Mental health problems are common in youth in low- and middle-income countries (LMICs), including South Africa. Preventative interventions, based on cognitive behaviour therapy (CBT), delivered in schools, have been found to alleviate symptoms of depression and anxiety in high income countries (HICs). However, less is known about whether youth in LMICs are able to engage with the core concepts of CBT.

To explore how young people in the Western Cape, South Africa, understand key CBT concepts, such as feelings, thoughts and behaviours.

We interviewed 22 young people (10–15 years of age; mean age 11.6 years; SD = 1.0) recruited from two public primary schools in the Western Cape, South Africa. Interviews were audio-recorded, transcribed verbatim, translated from Afrikaans into English where necessary and analysed thematically using a deductive approach.

Young people described feelings as internal, private, and should only be shared with trusted others. They also described how feelings varied, depending on the situation. They found the concept of thoughts more challenging to describe. Youth were able to say what they do when they experience unpleasant feelings, and they linked their behaviours to their feelings and thoughts.

In this cultural context, our qualitative investigation found evidence that young people were able to engage with abstract concepts including feelings and to some degree, thoughts. To ensure that CBT-based interventions are developmentally appropriate and accessible, psychoeducation may help youth distinguish between thoughts, feelings and behaviours, and a focus on identifying and naming feelings may be beneficial.

心理健康问题在包括南非在内的低收入和中等收入国家 (LMIC) 的青年中很常见。已发现在学校提供的基于认知行为疗法 (CBT) 的预防性干预措施可缓解高收入国家 (HIC) 的抑郁和焦虑症状。然而，对于中低收入国家的年轻人是否能够参与 CBT 的核心概念知之甚少。

探索南非西开普省的年轻人如何理解关键的 CBT 概念，例如感受、思想和行为。

我们采访了从南非西开普省的两所公立小学招募的22 名年轻人（10-15 岁；平均年龄 11.6 岁；SD = 1.0）。采访被录音，逐字转录，必要时从南非荷兰语翻译成英语，并使用演绎方法进行主题分析。

年轻人将感受描述为内在的、私密的，并且只应与信任的人分享。他们还描述了感觉如何根据情况而变化。他们发现思想的概念更难以描述。年轻人在经历不愉快的感觉时能够说出他们所做的事情，并将他们的行为与他们的感受和想法联系起来。

在这种文化背景下，我们的定性调查发现证据表明，年轻人能够参与抽象概念，包括感受，在某种程度上，还包括思想。为确保基于 CBT 的干预在发育上是适当的和可及的，心理教育可以帮助青少年区分思想、感受和行为，并且专注于识别和命名感受可能是有益的。