What is CBT?

Cognitive Behavioural Therapy (CBT) is a problem-focused type of intervention. Rather than an in-depth focus on past experience, CBT seeks to teach children to become their own therapist. CBT helps children recognise their thought patterns and identify where and when those patterns help and where they hurt.

Using problem solving strategies and skill building techniques the child, parent, and therapist work together to change dysfunctional thoughts and replace them with more proactive thoughts and behaviours.

"Cognitive Behavioural
Therapy is based
on the idea that how we
think & act both affect
how we feel."


CBT emphasizes collaboration and ongoing effort outside of the therapy session.
Children will regularly be assigned homework to increase their awareness of their own feelings. Frequently they will need some assistance from their parents to help identify and record this information.
The connection between feelings, thoughts, and behaviours will be a central part of our discussion as will the ability of the child to make changes within that “circle”.

One of the most important techniques in CBT for children with anxiety is called Exposure Therapy.
The basic idea is that children are exposed to the things that trigger their anxiety in structured, incremental steps, and in a safe setting. As they become accustomed to each of the triggers in turn, the anxiety fades, and they are ready to take on increasingly powerful ones.

Exposure Therapy is very different from traditional talk therapy, in which the patient and a therapist might explore the roots of the anxiety, in hopes of changing her behaviour. In Exposure Therapy we try to change the behaviour to get rid of the fear.

"Exposure Therapy
slowly and
helps a child
face his

Cognitive Behavioural Therapy is:

  • Structured
  • Goal-orientated
  • Short-term
  • Collaborative with the child and its family
  • Guided by both the child and the therapist
  • Psycho-educational

Who can benefit from CBT?

CBT is the treatment of choice for Anxiety Disorders, which is the most common of all mental health disorders. It is also useful for Mood Disorders. Empirical studies have demonstrated its short-term and long-term efficacy.
CBT is problem-focused, goal-oriented, structured and systematic and teaches children life-long skills. CBT can help children with:

  • Phobias
  • Obsessive Compulsive Disorder (OCD)
  • Generalised Anxiety Disorder (GAD)
  • Separation Anxiety Disorder
  • Social Anxiety Disorder
  • Panic Disorder
  • Post-Traumatic Stress Disorder (PTSD)
  • Mood Disorders (Depression)

Why is the therapeutic relationship so important?

The therapeutic relationship that develops between your child and Dr. Madeleine Vieira is very important. Your child must feel comfortable, safe and understood. This type of trusting environment makes it easier for the child to express his/her thoughts and feelings and to use the therapy in a useful way. It is also crucial that your child knows you are supporting the process.

How long does CBT last?

CBT is much shorter intervention than some other kinds of therapy, which can go on for years. The average number of sessions children attend is 16. This takes about 4 months. But each person is different, and the number of recommended sessions can vary depending on how long the symptoms have persisted and how complicated they are.

Sessions are 50 minutes and take place once weekly. 40 minutes of the session is spent with the child and 10 minutes for Dr. Madeleine Vieira, child, and parent(s) to review the session and to determine homework for the coming week. It is very important that the child and parents work on tasks from CBT in their home environment. These tasks help the child move skills from the therapy room to his or her life.

Consistency of a set day and time and place is very important in the process. Unplanned missed sessions may disrupt progress.

What happens in CBT sessions?

During the sessions, we will work to break down your child's problems into their separate parts such as the thoughts, physical feelings and actions. 
We will analyse these areas to work out if they are unrealistic or unhelpful and to determine the effect they have on each other and on your child. We will then be able to help your child work out how to change unhelpful thoughts and behaviours.
After working out what can be changed, we will ask your child to practise these changes in his daily life and discuss how this went during the next session.

The eventual aim of therapy is to teach your child to apply the skills he has learnt during treatment to his daily life. This should help your child manage his problems and stop them having a negative impact on his life, even after the course of treatment finishes.



"I used to worry about so many things, the news, my parents, my friends, and so much more. Dr. Vieira has taught me to face my fears and now I only worry sometimes about things that are really important. I feel much better!"
- Kevin, 6, Belgravia, London - UK

"My OCD used to make me late to school every day, but with Dr. Madeleine's help I am now on time! I spend less time getting ready in the morning and have learnt to beat Mr. OCD Bully and wash my hands less than before. I'm so happy!"
- Andrew, 7, Chelsea, London - UK

"I was never very comfortable around strangers and speaking in front of people I don't know. After a few sessions with Dr. Madeleine it's become easier to meet people and even make some new friends."
- Christine, 8, Knightsbridge, London - UK

“I used to be really scared of dogs, but after CBT with Dr. Vieira I have learnt to enjoy the company of dogs, even the really big ones!"
- Jenna, 10, Notting Hill, London - UK