The Role of Cognitive Behavior Therapy (CBT) Counseling in Managing Anxiety Disorders in Adolescents

The Role of Cognitive Behavior Therapy (CBT) Counseling in Managing Anxiety Disorders in Adolescents

Levinia Dian Kristina Wati*, Ali Murtadho, Windy Ernaeny, Aptaarkhan Aurell Is Haque

Islamic Religious Science, Walisongo State Islamic University Semarang, Indonesia

DOI: https://dx.doi.org/10.47772/IJRISS.2025.90300208

Received: 22 February 2025; Accepted: 08 March 2025; Published: 08 April 2025

ABSTRACT

This research aims to analyze the role of Cognitive Behavior Therapy (CBT) counseling and to analyze ways to manage anxiety disorders in adolescents. This research is a literature study using a qualitative paradigm with content analysis or interpretive content analysis, intertext analysis or intertextual analysis. The research results show that CBT plays an important role in managing adolescent anxiety disorders. The ability to target inappropriate thought patterns and help adolescents acquire skills that can be used throughout their lives is the key to its success. To improve therapy outcomes, it is important to consider the existing challenges. This includes a lack of access and social support. To maximize the impact of CBT on the adolescent population, increased access to trained therapists and the use of more advanced technology are necessary. However, the management of anxiety disorders in adolescents must be supported by various types of therapies such as psychopharmacological therapy, somatic therapy, psychological therapy, behavioral therapy, and religious therapy or what is known as dhikr therapy.

Keywords: Counseling, Cognitive Behavioral Therapy (CBT), Adolescent Anxiety Disorder

INTRODUCTION

Cognitive Behavioral Therapy (CBT) is a psychological therapy based on the idea that thoughts, feelings, and behaviors influence each other (Hofmann et al., 2012). The goal of CBT is to help people recognize and change irrational negative thought patterns or beliefs (cognitions) and replace them with more adaptive ways of thinking (Donovan & March, 2014). CBT also involves changing unproductive or bad behaviors into more constructive ones.

Cognitive Behavioral Therapy (CBT) is a psychological therapy based on the idea that thoughts, feelings, and behaviors influence each other (Hofmann et al., 2012). The goal of CBT is to help people recognize and change irrational negative thought patterns or beliefs (cognitions) and replace them with more adaptive ways of thinking (Donovan & March, 2014). CBT also involves changing unproductive or bad behaviors into more constructive ones.

Cognitive Behavioral Therapy (CBT), also known as Cognitive Behavioral Modification, is a behavioral modification therapy that uses cognition as the “key” to behavioral change. Therapists help clients by removing their negative thoughts and beliefs, to then be replaced with a better thought pattern construction (Podina et al., 2016).

Anxiety is often termed as Anxiety. Anxiety is a word that is familiar to us, because parents, adults, teenagers and children must have experienced what is called anxiety even though in different forms and types (Sutrisno, 2013). Anxiety is a complex and chronic emotional situation characterized by feelings of fear, restlessness and tension (Arifiati & Wahyuni, 2019). Anxiety occurs because people are unable to adjust to their social environment, anxiety can also arise because of the relationship of a mixture of various emotional processes and feelings that are mixed when individuals are experiencing emotional stress and mental stress. The level of anxiety of each person is different, some are high and some are low. Teenagers have quite high levels of anxiety because at this time their emotions are still up and down.

Counseling is assistance given by a guide (counselor) to a counselee or a group of counselees (clients, counselees, someone who has a problem) to overcome their problems by means of interviews with the aim that the client or group of clients understand more clearly about their own problems and solve their own problems according to their abilities by studying the suggestions received from the Counselor (Sumarwiyah et al., 2015).

Counseling services are an effort to provide assistance from a professional guide (counselor) to individuals who need help (conselees) with various techniques or methods to find solutions to the problems they are experiencing. Counseling services carried out in groups are given to a group of individuals who have the same problems by utilizing group dynamics in solving problems. The stages of counseling implementation include 4 stages, namely the opening, transition, activity and ending stages. Group counseling services with cognitive restructuring techniques aim to produce new habits in thinking by intervening or replacing irrational perceptions with rational ones that are the source of self-esteem problems. In line with research conducted by Damayanti & Nurjannah (2016) concluded that cognitive restructuring technique counseling has proven effective in increasing self-esteem, especially in individuals who have negative self-esteem (Apriatama et al., 2022).

Group counseling is a counseling service that utilizes groups to share experiences, help and provide feedback. Group counseling in its implementation utilizes group dynamics. Furthermore, according to Winkel, group counseling is a form of counseling service that in its implementation involves several people at once who are members of a small group. The therapeutic characteristics of group counseling are that there are things that are inherent in interpersonal interactions in the group and help to understand oneself better and find solutions to various difficulties faced. It can be concluded that group counseling is a process of providing assistance through a counselor (group leader) with several individuals who are members of the group (group members) who tend to have the same problems by utilizing group dynamics (Fitri et al., 2018).

Group counseling is a conducive environment that provides an opportunity for members to accept and provide ideas, feelings, support and assistance to other members. In group counseling there is also an opportunity to practice and receive feedback to learn new behaviors and be responsible for the choices that have been determined by themselves. This atmosphere can foster PSYCHOLOGY Number 6 of 1998 feelings of meaning for members which can then foster a positive self-concept and high self-esteem that will foster and increase self-confidence. Compared to individual counseling. group counseling has advantages because in group counseling members can get help and feedback from counselors and other members. In addition, members can directly practice new behaviors in a group and the results of these behaviors can be observed and evaluated by themselves, counselors and other members.

By participating in group counseling, teenagers who lack self-confidence will get a conducive and natural environment in accordance with their developmental stages and the opportunity to see and practice new behavior, namely self-confident behavior. They will also get the opportunity to provide support, assistance and feedback to each other. This will foster a positive self-concept which will then foster high self-esteem and increase self-confidence (Afiatin & Martaniah, 2016).

CBT, or Cognitive Behavioral Therapy, is a psychotherapy method that has been shown to be successful in treating anxiety disorders in adolescents. GAD, social anxiety, panic disorder, and generalized anxiety disorder are types of anxiety disorders that often emerge in young people and can impact their ability to socialize, attend school, and achieve emotional well-being (Zuraidah Zuraidah, 2023).

CBT focuses on how thoughts, emotions, and behaviors interact with each other. Coping skills training, controlled exposure, and cognitive restructuring help teens identify and change negative thought patterns that exacerbate their anxiety. In addition, family or school sessions are often more effective because parents or caregivers help with behavioral changes. (Leahy, R. L. 2017: 54).

METHODS

This research is a library research using a qualitative paradigm. Qualitative research is intended to examine the natural conditions of objects, data analysis is inductive, and the results of the research emphasize more on meaning rather than generalization (Sugiyono, 2010: 1). The process of reading the text is carried out repeatedly in various different contexts, so that new and increasingly rich meanings can be discovered (Norman K. Denzin & Yvonna S. Lincoln, 2009: 545).

The technique of analyzing library research data using content analysis or content analysis is interpretive, intertext analysis or inter-text analysis (Stefan Titsher & Friends, 2009: 108). So what is meant here is the collection of library research data by searching for, reading and reviewing books related to the problem.

The process of analyzing data using analysis techniques using content analysis. Content analysis is a technique used to draw conclusions through efforts to find message characteristics, and is carried out objectively and systematically (Lexy J. Moleong, 2012: 220).

The content analysis procedure must contain clear values ​​and messages, including:

1. The text is processed systematically using a previously designed theory,
2. The existing text is searched for analysis units and categorized according to theoretical references,
3. The analysis process is carried out on the understanding of the theory,
4. The analysis process is based on descriptive, carried out qualitatively (Suwandi Edraswara, 2010: 162).

RESULT

The Role Of Cognitive Behavior Therapy (CBT) Counseling  is on interaction process which facilities meaningful understanding of self and environment and result in the estabilize ment and /or clafication of goals and values of future behavior” (Key Sun, 2013: 47). The characteristics of professional counseling are as follows:

1. Counseling is a professional relationship established by a counselor who has been trained for the job.
2. In this professional relationship, clients learn decision-making skills, problem solving, and new behaviors or attitudes.
3. The professional relationship is formed based on the willingness of the client and the counselor (Abu Bakar & M. Laudin, 2010: 8).

The existence of differences in the definition of counseling, in addition to being caused by the development of counseling science itself, is also caused by differences in the views of experts who formulate counseling and the theories they adhere to. In the field of counseling, there are various schools and theories, which can be grouped into several categories. There are experts who classify counseling based on its function into three groups, namely: supportive, reductive, and reconstructive. Counseling is also distinguished based on its methods, namely directive and nondirective methods (Ulfiah, 2009).

Counseling is a form of relationship that is helpful. The meaning of help here is as an effort to help others so that they are able to grow in the direction they choose, are able to solve the problems they face and are able to face the crises experienced in their lives. The counselor’s job is to create the conditions necessary for the growth and development of the client (Syamsu Yusuf dan A. Juntiks Nurihsan, 2012: 9).

Group counseling services allow students to have the opportunity to discuss and resolve problems they experience through group dynamics (Luddin, A. B. M, 2013: 57). This service is provided so that students can have self-confidence so that they will be able to face their future later.

The objectives of guidance, which are a description of the general objectives, have been formulated in many definitions of guidance, including that guidance is stated as assistance given to individuals so that the individual:

1. Understand yourself and your environment. Understanding yourself includes recognizing your abilities, special talents, interests, ideals, and life values ​​that you have for your development. Understanding your environment includes recognizing your physical, social, and cultural environment. Environmental information can be divided into: educational, career, and social-personal information.
2. Able to choose, decide, and plan your life wisely in the fields of education, work, and social-personal. This includes helping individuals to choose their fields of study, careers, and personal lifestyles.
3. Develop your abilities and capabilities to the maximum.
4. Solve problems faced wisely. This assistance includes providing assistance to eliminate bad habits or attitudes that cause problems.
5. Manage your life activities, develop your perspective, and make decisions and be responsible for them.
6. Understand and direct yourself in acting and behaving according to the demands and conditions of your environment.

The function of guidance can be interpreted as a certain activity that supports or has meaning to the purpose of guidance. The function of guidance is often interpreted as the nature of guidance. For example, the function of guidance stated by Mortensen divides the function of guidance into:

1. Understanding the individual. A teacher and mentor can provide effective assistance if they can understand and comprehend the problems, nature, needs, interests, and abilities of their students. Therefore, effective guidance absolutely demands an understanding of the child as a whole.
2. Preventive and individual development. Preventive and development are two sides of the same coin. Preventive attempts to prevent the decline in child development and at least can maintain what has been achieved in child development through the provision of positive influences. While development provides assistance to develop attitudes and behavioral patterns that can help each individual to develop themselves optimally.
3. Helping individuals to perfect their ways of solving problems. Every human being at a certain time needs help in dealing with their environmental situations. The help needed for each individual is not the same (Yusup Gunawan, dkk, 2012: 44).

Counseling in Cognitive Behavior Therapy (CBT) has been recognized as an effective treatment for managing various types of anxiety disorders faced by adolescents, such as GAD, social phobia, and panic disorder. CBT addresses GAD by analyzing the relationship between maladaptive thoughts, emotions, and behaviors.

Cognitive Restructuring: CBT helps adolescents recognize and replace their negative or irrational thought patterns (e.g., “everyone will judge me badly”) with more realistic ones. According to research, cognitive restructuring can significantly reduce anxiety in a relatively short period of time.

Graded Exposure: This method involves gradual exposure to anxiety-provoking situations in a controlled environment, which gradually reduces the anxiety response. A teenager with social phobia, for example, can be taught to overcome their fear of public speaking.

Coping Competencies: CBT teaches adolescents skills such as stress management, relaxation, and response planning, which help them more confidently deal with stressful situations.

How To Manage Anxiety Disorders In Teens

There are several factors that cause anxiety disorders, including heredity, brain biochemistry, excessive opponent responses, life circumstances and learned behavioral habits (Hadi et al., 2017). One of the causes of anxiety is worry. When people are immersed in anxious thoughts, they lose their sense of subjective feelings. Anxiety that arises from worry increases heart rate, sweating, trembling, and when worry lasts (Putriana, 2018).

Cognitive factors such as self-efficacy (lack of confidence in carrying out tasks successfully) can also cause anxiety. Someone who has low self-efficacy will think that he cannot do tasks or is pessimistic about his abilities so that he tends to feel more anxious (Suryana, 2016).

Alternatives on how to deal with anxiety, namely:

1. If anxiety is at a general level, then the anxiety is brought to certain situations and experiences, this will reduce feelings of anxiety. Although what is experienced is so real, it will definitely be overcome as age develops, therefore a belief is needed in all the efforts that have been made.
2. If the anxiety experienced lasts more than 6 months, the initial step is to try consulting with a professional, teacher, psychiatrist and adolescent who specializes in handling adolescent problems. Anxiety disorders do require treatment if they are serious enough. Treatment for anxiety usually includes medical treatment, relaxation, and feedback to control tense muscles. A combination of various treatments can be applied (Asrori & Hasanat, 2022).

Therapy or treatment for stress, anxiety and depression includes:

Psychopharmacological Therapy

This therapy is carried out by using drugs that are effective in restoring the function of disorders in the brain’s nervous system. The way this psychopharmacological therapy works is by breaking the psycho-neuro-immunological network or circuit so that the stress experienced by a person does not affect other organs of the body. The therapies that are widely used are anti-anxiety drugs and anti-stress drugs.

Somatic Therapy

This therapy is used to eliminate somatic (physical) complaints by administering drugs that are aimed at the organs concerned.

Psychological Therapy

This therapy is used to strengthen the personality structure, self-confidence, physical or mental resilience and immunity as well as the ability to adapt and resolve the stress experienced.

Behavioral Therapy

This therapy is used to restore a person’s ability to adapt so that they can function normally again in everyday life or their social environment. To achieve the above, we should make changes to unhealthy habits or lifestyles. Therapy that can be used by means of SWOT analysis (Strength Weakness, Opportunity, and Threat).

Religious Therapy

This therapy is done by giving a religious touch to the patient and encouraging them to study religion and practice it in practice so that it can strengthen the patient’s faith. The therapy used is praying, dhikr and reciting or reading holy books (Sundara et al., 2022).

The appropriate therapy to overcome anxiety in students is psychological therapy and religious therapy by advising students to read the Qur’an or called dhikr therapy. Dhikr therapy seeks to bring remembrance of Allah SWT in daily activities, either by saying certain words that are in accordance with the Qur’an and Sunnah, or by contemplating the creation of His creatures. When dhikr activities can be applied in daily life, the positive impacts as described above will appear in a person. Dhikr, in it contains many psychological essences, namely: a) Dhikr as a medium for relaxation. The focus of this relaxation is not on muscle relaxation but on certain phrases that are said repeatedly with a regular rhythm accompanied by an attitude of surrender to the object of transcendence, namely God. The phrases used can be the names of God or words that have a calming meaning. The pronunciation of dhikr phrases accompanied by belief in His love, His protection and His other good qualities will create a sense of calm and security. b) Dhikr as a medium for catharsis. Dhikr will always be related to prayer and has a strong bond, especially in relation to healing the heart, so dhikr is more important to be conveyed in sincere prayer. c) Dhikr as a medium of hope for God (expectation). Dhikr will create a feeling of optimism in Allah SWT that Allah will always help him in facing all the calamities that befall him. d) Dhikr as a medium to surrender to Allah SWT. Dhikr makes someone continue to remember the Creator. They will always be happy and pleased with what Allah has given them (Niko, 2018).

In addition to the two methods above, the role of family and close friends can also help resolve anxiety problems. Adequate support and attention from close friends and family is very important in the process of healing anxiety because it means a lot to the sufferer. Communication is the key because with close friends and family the sufferer can communicate about the problems being faced so that the root of the problem can be identified and can be solved together.

In the Qur’an, several solutions have been mentioned to deal with anxiety, stress and depression. As in Q.S Al-Baqarah verse 153 as follows:

يَا أَيُّهَا الَّذِينَ آَمَنُوا اسْتَعِينُوا بِالصَّبْرِ وَالصَّلَاةِ إِنَّ اللَّهَ مَعَ الصَّابِرِينَ

Meaning: O you who believe, make patience and prayer your helpers, indeed Allah is with those who are patient.

DISCUSSION

Although CBT has been empirically proven to be effective, there are several problems that hinder its implementation:

1. Adolescent Motivation and Engagement: Adolescents who are reluctant to participate or have low expectations of therapy often have difficulty attending CBT regularly.
2. Lack of Trained Therapists: Not all areas have access to experienced adolescent CBT therapists. This is a barrier, especially in low-resource or rural areas.
3. Social Context: A supportive family and social environment are critical to the success of CBT therapy. Family disharmony or an unsupportive environment can lead to poorer therapy outcomes.

CBT not only helps people with their anxiety symptoms, but it also helps them with other things, such as learning better and having better relationships with others. Some of the key components that support the use of CBT are:

1. Family Support: Taking part in CBT sessions with family can improve good outcomes, as it can create an environment that supports behavioral change.
2. If CBT is implemented in a community or school, it can help adolescents who are facing academic or social pressures. It can also raise public awareness of the importance of mental health.

CONCLUSION

CBT plays a vital role in managing adolescent anxiety disorders. The ability to target inappropriate thought patterns and help adolescents acquire lifelong skills is key to its success. To improve treatment outcomes, it is important to consider the challenges that exist. These include lack of access and social support. To maximize the impact of CBT in the adolescent population, increased access to trained therapists and the use of more sophisticated technology are needed. However, the management of anxiety disorders in adolescents must be supported by a variety of therapies such as psychopharmacological therapy, somatic therapy, psychological therapy, behavioral therapy, and religious therapy or referred to as dhikr therapy.

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