At What Age Can Kids Start CBT? How Play Therapy and CBT Work Together at Compassionate Counseling St. Louis
As a parent, you might be wondering: Is CBT really appropriate for my 4-year-old? That’s a great question—and one I get all the time! When we think of Cognitive Behavioral Therapy (CBT), we often imagine “talk therapy.” And yes, for teens and adults, CBT often looks like exactly that—talking through emotions, practicing new ways of thinking, and building coping skills.
But here’s the thing: CBT is incredibly flexible. When we work with young kids (ages 3-7), CBT doesn’t look like sitting on a couch and chatting about feelings. Instead, it’s playful, creative, and hands-on. We integrate play therapy techniques because play is your child’s natural language.
At Compassionate Counseling St. Louis, we specialize in helping anxious and angry kids. Our therapists tailor sessions to each child’s needs—whether that’s through Child-Centered Play Therapy (CCPT), art, games, or a blend of structured CBT techniques and playful activities that build skills in a way that feels fun and safe.
This is why we love CBT, because it can be molded and tailored to fit the approach needed by the client. For adults and adolescents, it may fit the image of traditional talk therapy, whereas for young children it may mimic art or play therapy—or an approach that is more fun and engaging, as we know the one of the best predictors of a good outcome from therapy is that your child enjoys therapy.
Image Credit: Alvin Mahmudov @alvinmahmudov on Unsplash
How Does CBT Work with Young Kids?
CBT focuses on helping kids recognize their thoughts and feelings so they can learn new behaviors and coping skills. With young children, we often use storytelling, art, and role-play to make those abstract concepts concrete.
Here’s an example from Molly Shaffer, MA, LPC, one of our TF-CBT and anxiety specialists here in St. Louis. She uses the idea of “Superhero vs. Villain Thoughts” with her younger clients. It’s a playful way to teach kids how to spot unhelpful (villain) thoughts and replace them with helpful (superhero) ones.
🦸♂️ Example:
Villain Thought: “I’m so stupid.”
Superhero Thought: “I’m still learning, and I’m trying my best!”
It’s simple, engaging, and helps kids start to shift their thinking in a way they can really understand.
Play Therapy + CBT = The Best of Both Worlds
For kids who are anxious, angry, or overwhelmed, play therapy offers a powerful space to express what’s hard to put into words. That’s why many of our therapists integrate CBPT, or cognitive behavioral play therapy. We work with littles as young as age 3 and can build those same crucial CBT skills in a way that really makes sense for their anxious, angry brains.
➡️ Learn more about therapy for anxious preschoolers
And if your child is older or needs a more structured approach, we’ve got you covered. Molly, Rachel, and the rest of our team tailor therapy to fit each child’s developmental needs and emotional readiness. Whether we’re working on coping strategies for anxiety-driven anger, building frustration tolerance, or helping your child feel more confident at school, we use evidence-based approaches that work.
Ready to Get Started?
If your child is struggling with anxiety, anger, or big emotions, we’re here to help. At Compassionate Counseling St. Louis, we offer specialized therapy for kids, teens, and young adults—and we partner with parents through parent coaching. Whether you’re looking for play therapy, CBT, or a combination of both, our therapists tailor every session to meet your child’s unique needs.
➡️ Schedule your free phone consultation today
We’ll help you figure out the next best step, whether it’s getting started with us or connecting you with another trusted resource.
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We can’t wait to support your family!
Curious to learn more about anxiety therapy for kids, teens, and college students in St. Louis? Wondering if you need to connect with a therapist in St. Louis? Compassionate Counseling St. Louis specializes in anxiety therapy for teens, kids, and college students, along with partnering with parents through parent coaching - basically therapy for parents here in St. Louis. We’re located in Clayton and work with clients throughout the St. Louis region. To schedule a free phone consultation, please use our contact page.
