The role of CBT in the treatment of eating disorders in children and adolescents

When young people develop a behavioural or emotional disorder, it is assumed that their cognitive beliefs or problem-solving capacities are impaired, or that they lack the appropriate behavioural repertoires to address their difficulties. Cognitive difficulties may reflect deficiencies or distortions in thought processes. In the field of adolescent mental health, it is often assumed to be cognitive distortions that create problems, reflecting as they do, irrational or flawed attitudes and beliefs. In obsessive compulsive disorder (OCD), for example, these beliefs may focus on the need to engage in rituals because of notions about the consequences of doing or not performing them. Unwelcome cognitive thoughts or images are triggered by negative experience, particularly of a harmful or contaminating nature. Automatic thoughts are generated that enhance feelings of guilt and

encourage phobic avoidance of trigger situations. Compulsive thoughts or ritualised behaviours are then utilised to neutralise the automatic thoughts and are reinforced by anxiety reduction.