Teen years come with plenty of ups and downs—school pressure, changing friendships, and the challenge of figuring out who they are. For some adolescents, these stressors lead to negative thought patterns that fuel anxiety, sadness, or self-doubt. When those thoughts take hold, they can start shaping how a teen feels about themselves and how they respond to the world around them.
Cognitive-behavioral therapy (CBT) is one of the most effective tools for helping teens break out of these cycles. Instead of getting stuck in overwhelming emotions, CBT teaches practical skills to challenge unhelpful thinking, cope with stress, and build confidence. Best of all, it’s flexible—therapists can use activities, games, and real-life exercises that make the process engaging and meaningful for teens.
In this post, we’ll explore how CBT works, signs your teen may benefit, and specific exercises that can help them build healthier habits and mindsets.
What is CBT?
Cognitive-behavioral therapy is a form of psychotherapy that helps individuals identify and change destructive or disturbing thought patterns that negatively influence behavior and emotions.
A standard session of cognitive-behavioral therapy typically lasts for one hour. CBT sessions can be conducted on a weekly or biweekly basis, depending on the individual needs of the adolescent and their current mental health state. During each session, the therapist will focus on identifying any maladaptive thought patterns that could be influencing negative behaviors or emotions.
The beauty of CBT is that it can be made engaging and even fun by incorporating activities, games, and exercises specifically designed for teenagers.
Signs a Teen Might Benefit From CBT
It’s not always easy to know when your teen’s struggles are more than just “typical adolescence.” CBT can be especially helpful for teens who are stuck in negative thought patterns or coping with ongoing emotional distress. Some signs that CBT may be a good fit include:
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Persistent negative self-talk – Saying things like “I’m a failure” or “Nobody likes me.”
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Excessive worry or anxiety – Struggling to relax, obsessing over worst-case scenarios, or experiencing panic attacks.
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Avoidance behaviors – Skipping school, avoiding social situations, or refusing responsibilities because of fear or stress.
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Difficulty managing emotions – Frequent outbursts, irritability, or shutting down when upset.
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Ongoing sadness or low motivation – Loss of interest in activities they used to enjoy or trouble keeping up with schoolwork.
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Unhealthy coping strategies – Using isolation, aggression, or risky behaviors to manage stress.
Recognizing these patterns early gives parents the chance to connect their teen with support before the issues become more overwhelming. CBT offers practical tools to help teens challenge these thought cycles and build healthier ways of coping.
Five Engaging CBT Activities for Teens
Here are five unique, interactive CBT exercises that can help teens develop a positive outlook while addressing their mental health. These can be incorporated into the overall behavioral health treatment plan for your teen or adolescent.
1. Thought Record (Challenging Negative Thoughts)
Negative thoughts can hit teens fast, making them feel overwhelmed, anxious, or even hopeless. They might assume the worst after a bad grade or convince themselves that no one likes them after an awkward moment.
A thought record slows down this cycle, helping them recognize distorted, negative thought patterns and replace them with something more realistic.
How to Try It:
- Have them write down a stressful situation (e.g., “I got a bad grade on my math test”).
- Ask them to write their first automatic thought (e.g., “I’m terrible at math and will fail the class”).
- Have them list the emotions tied to that thought (e.g., “Frustrated, anxious, embarrassed”).
- Help them look for evidence for and against the thought (e.g., “I’ve passed tests before,” “One test doesn’t decide my whole grade”).
- Guide them in reframing the thought into something more balanced (e.g., “I didn’t do well on this test, but I can study differently next time and improve”).
Why it Works:
Teens often accept their thoughts as facts, especially when emotions run high. This exercise teaches them to slow down, question their assumptions, and replace extreme thinking with something more balanced. Over time, it helps them control their emotions and reactions more.
2. Mood and Thought Tracking
Teens don’t always recognize how their thoughts and moods are connected. They might say they feel “off” but struggle to explain why.
Tracking their thoughts and moods helps them see patterns, like whether certain situations or people trigger stress, and gives them a clearer picture of what affects their emotions. This is especially helpful for teens diagnosed with bipolar disorder.
How to Try It:
- Have them keep a journal or use a mood-tracking app.
- Encourage them to write down their emotions a few times a day and what was happening before they felt that way.
- At the end of the week, help them look for patterns (e.g., “I always feel anxious before history class” or “I feel better after soccer practice”).
Why it Works:
Once teens see the connections between their thoughts, actions, and emotions, they can start making small changes, like avoiding certain triggers or using coping skills when they notice a pattern forming. This also gives therapists and parents valuable insight into what’s actually going on inside their heads.
3. The ABC Model (Activating Event, Beliefs, Consequences)
Many teens believe their emotions come directly from situations, but their beliefs about those situations shape how they feel and react. The ABC model helps them break down this process and recognize when their beliefs are making things worse.
How to Try It:
- A (Activating Event): Have them describe the situation (e.g., “A friend ignored my text”).
- B (Beliefs): Ask them what they assumed about it (e.g., “They must be mad at me” or “They don’t want to be my friend”).
- C (Consequences): Have them write down how they reacted emotionally and behaviorally (e.g., “I felt rejected and avoided them at school”).
- Help them challenge the belief by asking, “What’s another possible explanation?” (e.g., “Maybe they were busy or forgot to reply”).
Why it Works:
This exercise shows teens that the situation itself doesn’t always cause their feelings but by how they interpret it. When they learn to question those interpretations, they can stop small stressors from becoming full-blown emotional spirals.
4. Gratitude and Positive Journaling
When teens struggle with anxiety or depression, they tend to focus on what’s going wrong. Writing down positive experiences helps them shift their perspective and notice the good moments, even on tough days.
How to Try It:
- Have them write down three good things that happened each day (big or small).
- Encourage them to add details about why each moment was meaningful.
- If they struggle to think of positives, remind them to look for small wins (e.g., “I liked my outfit today” or “I finished my homework early”).
Why it Works:
This practice rewires the brain to pay more attention to positive experiences. Over time, it can help teens feel more hopeful and resilient, even when things aren’t perfect.
5. Coping Skills Toolbox
When emotions run high, it’s hard to think clearly. That’s why having a go-to list of coping strategies is so important — it gives teens a quick way to calm down before things escalate.
How to Try It:
- Have them brainstorm healthy coping strategies (e.g., deep breathing, music, exercise, drawing, journaling).
- Help them put together a list (digital or written) so they can reference it when they need it.
- Encourage them to test out different strategies to see what works best for them.
Why it Works:
This gives teens a sense of control over their emotions. Instead of feeling overwhelmed or stuck, they have options they can turn to in the moment.
6. Behavioral Experiments
Many teens struggle with anxious thoughts like “Everyone will judge me if I speak up in class” or “No one wants to hang out with me.” These beliefs often go unchallenged, leading to avoidance and isolation. Behavioral experiments help them test their fears in real life and see if their assumptions are actually true.
How to Try It:
- Have them write down a fear-based assumption (e.g., “If I say something in class, everyone will think I’m dumb”).
- Encourage them to test it by taking a small action (e.g., answering one question in class).
- Afterward, help them analyze what actually happened (e.g., “No one laughed. A few people also got the answer wrong. The teacher seemed glad I participated”).
Why it Works:
This method helps teens realize that their fears are often exaggerated. The more they practice testing their worries, the more confidence and self-esteem they gain in social and academic settings.
7. The Worry Jar
Worries can feel nonstop and overwhelming for anxious teens. Writing them down and setting them aside can create distance and give them a sense of control.
How to Try It:
- Have them write down their worries on slips of paper and put them in a jar.
- Set a designated “worry time” each day where they can read them if they want.
- After a week, have them go through old worries and see which ones still feel important.
Why it Works:
This activity helps teens separate themselves from their worries. It also shows them that many of their anxieties don’t last as long as expected, making future worries feel less overwhelming.
Why CBT Works for Teens
CBT is one of the most widely studied and effective forms of therapy for adolescents. What makes it especially powerful during the teen years is its practical, skill-based approach. Instead of only talking about feelings, CBT gives teens tools they can actively use in daily life to manage stress, challenge negative thinking, and build confidence.
Some key reasons CBT works well for teens include:
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It’s structured and goal-oriented – Teens can see progress as they practice strategies and track changes over time.
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It builds self-awareness – By learning to spot unhelpful thought patterns, teens gain insight into why they react the way they do.
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It’s hands-on – Activities, journaling, and real-life experiments make therapy engaging rather than abstract.
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It encourages independence – CBT equips teens with coping skills they can use outside of sessions, giving them more control over their emotions and behaviors.
Because adolescence is such a formative stage, developing these skills early helps teens build resilience they can carry into adulthood.
Tips for Parents to Support CBT at Home
CBT works best when teens practice what they learn outside of therapy. Parents play an important role in reinforcing these skills at home and creating an environment that supports growth.
Here are a few simple ways to help:
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Encourage practice – Ask your teen to share a tool or exercise they learned in therapy and support them in using it when challenges come up.
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Model balanced thinking – Show them how you reframe your own mistakes or stress (“I had a tough day, but tomorrow’s a new start”) so they see CBT principles in action.
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Celebrate small wins – Progress may be gradual, but every effort matters. Acknowledge their work, even if the outcome isn’t perfect.
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Create space for conversations – Let your teen know you’re available to listen without judgment, which makes it easier for them to open up about struggles.
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Stay consistent – Encourage healthy routines like sleep, exercise, and downtime, which help CBT strategies stick.
When parents take an active role, CBT becomes more than just a therapy session—it becomes a set of skills woven into daily life.
Support That Empowers Teens to Grow
Negative thoughts and overwhelming emotions don’t have to hold your teen back. With CBT, they can learn practical tools to manage stress, challenge unhelpful thinking, and build confidence in themselves and their future.
At Imagine Boise, we specialize in helping teens engage with therapy in meaningful, hands-on ways. Through CBT and other evidence-based approaches, we guide adolescents in developing healthier coping skills, improving self-esteem, and finding hope during challenging times.
If your teen is struggling with anxiety, depression, or stress, we’re here to support their growth every step of the way.
Contact us today to learn more about our CBT-based teen therapy programs and how we help adolescents build resilience and emotional strength.