Cognitive behavioral therapy and parent contracts, do these two things have anything in common? It may not appear so at first but let’s take a look into the subject and see. First, what is cognitive behavioral therapy? The word “cognitive” refers to mental processing and behavior therapy is typically thought to be some type of therapy to alter a specific behavior. When you put all of this together you get behavior therapy that is applied through mental processing or cognitive behavioral therapy. Behavior therapy can be approached in many different ways including reward/punishment systems, educational approaches, and others. Cognitive behavioral therapy analyzes the mental process that leads up to or happens when the problem behavior occurs and then teaches the teen how to change the process before it becomes a problem.
So, how would a parent contract be useful or helpful in cognitive behavioral therapy? Cognitive behavioral therapy often involves some type of journal keeping, worksheets, or other written process in which the person writes out the mental process as it occurs. This is absolutely critical to the success of the cognitive behavior therapy. These worksheets and journal entries are teaching the person to recognize destructive or problem thoughts and triggers that are leading to the behavior that has become a problem (intermittent explosive behavior, social anxiety, oppositional defiance, etc). By recognizing these patterns, the patient and therapist can work together to stop the negative thought process before if gets to the point that the negative behavior occurs. Having a parent contract that defines what is expected of the child or teen in between sessions with his/her therapist is an effective way to make sure that the teen is doing the assignments without being mean, nagging, or intruding.
The parent contract must be developed in the presence of, and with the coordination of, the therapist so it will be part of the process and not threatening. It is essential that the parent, counselor, and teen are all involved in developing the parent contract and agree on the elements included. The parent contract should be clear and concise with directions about how the parent contract will be implemented and enforced as well as what the consequences will be if the parent contract is broken. For instance, the therapist may require that the teen writes at least one journal entry per day that is at least one paragraph in length and that he/she fill out a minimum of one CBT (Cognitive Behavior Therapy) worksheet everyday. The contract may simply state that at a set time every day (say 10 PM) the teen will bring both the journal and completed worksheet to one of his/her parents for review. The parent contract should also be clear as to whether or not the parent should read the information. Many teens do not want their parents analyzing their mental process (and typically that is the therapists job) so the contract may simply state that the child has to show the completed assignments to the parent and allow him or her to initial each one showing he/she has seen it but that he/she is not allowed to read the contents.
To be effective the contract should also provide consequences for the rules being broken. This may be that the therapist will be notified at a certain point, that the teen will be admitted to some other kind or treatment program, or whatever the parent, teen, and therapist agree is a fair and reasonable consequence that will keep each of the involved party’s best interest in mind. In essence, the parent contract in conjunction with cognitive behavioral therapy works as an accountability element in between sessions with the therapist. The only way that any therapy is effective for helping struggling teens is if the things learned in the sessions are implemented at home. Having a parent contract as part of the cognitive behavioral therapy process makes sure that some effort is being made to implement what is learned. This gives the teen immediate consequences is he/she does not follow through with what is agreed on and also ensures the parent that the money being invested into the treatment is not just being wasted because neither the teen or therapist is informing them that the teen is choosing to not participate in the recommend treatment.