1. (session1 to 3)Focused on understanding of feelings in oneself & others, emphasis on anxiety, self esteem, anger 2.(session 4to8)Focused on anxiety & anger management children were taught relaxation procedures, using physical activities, breathing exercise, positive thoughts, A-B-C model, thought stopping 3. (session 9to 16)focused to taught assertiveness training, Self-monitoring (frequency counts, duration of the problem, self-ratings, diaries).

Psychological distress Result Psychological distress Pre Treatment Post Treatment t p M SD Self Concept 34.6 8.4 45.2 2.5 3.04 0.02 Depression 66.9 8.2 54.3 18.1 1.87 0.03 Anger 70.5 17.0 55.7 19.3 1.98 Anxiety 67.3 10.7 51.2 9.8 2.01 Disruptive Behavior 65.5 10.0 49.4 16.7 2.14 0.01 *P<0.05

Pre test and post test Differences

Gender differences pre assessment

Gender differences post assessment

Different Behavioral Responses of Children towards Therapy & therapist Girls (age 8-11) were interested to have sessions Girls have done their Home Work Boys (age 7-10) were more interested to have counseling and gossips Home Work was not done by mostly boys mostly Boys (age 7-10) are more inclined towards therapist

Conclusions The findings pertaining to intervention, cognitive therapy has significant impact on children. Significance gender differences were found ;Female are more depressed Male children are more anger and have high level of anxiety.

Implication of the Study CBT must be part of “teacher training programs” so that they should be able to manage children problems. School psychologists and therapist must be associated with schools to provide their psychological assistant in educational setup.

Limitations & Suggestions CBT adaptation within cultural differences in accordance to Children needs In Pakistan, school psychological interventions are still missing in our educational setup especially in Govt./public school it should be imply to all educational systems as like high or elite school franchises More research is required

Questions

Message of the day There can be no keener revelation of a society's soul than the way in which it treats its children." (Nelson Mandela, Former President of South Africa) Every Child is unique, gifted; Child must be taught how to think, not what to think! Sidra

Thanks