Many psychologists and therapists use cognitive behavioral therapy to treat a variety of mental illnesses, including bipolar disorder, anxiety disorders, eating disorders, and depression. It can be used with teens who struggle with addiction and other risky behavior, such as cutting.

Essentially, cognitive behavioral therapy (CBT) aims to change behavior by identifying negative and distorted thinking patterns (or thoughts). This successful form of therapy emphasizes the link among thoughts, feelings, and behavior.

More importantly, it attempts to identify the way that certain thoughts contribute to the unique problems of a teen’s life. By changing the thought pattern and by replacing it with thoughts that are aimed toward a specific therapeutic goal, a teen’s life can slowly begin to change.

To do this, a teen may be asked to use a thought diary. It’s a documentation tool for monitoring feelings of anxiety, fear, hurt, anger, shame, guilt, or sadness. Along with noting when and where these feelings were experienced, an adolescent would also write down the associated thought he or she had with that feeling in a particular situation.

Reflecting on the self-talk one had during a specific situation can facilitate finding those thoughts that are harmful and self-defeating. Without this sort of reflection, these damaging thoughts might go unnoticed, and cultivating this sort of awareness is the benefit of cognitive behavioral therapy.

However, that’s not all. A thought diary also invites an adolescent to write down an alternative thought — one that is more helpful, realistic, and supportive.

For example, instead of “I am worthless,” the new thought might be “I can do this.” Teens working with a CBT therapist would learn that helpful thoughts are ones that promote self-acceptance. They also state preferences versus thoughts that make absolute demands with words like “should” or “must.”

An adolescent is then encouraged to use his or her new, alternative thoughts, particularly when in similar circumstances. As therapy continues, the process of distinguishing feelings continues. Other emotions such as annoyance, concern, regret, or remorse are also examined to uncover their effects on a teen’s behavior and choices.

The thought diary also is used to rate the intensity of emotions, further increasing an adolescent’s awareness of feelings, thoughts, and behavior. CBT’s ability to increase one’s awareness also facilitates the ability to stop making choices unconsciously and start to make decisions that support a healthy self-esteem. This is an essential component to the success of an adolescent.

Indeed, cognitive behavioral therapy can facilitate mental well-being, reduce anxiety, minimize risky behavior, and prevent drug use. CBT is increasingly being used with troubled youth, and the thought diary is one of the powerful tools used in CBT to make these changes possible.