Trauma-Focused

Cognitive Behavioral Therapy

(TF-CBT)

A child's experience of a traumatic event can have lifelong repercussions.

Trauma can be visualized as an iceberg. The part of the iceberg that is above the water are the behaviors that have resulted from the traumatic event(s). The bigger part, underneath the water, is what has happened to a person and what that person thinks it says about them and others as a result of the event(s). It is the child’s experience of the event, not the event itself, that is traumatizing.

What is Trauma-Focused Cognitive Behavioral Therapy?

Trauma Focused Cognitive Behavioral Therapy (TF-CBT) is an evidenced-based trauma treatment proven to decrease symptoms of PTSD, anxiety, depression, and other child behavior problems. It is also proven to decrease shame, improve parenting skills, and strengthen the child-caregiver relationship. There have been 20+ randomized controlled trials which have shown significant statistical and clinical decreases in symptoms for both complex trauma and single event trauma.

On average, single event trauma cases require approximately 12-15 sessions to work through the TF-CBT process.

Complex trauma cases tend to require approximately 25-30 sessions to work through the TF-CBT process.

TF-CBT: An Eight-Stage Process

These eight stages must be completed in sequence.

1.

Psychoeducation and Parenting Skills
(Learning About Trauma)

2.

Relaxation Skills
(Handling Stress)

3.

Affect Regulation
(Identifying and Expressing Feelings)

4.

Cognitive Coping
(Changing Thoughts)

5.

Trauma Narrative Creation/Development

6.

In-Vivo Exposure to Trauma Reminders
(Working Through the Narrative)

7.

Conjoint Session(s)
(Sharing the Trauma Narrative)

8.

Enhancing Future Safety and Social Skills
(Safety Planning)

The Importance of the Child and Caregiver Relationship

The identified client is not actually the child. It is the relationship between the child and their closest caregiver. TF-CBT involves directly describing the personal trauma experiences, and caregivers directly hearing the narrative from the child’s perspective.

During treatment, children talk and write about their experiences. The process is based on years of research on the importance of gradual exposure to traumatic memories. The trauma narration process is collaborative and therapeutic. It is not forensic in nature. Rather than eliciting forensic details, this process is designed to elicit a child’s subjective perceptions and thoughts, feelings, and sensations related to the traumatic experience.

Although details related to the event may emerge, the focus of the narration process is not on fact-finding or on clarifying details. Instead, it is intended to help the child face and process the trauma event(s), address any distorted thoughts, develop adaptive views of themselves, their relationship with others and their future, and ultimately, reduce related distress.

Very importantly, the process is focused on supporting the child in making meaning of their trauma experiences.

A few imperative principles from The National Child Traumatic Stress Network

Seeing Beyond Behaviors

If we don’t look for or acknowledge trauma in the lives of children and adolescents, we end up chasing behaviors and limiting the possibilities for change.

Believe, Support & Ask Questions
If you don’t ask, they won’t tell. The majority of maltreated children never disclose during childhood, because most disclosures don’t go well for them (the child must be believed and supported).
What Is Not Integrated Is Repeated

All behavior is an attempt to meet a need. Understanding the connection between a child’s behaviors and their trauma history is an essential part of promoting long-term healing.

If you are interested in TF-CBT services, please contact the office to schedule an appointment for an assessment and trauma screening, (231) 715-8466.