Teenagers are often susceptible to a range of mental health issues in high school, thanks to the whirlwind of changes they experience during adolescence. This vulnerability can be attributed to hormonal fluctuations, changing social dynamics, academic pressures, and the transition toward independence. Common mental health conditions impacting this demographic include anxiety disorders, depression, eating disorders, and ADHD, among others. One of the most widely-used, evidence-based treatments for teen mental health concerns is cognitive-behavioral therapy (CBT). CBT activities for teens are often engaging and fun, making the treatment more effective.
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.
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.
Learn More About CBT for Teens at Imagine Boise
While these activities can be beneficial, it’s crucial for teens dealing with mental health issues to seek professional treatment and counseling services. Therapists and counselors trained in CBT can provide the necessary guidance and support.
Our team of dedicated professionals is committed to helping adolescents navigate their mental health journey. We understand the unique challenges teens face and utilize innovative, engaging methods, including CBT, to address them.
We offer a range of mental health services for teens and adolescents, including the following programs:
- Partial hospitalization program (PHP)
- Intensive outpatient program (IOP)
- Alumni program
- Aftercare program
Don’t let your teenager struggle alone. Reach out to Imagine Boise today, and let us help them find the path to positive mental health. Call us at 888.597.2807 or reach out online. Our caring and professional team can answer any questions.