Children’s CBT skills, Metacognition, Empathy, and Theory of Mind

Abstract

Purpose: Cognitive Behavioural Therapy (CBT) is an evidence based treatment for common mental health problems that affect children, young people, and adults. The suitability of CBT for children has been questioned because it requires children to think about their thoughts, feelings, and behaviours. The aim of this study was to investigate which cognitive and affective capacities predict children’s ability to relate thoughts, feelings, and behaviours. Design/methodology/approach - Fifty nine typically developing children aged between 8-11 years took part in the study. CBT skills were assessed on a story task that required children to relate the character’s thoughts to their feelings and behaviours. Children also completed an assessment of IQ, a feeling-of-knowing metamemory task that assessed metacognition, and a higher-order Theory of Mind (ToM) task. Furthermore, parents rated their child’s empathy on the Children’s Empathy Quotient. Findings – Children demonstrated high levels of CBT skills, metacognition, and ToM. CBT skills were significantly predicted by metacognition and empathy, but not ToM. Originality/value – The findings suggest that CBT is developmentally appropriate for 8-11 year old children; however, young children and children with mental health problems may have impaired metacognition and CBT skills. Metacognition and empathy may moderate the efficacy of child CBT and warrant further investigation in clinical trials.