Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past.
They concentrate on a person’s views and beliefs about their life, not on personality traits.
Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families.
Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.
HOW TO GET HELP:
If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet.
You may, or may not, find a competent therapist in this manner.
It is wise to check on the credentials of a psychotherapist.
It is expected that competent therapists hold advanced academic degrees.
They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.
Of course, they should be licensed to practice in your state.
You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations.
You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition.
These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.
The greatest risk to children’s health is not cancer, heart disease, or any other
form of illness. The leading killer of children in the United States is injury. In a
single year, 10,000 children under age 15 die, 30,000 are permanently disabled,
and 16 million require emergency medical care because of injuries. Children
under age 4 are at special risk.
In the past, injury was thought to be due to “accidents.” This term is no
longer used in the field of injury prevention because it implies that injury is a
random, unpredictable event. In fact, the large majority of childhood injuries
can be predicted and prevented by parents.
Behavior therapists have traditionally advocated three levels of intervention
for parents in dealing with small children.
Change the child’s surroundings, also known as theenvironment;
Change the parent’s own way of dealing with the child;
As a last resort, change the child’s behavior.
It is clear that parents or teachers can increase children’s safety skills and
that such teaching should begin early in life and continue throughout childhood.
However, researchers believe that children under the age of 4 should never
be made responsible for their own safety behavior. Whenever there is a choice
between changing the environment or changing behavior, changing the environment
is a better solution because it requires less energy, less vigilance, and less
planning to execute. However, in many cases no environmental change is possible.
In such cases, safety must rely on a parent’s protective behavior. Below,
some of the leading causes of injury to children are detailed.
Drowning is the most frequent cause of death in children under age 4.
Drowning in swimming pools is common, but children can drown in any body of
water, from an ocean to an irrigation ditch. Indoor drowning in seemingly
harmless situations also occurs. Being left alone even for a few moments in the
bath is enough for infant drowning to occur. Other sources of water such as toilets
or buckets are hazardous when crawling infants grab them when standing
and then tumble forward.
Fencing around pools that cannot be readily opened by children has been
shown to reduce drowning. A complete fence, rather than one side of the house
opening onto a three-sided fence, is necessary to protect children in the home.
Inflatable toys may lure children toward the water without protecting them
and thus should never be left in the pool. Safety-approved flotation devices
should be worn by all members of a boating group, especially small children.
Latches for toilet lids can be purchased and buckets can be emptied between use
or placed out of reach.
A five-gallon bucket is particularly risky because it tends not to tip when
a child falls into it. Such buckets might well be avoided entirely by parents of
small children. Finally, bathtubs should be drained immediately after use.
There is no substitute for nonstop, vigilant supervision when a child is in
or near water, either in the bath or by a backyard wading pool. Tragedies can
occur when a parent answers the telephone or goes to the door for only a
Letting the bell ring or taking the child in a towel with you is the only
safe alternative. No amount of experience or swimming lessons will make a
small child safe in the water without adult supervision.
The second leading cause of death for small children is automobile
crashes. Properly used restraints can reduce serious injury by up to 70%. A
child riding on a lap is not protected but is at double risk: Not only is it physically
impossible for the parent to keep the child from being thrown into the
windshield and dashboard, but if the adult is unbelted, the force of the
adult’s body may crush the child. Although laws requiring seat-belt use are
now in force in all 50 states, many parents fail to use safety restraints. This is
the simplest and easiest way to keep a young child safe.
Children at this age level are less likely to be injured as pedestrians than
are older children, as parents correctly recognize that young children cannot
cross streets safely in the absence of an adult. However, toddlers are more
likely than older children to wander into the street or driveway; and, because
toddlers are small, drivers are more likely to back over them when leaving a
garage or driveway.
Infant safety seats typically face the rear. Toddler seats more often face
forward. It is central to the child’s safety that the correct seat for the child’s
body weight be used, that the correct routing of the seat belt around the safety
seat be followed, and that straps be adjusted to the child’s body and used
(e.g., shoulder straps should not be slipped off and lap straps should go
across the thighs, not the abdomen).
A regular seat belt is not safe for a child if the shoulder strap cuts across
the child’s neck or face when fastened. A lap-only belt in such a case is safer,
although it is not as protective as an age-appropriate safety seat.
Environmental barriers such as fences between traffic and areas where
children play (including driveways) are a preferred strategy. Research suggests
that minivans and other vehicles with less visibility when backing up
may be poor choices in a family with very young children.
Parents should have a rule that the car does not move until the child is
secured in a safety seat. Children have been killed as their car pulled out of a
driveway and the child slipped out of the door.
Most children who have been in a safety seat from birth may never
protest using the restraint. Others may undo their restraint if not supervised.
Firmness, as well as contingent reward (receiving a reward for correct behavior)
for use and sufficient entertaining attention when the child remains in
the restraint helps.
Research has shown that children are better behaved in the car when
wearing safety restraints. Parents are also less likely to be distracted by a
child in a restraint.
Parents can also keep their children (and others’ children, too) safe by
not driving after drinking alcohol, when very tired, or when taking medication
that limits judgment or reaction time.
When anyone is entering or leaving a driveway, picking the child up or
holding his or her hand is a sensible strategy.
Most fatal burns come from house fires. Flame burns occur when a
child’s clothing is exposed to a flame. Scald burns from hot liquids occur at
much lower temperatures and more quickly in infants and toddlers than in
older children and adults. Scalds can occur from plain tap water, from hotwater
vaporizers, or from hot food on the stove or beverages at the table.
When formula is heated in the microwave, the container can feel only
warm when the liquid inside is actually hot enough to burn infants’ or toddlers’
airway sufficiently to make them swell shut. Carelessly extinguished
cigarettes or cigarette lighters can also burn toddlers who are fascinated by
glowing or shiny objects.
All homes should be equipped with several smoke detectors with batteries
that are checked frequently. Selecting an anniversary such as New Year’s
Day or the Fourth of July to sound the smoke alarm makes it easier to
remember. Outside windows in rooms where infants and toddlers sleep
should be specially marked to alert firefighters.
Children’s clothing, especially sleepwear, should be close fitting and
flame retardant. Setting the thermometer on the family water heater to 120°
– 125° F can eliminate scald burns from the tap water and putting guards on
the stove front can protect small exploring hands from touching a hot pan.
Hot-water vaporizers should never be used with children; cool-mist
vaporizers are just as effective. Food or liquid heated in a microwave should
be stirred well and sampled by an adult before it is given to a child.
Parents should have an escape route planned from each room in the
house and should exit low (below the smoke) and immediately with their
child at the first sign of a fire. Parents should test carefully to ensure bath
water is only tepid prior to putting a child in the bath.
Because small children reach and grab for things, hot beverages should
never be consumed or placed near a small child. Cooking should be done
away from children, and pot handles should be turned in so that the pot cannot
be overturned. Matches, lighters, and lighted cigarettes should never be
left where a child can reach them.
Poisoning deaths have diminished in recent years due to child-resistant
packaging, limits on the amount of medication in a single container, reductions
of some toxic chemicals (e.g., lead), and improved poison control centers.
However, poisonings from cleaning products, solvents, and medications
continue to occur.
Before an infant can crawl, all poisonous materials should be placed in a
high cupboard or a secure latch should be installed on the cabinet where they
are kept. Medications for both humans and pets should be stored in childresistant
containers in a locked cabinet. Health aids that pose a risk (like
iron compounds) should be similarly stored. Flavored children’s medications
(e.g., cough syrups) are particularly likely to be swallowed if left where the
child can find them.
In addition to all bathroom and kitchen cleaners, substances such as
drain cleaners, petroleum products, cosmetics such as lemon-scented nail
polish remover, plant fertilizers, and turpentine should be rounded up and
Many poisonings occur from a mother’s or grandmother’s purse, which
might contain cosmetics and medications; if these are kept in a purse, they
should be placed in child-resistant containers and be safely stored.
Placing materials in child-resistant containers, securing latches, and taking
other similar precautions are time-consuming but vital steps. Supervision
of crawling infants and toddlers is also essential in any new location where
toxic materials such as cigarettes, pesticides, or poisonous plants might be
During the first 18 months of life, mouthing objects is one important way
a child explores the world, and older toddlers still taste interesting-looking
Knowing the poison-control center number in an emergency and having
syrup of ipecac in the house to induce vomiting (only if so instructed) can
also prevent a serious consequence should a poisoning occur.
Choking and Suffocation
There are several sources for injury due to insufficient oxygen. Choking
can occur with common foods (foods that most often cause choking include
soft, pliable foods such as hot dogs or grapes and hard, slick, round foods
such as candies or nuts). Similarly, adult medications, pieces of balloons, foreign
objects from toys or from off of the floor can block a child’s airway.
Strangulation can occur when the cord holding a baby’s pacifier or the
cord from window blinds wraps around the child’s neck or when a child’s
head is wedged in between slats of a crib or a gate large enough to allow the
child’s head to pass through.
Children can suffocate in small refrigerators, under mechanically powered
garage doors, or in old trunks.
Recognition that any object large enough for a child to crawl into is a hazard
that should be locked shut or removed is a first step. Examining all children’s
furniture (such as cribs with slats greater than 2 3/8 inches apart) and
other objects that might trap a child’s head is another. A pacifier or other toy
should never be attached to the child with a string. Similarly, the loop from
blinds is also a potential hazard that can be removed by simply clipping the
loop above the child’s reach.
Selection of foods that do not pose a risk or making risky foods harmless
(i.e., slicing hot dogs lengthwise, cutting grapes into pieces, buying flat candy
rather than round) will help avoid injury. Infants and small children can
choke on adult-sized medications such as aspirin tablets; only liquids should
be given to infants and liquids or chewable medications to toddlers after they
The warning with some toys, “Not recommended for children under age
3,” should be taken seriously. These toys may have small parts that could
choke an infant.
Similarly, common household objects such as a thimble or outdoor
objects such as pebbles can choke a young child. An area must be swept clear
of any small objects or constant vigilance with a crawling or toddling child is
necessary. Automatic garage-door openers need to be checked periodically to
ensure that the door maintains sufficient sensitivity to reverse itself quickly
should it encounter any object blocking its closure.
There are many other dangers to a small child within the home (e.g.,
firearm injury, electrocution) and outside the home (e.g., tricycle injuries,
animal bites). In general, environmental barriers between the child and the
hazard, removal of the hazard when possible, and the use of consistent
parental supervision are most important. As children grow, their knowledge
and use of safety skills should be repeatedly tested before parental supervision
Once safety becomes a habit, it becomes easy to change one’s lifestyle.
Altering one’s environment and behavior to promote safety can become second
Because injury continues to be the leading cause of death in the U.S. up
to age 40, what better legacy to leave a child than a healthy respect for hazards
that result in injury and the knowledge and motivation to ensure safety
at each stage in development?
For more information or to find a therapist:
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