Easy-to-Teach Preventative Mental Health: CBT in Action

Dr Michael E. Bernard

Founder, You Can Do It! Education

Emeritus Professor, California State University, Long Beach
Former Professor, Melbourne Graduate School for Education, Melbourne University
Doctorate of Educational Psychology

In an era where mental health challenges among young people are rising at alarming rates, the importance of effective school-based preventative mental health programs cannot be overstated. Research consistently shows that early intervention is key, with schools ideally positioned to implement programs that reach children during their formative years.

Below, I explore an evidence-based best practice in preventative mental health programs for schools that are rooted in Cognitive Behaviour Therapy (CBT), specifically Rational Emotive Behaviour Therapy (REBT) and its educational derivative, Rational Emotive Education (REE).

The Growing Need for Mental Health Prevention in Schools

Recent statistics depict a concerning picture of youth mental health. According to my research on student wellbeing conducted in collaboration with the Australian Council for Educational Research, 48% of students today say they worry a lot, 44% say their feelings are easily hurt, 41% say they are very stressed, 32% say they feel bad for long periods, and 29% say they lose their temper a lot. This data is consistent with various global studies that approximately one in five children and adolescents experience mental health difficulties that significantly impact their daily functioning. If these challenges remain unaddressed, they can result in more severe issues in adulthood, such as chronic mental illness, substance abuse, and social difficulties.

Schools provide a universal point of access to children and adolescents, making them ideal settings for implementing preventative strategies. Rather than waiting for problems to become severe enough to require clinical intervention, school-based programs can equip students with protective skills and knowledge that reduce the likelihood of developing mental health issues in the first place.

The Evidence for CBT and REBT in Preventative Programs

Research strongly supports teaching young people the fundamentals of Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavior Therapy (REBT) as effective preventative mental health measures. These approaches have demonstrated success in reducing the risk of anxiety, depression, anger management issues, and even maladaptive behaviours such as alcohol and substance abuse.
At their core, both CBT and REBT focus on the relationship between thoughts, emotions, and behaviours. By teaching students to identify and challenge unhelpful thinking patterns, these approaches empower young people with lifelong skills for emotional regulation and psychological resilience.

The CBT Approach

Cognitive Behavioral Therapy, developed by Aaron Beck, focuses on recognising and restructuring negative thinking patterns. When adapted for school settings, CBT-based programs typically teach students to:

Identify automatic thoughts that arise in challenging situations.
Recognise cognitive distortions such as catastrophising, black-and-white thinking, or over-generalisation.
Challenge negative thoughts with evidence and alternative perspectives.
Replace unhelpful thinking patterns with more balanced and realistic ones.

Research shows that when young people learn cognitive restructuring techniques, they exhibit significant improvements in emotional wellbeing. A meta-analysis of school-based CBT programs found moderate to strong effects in reducing anxiety symptoms and preventing the onset of depression among at-risk youth.

The REBT Approach

Rational Emotive Behavior Therapy, the earliest form of CBT, was developed by Albert Ellis. Its applications in the form of Rational Emotive Education were pioneered by William Knaus, Ann Vernon, and myself. It specifically focuses on identifying and challenging irrational beliefs that lead to emotional distress. In school settings, REBT-based programs typically teach students to:

Recognise irrational beliefs such as “I must always succeed,” “I need everyone to like me,” or “It’s awful, and I can’t stand doing homework.”
Understand the difference between rational and irrational thinking.
Dispute-challenge irrational beliefs through logical questioning.
Develop rational alternatives that promote psychological flexibility.

Studies show that when children and adolescents learn to identify and challenge irrational beliefs, they exhibit improved emotional resilience, decreased anxiety, and improved behavioural outcomes. Emphasising the development of rational beliefs acts as a protective factor against various mental health challenges.

Innovation in Preventative School-Based Mental Health

My collaboration with colleagues over 25 years has been recognised as innovative best practice in school-based preventative mental health, particularly in the application of REBT and REE (Co-Founder, Australian Institute for Rational Emotive Therapy; Founder, You Can Do It! Education) for school-age children and adolescents.

I have written extensively in this area, including my work as an author and editor on over 15 books, such as “Rational-Emotive and Cognitive-Behavioral Approaches to Child and Adolescent Mental Health: Theory, Practice, Research,” 30 book chapters, and published articles.

My work draws heavily from CBT and REBT principles, translated into developmentally appropriate activities and lessons for classroom implementation. A significant contribution to the field is the development of You Can Do It! Education’s Program Achieve curricula in its 5th edition —a comprehensive preventative mental health and social-emotional learning curriculum for early childhood, primary and secondary school students.

You Can Do It! Education and Program Achieve as a Preventative Mental Health Curriculum

Program Achieve is one of the most well-established preventative mental health curricula globally. This online curriculum features a variety of classroom activities based directly on CBT and REBT principles.

Program Achieve is founded on decades of one-on-one counselling using REBT and REE with school-age children referred for mental health challenges, such as anxiety, low self-esteem, and anger. I have developed creative and highly effective activities that teach children as young as six how to think rationally when faced with stressful situations (see the latest edition, Strengthening Attitudes and Behaviours for Learning: Activities for Students with Achievement and Behaviour Challenges).

Program Achieve focuses on enhancing the prefrontal cortex’s ability to manage thinking and emotional regulation, including recognising, challenging, and changing irrational beliefs into rational ones (e.g., avoiding catastrophising and not taking things personally).

Program Achieve has a distinct focus on mental health challenges (referred to as ‘social-emotional blockers’):

Anxiety
Feeling down
Anger
Not paying attention
Procrastination

What is unique about Program Achieve as a preventative mental health curriculum is that you don’t have to be a trained counsellor or mental health specialist. It is easy to teach due to its detailed, easily accessible language and activities.

Program Achieve is Australia’s first social-emotional learning program, with over 1,000,000 students participating in classroom presentations. Many of the lessons are designed to build the “5 Keys for Achievement and Social-Emotional Wellbeing”:

Confidence (academic and social)
Persistence (task completion and goal achievement)
Organisation (goal setting and time management)
Getting Along (social awareness-empathy, social skills and relationship building)
Resilience (emotional awareness and self-management for coping with setbacks and challenges)

Program Achieve’s lessons systematically teach students to recognise and confront negative thoughts and irrational beliefs undermining these foundations. Through age-appropriate lessons, students learn cognitive restructuring techniques and develop rational thinking patterns that enhance emotional regulation and promote positive behaviour.

Research on Program Achieve demonstrates its effectiveness in improving student outcomes across multiple domains, including academic achievement, behavioural indicators, and measures of psychological wellbeing. Schools that implement the program report reductions in anxiety, depression, and behavioural issues, along with improvements in classroom climate and student engagement.

Being proud of who you are is one side of the self-acceptance coin. The other side is the process of how you go about accepting yourself no matter what and refusing to put yourself down.

Rational self-acceptance means that you carry a stable sense of positive self-worth based on things about yourself you are proud of in situations that might be negative and stressful. You fully understand that your self-worth remains unchanged throughout.

Rational self-acceptance means an end to self-rating and self-downing. It means an end to looking to others and your achievements as ‘necessities’ to feel good about yourself. Sure, achieving well and receiving recognition feels good, but that doesn’t mean you need achievement and approval to value yourself. The valuing of yourself needs to come from within, from a sense of who you are and an acceptance of your value because of who you are and because you are alive.

Best Practices in Implementation

Although the evidence supporting CBT and REBT-based programs is compelling, their effectiveness ultimately depends on the quality of implementation. Based on research and practical experience, several best practices emerge for schools aiming to establish preventative mental health programs:

1. Whole-School Approach

The most effective preventative programs adopt a whole-school approach, integrating mental health promotion across multiple levels:

Universal tier reaching all students with foundational skills.
Targeted interventions for students showing early signs of difficulty.
Individual support coordinated with external services when needed.

This multi-tiered framework guarantees extensive coverage while permitting varied support based on student needs.

2. Developmental Appropriateness

Best practice involves adapting cognitive-behavioural approaches to meet students’ developmental stages. As Program Achieve illustrates, the same core principles can be taught at various levels using age-appropriate language, examples, and activities.

For younger children, programs typically emphasise the fundamental connections between thoughts and feelings, often using visual aids, stories, and concrete examples. For adolescents, programs can present more nuanced concepts related to cognitive distortions and belief systems.

3. Teacher Training and Support

Teachers play a crucial role in effectively delivering preventative mental health programs. Best practice includes:

Comprehensive initial training in program content and pedagogy.
Ongoing coaching and support during the implementation.
Regular opportunities for reflection and troubleshooting.
Access to mental health professionals for consultation.

When teachers understand and value the underlying principles of CBT and REBT, they can more authentically model and reinforce these approaches throughout the school day.

4. Parent and Community Engagement

Extending a program’s influence beyond school walls significantly enhances its effectiveness. Successful programs typically include:

Parent education sessions on key concepts.
Take-home activities that reinforce classroom learning.
Regular communication about program content.
Coordination with community mental health resources.

When parents understand and support the rational-emotive and cognitive-behavioural strategies their children are learning, they can reinforce these methods at home, fostering a consistent environment for skill development.

Monitoring and Evaluation

Rigorous evaluation is another hallmark of best practice in preventative mental health programs. Effective monitoring generally includes:

Pre and post-assessments to measure changes in targeted outcomes.
Implementation of fidelity measures to ensure quality delivery.
Regular feedback from students and teachers to guide improvements.
Long-term follow-up to assess sustained impact

This commitment to evaluation shows program effectiveness and provides valuable data for ongoing improvement.

In Australia, over the past two decades, more than 500,000 students have completed my Survey of Student Wellbeing, published by the Australian Council for Educational Research, to gather baseline data on students’ social-emotional capabilities and to assess the impact of You Can Do It! Education and Program Achieve.

Conclusion

Research conclusively supports the teaching of CBT and REBT principles as effective methods for reducing the risk of mental health challenges among young people. When implemented with a focus on best practices, school-based preventative programs can significantly decrease rates of anxiety, depression, anger management issues, and maladaptive behaviours such as substance abuse.

You Can Do It! Education’s Program Achieve successfully translates rational-emotive and cognitive-behavioural principles into effective classroom practices. By systematically teaching students to identify and challenge negative thoughts and irrational beliefs, such programs equip young people with essential skills for lifelong mental health and resilience.

As mental health challenges among youth continue to rise, implementing evidence-based preventative programs represents not only a best practice but also an ethical imperative for schools committed to supporting student wellbeing. By investing in prevention, schools can play a crucial role in reversing mental health trends and fostering a generation of psychologically resilient young people.

References

Bernard, M.E. (2024). Strengthening Attitudes and Behaviours for Learning. Activities for Students with Achievement and Behaviour Challenges. East Melbourne: The Bernard Group.

Bernard, M.E. (2020). Self-acceptance. REBT as the psychological armor that protects children and adolescents. In M.E. Bernard & M.D. Terjesen (Eds.), Rational-Emotive and Cognitive-Behavioral Approaches to Child and Adolescent Mental Health: Theory, Practice, Research, Applications. Cham, Switzerland: Springer Nature, pp. 223-240.

Bernard, M.E. (2020). Academic procrastination and educational underachievement: How REBT works. In M.E. Bernard & M.D. Terjesen (Eds.), Rational-Emotive and Cognitive-Behavioral Approaches to Child and Adolescent Mental Health: Theory, Practice, Research, Applications. Cham, Switzerland: Springer Nature, pp. 395-418.

Bernard, M.E. (2003; 2024). The Social-Emotional Well-Being Surveys (2nd Edition). Camberwell, Victoria: Australian Council for Educational Research.

Vernon, A., & Bernard, M.E. (2020). Rational Emotive Education as social-emotional learning. In M.E. Bernard & M.D. Terjesen (Eds.), Rational-Emotive and Cognitive-Behavioral Approaches to Child and Adolescent Mental Health: Theory, Practice, Research, Applications. Cham, Switzerland: Springer Nature, pp. 419-452.

Bernard, M.E. & Terjesen, M. (Eds.). (2018). Rational-Emotive and Cognitive-Behavioral Approaches to Child and Adolescent Mental Health: Theory, Practice, Research, Applications. Cham, Switzerland: Springer Nature, pp. 543.

Bernard, M.E., Elias, M.J., Bell, P. J., Ferrito, J. J. & Langione, K. (2017). Social
and emotional learning: Role of school psychologists in Australia. In M. Thielking & M. Terjesen (Eds). Handbook of Australian School Psychology International Research, Practice and Policy. Switzerland: Springer Publishing, pp. 503-519.

*Featured blog image credit: Photo by JESHOOTS.COM on Unsplash

Embracing your authentic self. Photo by Brooke Cagle on Unsplash.

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