Children and adolescents with conduct problems participate in Cognitive Behavioral Therapy (CBT), either in individual or group format, in view of learning social problem-solving skills that enable them to behave in more independent and situation-appropriate ways. Parents must support their child’s learning processes in everyday life and therefore these processes need attention in CBT sessions in which parents and their child participate. The social problem-solving model of CBT previously described (Matthys & Schutter, Clin Child Fam Psychol Rev 25:552–572, 2022; Matthys & Schutter, Clin Child Fam Psychol Rev 26:401–415, 2023) consists of nine psychological skills. In this narrative review we propose that instead of addressing each skill separately in sessions with both parents and their child, therapists work on three schemas (latent mental structures): (1) goals, (2) outcome expectations, and (3) normative beliefs about aggression. Based on social-cognitive and cognitive neuroscience studies we argue that these three schemas affect five core social problem-solving skills: (1) interpretation, (2) clarification of goals, (3) generations of solutions, (4) evaluation of solutions, and (5) decision-making. In view of tailoring CBT to the individual child’s characteristic schemas and associated social problem-solving skills, we suggest that children and adolescents participate in individual sessions with their parents. The therapist uses Socratic questioning in order to find out characteristic schemas of the child, encourage reflection on these schemas, and explore alternative schemas that had previously been outside the child’s attention. The therapist functions as a model for parents to ask their child questions about the relevant schemas with a view of achieving changes in the schemas.

有行为问题的儿童和青少年以个人或团体的形式参加认知行为治疗（CBT），以学习解决社会问题的技能，使他们能够以更独立和适合情况的方式行事。父母必须在日常生活中支持孩子的学习过程，因此这些过程需要在父母和孩子参与的 CBT 课程中得到关注。先前描述的 CBT 社会问题解决模型（Matthys & Schutter, Clin Child Fam Psychol Rev 25:552–572, 2022；Mathys & Schutter, Clin Child Fam Psychol Rev 26:401–415, 2023）由九种心理技能组成。在这篇叙述性评论中，我们建议治疗师不要在与父母及其孩子的会谈中单独讨论每种技能，而是研究三种图式（潜在的心理结构）：（1）目标，（2）结果期望，以及（3）规范信念关于攻击性。基于社会认知和认知神经科学研究，我们认为这三种模式影响五种核心社会问题解决技能：（1）解释，（2）目标澄清，（3）解决方案的生成，（4）解决方案的评估， (5)决策。鉴于要根据每个孩子的特征图式和相关的社会问题解决技能来定制CBT，我们建议儿童和青少年与父母一起参加单独的课程。治疗师使用苏格拉底式提问来找出孩子的特征图式，鼓励对这些图式进行反思，并探索以前不在孩子注意力范围内的替代图式。 治疗师充当父母的榜样，向孩子询问有关相关图式的问题，以期实现图式的改变。