TF-CBT
(Trauma Focused Cognitive Behavioral Therapy):
TF-CBT is a structured, short-term treatment model that effectively improves a range of trauma-related outcomes in 8-25 sessions with the child/adolescent and caregiver. Although TF-CBT is highly effective at improving youth post-traumatic stress disorder (PTSD) symptoms and diagnosis, a PTSD diagnosis is not required in order to receive this treatment.
TF-CBT also effectively addresses many other trauma impacts, including affective (e.g., depressive, anxiety), cognitive and behavioral problems, as well as improving the participating parent’s or caregiver’s personal distress about the child’s traumatic experience, effective parenting skills, and supportive interactions with the child.
When It's Used
TF-CBT was originally geared toward helping children who were the victims of sexual abuse, but its scope has widened to include children and adolescents who have experienced a single or repeated experience of sexual, physical, or mental abuse or who have developed post-traumatic symptoms, depression, or anxiety.
If a child or adolescent also exhibits serious behavioral, substance abuse, or suicidal ideation, other forms of treatment, such as dialectical behavior therapy, may be more appropriate as an initial intervention and can be followed up with a trauma-sensitive approach.
What to Expect
TF-CBT is a short-term intervention that generally lasts anywhere from eight to 25 sessions and can take place in an outpatient mental health clinic, group home, community center, hospital, school, or in-home setting. Treatment takes place with a non-offending parent or caregiver. Often, the treatment will begin where the child and non-offending caregiver have separate therapy sessions and advance to engaging in
joint sessions.
Cognitive behavioral techniques are used to help modify distorted or unhelpful thinking and negative reactions and behaviors. Learning to challenge invasive thoughts of guilt and fear can help a patient to reorganize their thinking in a healthier and happier way.
The family therapy aspect of trauma-focused CBT attends to the problems family members may have in dealing with the trauma suffered by the child, including the use of various stress management, communication, and parenting skills.
Research comparing TF-CBT to other treatment models shows significantly greater gains in well-being for children and parents.
How it Works
Early trauma can lead to guilt, anger, feelings of powerlessness, self-harm, acting out, depression, and anxiety. Post-traumatic stress disorder, which affects children and adults, can manifest in a number of ways, such as negative recurring thoughts about the traumatic experience, emotional numbness, sleep problems, difficulty concentrating, and extreme physical and emotional responses to anything that triggers a memory of the trauma.
By integrating the theories and techniques of several therapeutic interventions, TF-CBT can address and improve the symptoms of post-traumatic stress in youth.
Core features of TF-CBT treatment include:
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Psychoeducation, which teaches the victim about the normal reactions to traumatic experiences. This can help them reduce feelings of guilt or culpability for what happened.
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Coping skills, including relaxation exercises like deep breathing, mindfulness, acceptance, identifying and redirecting thoughts, and other methods.
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Gradual exposure, which involves gradually introducing the patient to memories of their traumatic experience, with the goal of reconditioning their response to triggers and easing emotional distress.
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Cognitive processing, which can include developing skills to recontextualize unhelpful feelings and thoughts, and regulate emotions.
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Caregiver involvement, which may include rebuilding trusting adult relationships for the child and training the caregiver in how to best be a resource for the child.
The goal of the treatment is to help the client develop a sense of safety and security, to repair or develop healthy social skills, and for the caregiver to feel more confident in their ability to help the child in a productive manner.
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