Cognitive Behavioural Therapy for Adolescents and Young Adults: An Emotion Regulation Approach

267 Pages·2018·1.79 MB·English

by  Lawrence Howells

Cognitive Behavioural Therapy for
Adolescents and Young Adults
Cognitive Behavioural Therapy for Adolescents and Young Adults: An Emotion
Regulation Approach provides a unique focus on therapeutic practice with
adolescents and young adults, covering everything from psychological theories
of adolescence to the treatment of common emotional difficulties.
Beginning with a review of development through adolescence into adulthood,
and the principles of CBT, this book highlights problems with traditional models
of CBT for adolescents and young adults. In a fresh approach, this book separates
CBT from diagnosis and grounds it instead in emotion science. Adolescents
and young adults learn not about disorders and symptoms, but about emotions,
emotional ‘traps’, and how they can use CBT to bring about change. There
are chapters on fear, sadness, anger, emotion dysregulation, and happiness. Each
chapter provides an outline of emotion science, a clear cognitive behavioural
formulation (‘trap’), and evidence-based interventions. Clinicians are walked
through the process using case illustrations.
Cognitive Behavioural Therapy for Adolescents and Young Adults represents
a transformation of CBT practice, and will become a valuable treatment manual
to training and practising mental health professionals, especially psychotherapists
specialising in CBT.
Dr Lawrence Howells is a clinical psychologist specialising in work with
adolescents and young adults. He has previously worked as clinical lead for a
youth psychology team and currently works in a multidisciplinary youth mental
health team.
“Dr Howells’s new book, and method, reimagines CBT for the next generation.
Grounded in fine-grain, intelligent clinical practice and expertise, the innovative
techniques described here focus on developing a can-do mentality in young
people – crucially, helping them reframe their ‘symptoms’ as normal responses
to the developmental challenges of life. On the basis of cutting-edge psychological
science, and with many clear case examples, Dr Howells tilts CBT on its axis
to show how young people can understand their feelings, harness their latent
abilities, and take back control of their futures. At a time when young people
are facing unprecedented emotional challenges, Dr Howells’s powerful new re-
reading of CBT is a priceless gift to give them, their families, and the professionals
with whom they work.”
Dr Roger Kingerlee, Consultant Clinical Psychologist,
Norfolk and Suffolk Foundation Trust
“This book offers a practical and refreshingly different approach to doing cog -
nitive behaviour therapy (CBT) with adolescents and young adults. It is an ideal
text for the therapist who is starting out in offering CBT for adolescents, as well
as for the more experienced clinician who wants to refresh their knowledge and
to review and reflect on their applied skills. The evidence base and theory driving
the approach blends seamlessly into each chapter. A great addition to the existing
CBT practitioner texts for those working with adolescents and young adults!”
Dr Maria Loades, Senior Lecturer/Senior Clinical Psychologist/NIHR
Research Fellow, University of Bath
“As health care restructures to respond in a more timely way to the mental health
needs of young people in transition from childhood to adulthood, we urgently
need psychosocial interventions that are fit for purpose and transcend our artificial
diagnostic frameworks. Dr Howells offers a developmentally attuned approach
which is transdiagnostic and, with its primary focus on emotions, is better targeted
than traditional CBT for young people. Novel therapies like this are needed as the
new 12–25 system of youth mental health care takes shape in many countries.
They can be enhanced through new technologies like virtual reality and online
platforms but the theoretical and practical building blocks mesh well with the
experience and needs of young people. This approach is likely to evolve further
with feedb ack from young people themselves and experienced therapists.”
Professor Patrick McGorry, Professor of Youth Mental Health
at the University of Melbourne, and President of the
International Association for Youth Mental Health
“The term ‘paradigm shift’ is often overused. However, in the case of Lawrence
Howells’ new book I believe that we are witnessing exactly that. This book gives
us a really fresh approach to CBT with adolescents and young adults, at a time
where effective psychological therapy approaches with this age group are more
crucial than ever. Howells’ approach will help adolescents and young adults to
understand a range of emotions – fear, sadness, anger, and shame – and to learn
methods of bringing about change, aiming at a desired outcome of happiness and
wellbeing.”
Professor Jamie Hacker Hughes, Consultant Clinical Psychologist,
Psychotherapist and Supervisor, and Past President of the British
Psychological Society (2015–2016)
“An excellent, stimulating and at times challenging addition to the literature,
this book is highly recommended for both novice and experienced therapists or
indeed anyone working with young people who feel that simple yet powerful
models would be useful in helping them to connect with and help young people
experiencing a variety of emotional issues. Highly recommended.”
Dr Jon Wilson, Consultant Psychiatrist and Medical Psychotherapist at
the Norfolk Youth Service. Clinical Senior Lecturer
at the University of East Anglia

Cognitive Behavioural
Therapy for Adolescents
and Young Adults
An Emotion Regulation Approach
Lawrence Howells
First published 2018
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2018 Lawrence Howells
The right of Lawrence Howells to be identified as author of this work
has been asserted by him in accordance with sections 77 and 78 of
the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including photocopying
and recording, or in any information storage or retrieval system,
without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification
and explanation without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Names: Howells, Lawrence, author.
Title: Cognitive behavioural therapy for adolescents and young adults :
an emotion regulation approach / Lawrence Howells.
Description: Milton Park, Abingdon, Oxon ; New York, NY :
Routledge, 2018. | Includes bibliographical references.
Identifiers: LCCN 2017059367| ISBN 9781138707467 (hbk) |
ISBN 9781138707474 (pbk) | ISBN 9781315201382 (ebk) |
ISBN 9781351781848 (web) | ISBN 9781351781831 (epub) |
ISBN 9781351781824 (mobipocket)
Subjects: LCSH: Cognitive therapy for teenagers. | Adolescent psychotherapy.
Classification: LCC RJ505.C63 H69 2018 | DDC 616.89/14250835 – dc23
LC record available at https://lccn.loc.gov/2017059367
ISBN: 978-1-138-70746-7 (hbk)
ISBN: 978-1-138-70747-4 (pbk)
ISBN: 978-1-315-20138-2 (ebk)
Typeset in Times New Roman and Gill Sans
by Florence Production Ltd, Stoodleigh, Devon, UK
For Lucy, Taliesin, Tegan, Cassidy, and Seren

Contents
Acknowledgements xiii
1 Introduction 1
2 Adolescent development 5
What and when is adolescence? 6
Physical development 6
Brain development 7
Cognitive development 8
Social cognitive development 9
Identity development 10
Emotion and emotion regulation development 12
Relations with families and peers 16
Bringing it all together: theories of adolescent
development 20
3 Principles of cognitive behavioural therapy
(CBT) 28
History of CBT 28
Theoretical principles of cognitive behavioural
therapy 29
Practical constructs of CBT 31
Evidence base 40
4 Problems with diagnosis-based CBT in
adolescents and young adults 43
Problems with diagnosis 43
Problems with CBT in routine clinical practice 49