Table 1.

What children and adolescents learn in cognitive behavioral therapy

Step	Psychological skill
1	Recognition of problematic social situations
	Which social situations are problematic for me? This is important to know in view of starting thinking in a situation that might be difficult for me to handle
2	Recognition of facial expressions
	What do other person’s facial expressions tell me about their feelings and about a possible social problem? If the other person feels anxious, sad, or angry this person can expect me to respond to this. I really need to think now
3	Emotional awareness and regulation
	What do I feel myself? And in case my own feeling (e.g., anxiety, sadness, anger) is too strong, what can I do to cope with this feeling?
4	Behavioral inhibition and working memory
	I shouldn’t act right away. Rather, I should think first and concentrate on what is the problem and how to solve it
5	Interpretation and empathy
	When I see that someone else has done something bad to me, I shouldn’t always think this person did that on purpose. Maybe I’m inclined to think this because I’m convinced that’s the way how people treat each other. On the other hand, when I see that the other person feels bad I should try to understand what did happen. Maybe I don’t see that I did hurt the other because I’m not used to paying attention to it. And what do I feel myself when I see how this person feels? Do I understand what this person might feel? Am I prepared to care for this person?
6	Clarification of goals
	When I want to solve this problem, what is my goal? If I know my goal, I can better think about what to do. Do I want to get my way or revenge for wrongs done? Or do I want to work things out and find a solution together with this person?
7	Generation of solutions
	In a difficult situation I must try to come up with one or more solutions. Maybe I think that only aggressive solutions work. Perhaps there are also solutions that bring both me and the other person benefits? To find such ‘kind’ solutions, I need to think what the problem actually is (step 5) and what I want to achieve (step 6)
8	Evaluation of solutions based on outcome expectations and normative beliefs
	Then, I would do well to think about consequences of solutions for me, the other person, and our relationship, both on the short and long-term. I may have difficulty believing that positive consequences can also be expected to result from solutions that are clearly not aggressive but ‘kind’ (or constructive) instead. Related to this, I would do well to consider if the solutions I’m thinking about do not harm the other person
9	Decision-making
	In the end I choose the best solution for both of us. For this, I have to make connections between previous steps: What is the problem? What is my goal? What are possible solutions? And what is the solution that is most beneficial for the other person and myself? This can be difficult for me. But many positive experiences with appropriate solutions will help me making correct decisions