Cognitive Behavioral Therapy (MMTT)

Trauma is perceived as a physical or psychological threat or assault to a person’s physical integrity, sense of self, safety and/or survival or to the physical safety of a significant other; family member, friend, partner. (Kilpatrick, Saunders, and Smith, 2003). An adolescent may experience trauma from a variety of experiences, including but not limited to: abuse (sexual, physical, and/or emotional); neglect; abandonment; bullying; exposure to domestic violence and/ or community violence; natural disasters; medical procedures; loss/grief due to a death of a family member(s); surgery; accidents or serious illness; and war (Kilpatrick, Saunders, and Smith, 2003).

A., Mannarino, A. P., Kliethermes, M., & Murray, L. A. (2012). Trauma-focused CBT for youth with complex trauma. Child abuse & neglect, 36(6), 528-541.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a conjoint child and parent psychotherapy approach for children and adolescents who are experiencing significant emotional and behavioral difficulties related to traumatic life events. This online TF-CBT course shows step by step instruction in ten modules for each component of therapy. According to the introduction on the Trauma-Focused Cognitive Behavioral Therapy website it states that, “There is strong scientific evidence that TF-CBT helps children, adolescents, and their parents overcome many of the difficulties associated with abuse and trauma.” This is a very detailed online course that gives live video examples on how each process is done.

This theory proposes that a traumatic event produces maladaptive assumptions and beliefs about the world, other people, and the self that interfere with recovery (Schultz, Barnes-Proby, Chandra, Jaycox, Maher, & Pecora, 2012). CBITS uses cognitive-behavioral techniques (for example, psychoeducation, relaxation, social problem solving, cognitive restructuring, and exposure). Cognitive-behavioral therapies work to teach people skills to combat these underlying issues, including correction of maladaptive assumptions, processing the traumatic experience instead of avoiding it, learning new ways to reduce anxiety and solve problems, building peer and parent support, and building confidence to confront stress in the future (Schultz, et al.,

The National Child Traumatic Stress Network (NCTSN) was stablished by Congress in 2000 and brings a comprehensive focus to childhood trauma. This network raises the average standard of care and improves access to services for traumatized children, their families and communities throughout the United States. The NCTSN defines trauma‑focused cognitive behavioral therapy (TF‑CBT) as an evidence‑based treatment approach that is shown to help children, adolescents, and their caregivers overcome trauma‑related difficulties. It is designed to reduce negative emotional and behavioral responses following a traumatic event. The treatment addresses distorted beliefs related to the abuse and provides a supportive environment so the individual can talk about their traumatic experience. TF‑CBT also helps parents cope with their own emotional issues and develop skills to support their children.

This project is based on the idea that TF-CBT is more beneficial and has a greater outcome for short-term to long-term benefits than regular therapy sessions and interventions alone. Is a psychosocial treatment model designed to treat posttraumatic stress along with other related emotional and behavioral difficulties in children and adolescents, the concept was originally developed to begin to address the psychological trauma associated with child sexual abuse, but it has since been adapted for use with children who have a wide array of traumatic experiences, including community violence, traumatic loss, and the often multiple psychological traumas experienced by children in foster care placement. (Trauma-Focused Cognitive Behavioral Therapy,

Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., & Amaya-Jackson, L. (2008). Evidence-Based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child & Adolescent Psychology, 37, 1, 156-183.

Some of the trauma that children and adolescents experience or witness may consist of sexual abuse, neglect, maltreatment, violence, physical abuse, vehicular accidents, and crimes. As previously mentioned these traumatic events may cause PTSD and other common comorbidities such as anxiety, depression, and possibly aggressive or impulsive behavior. To better understand how TF-CBT treatments help, it may be useful to understand what exactly PTSD is, and what it looks like in children and adolescents. According to the DSM-IV (2013), PTSD consists of persistent re-experiencing of the trauma experienced, avoidance of traumatic reminders such as certain people, places, and conversations, a general numbing of emotional responsiveness, and chronic physiological hyper arousal. Generally children with PTSD characteristically look different than adults whom are suffering from PTSD. The National Center for PTSD article displayed by the U.S. Department

Two hundred twenty-nine 8- 14 year old children and their primary caretakers were randomly assigned to TF-CBT forms of alternative treatments. These 229 children had significant symptoms of PTSD, with 89% meeting full DSM-IV PTSD diagnostic criteria.(Cohen, Deblinger, Mannarino, & Steer, 2004, p. 399). “More than 90% of these children had experienced traumatic events in addition to sexual abuse.” (Cohen, Deblinger, Mannarino, & Steer, 2004, p.400). Traumatic events can include physical abuse, threats, and even just witnessing another individual being abused can cause a person to experience more

Trauma can be defined as an event or experience that hinders an individual’s ability to cope (Covington, 2008). These experiences have the power to alter biology and brain function, especially earlier on in life. Trauma can change an individual’s world-view, impacting their sense of self. This can lead to difficulties with self-regulation and higher incidences of impulsive behavior (Markoff et al., 2005). Often, individuals who have endured traumatic incidences turn to self-medication as a form of coping (De Bellis, 2002).

According to Hussey et al (2006), it is estimated that one million children are victims of abuse and neglect on a yearly basis. Of those one million children, 1500 will die due to abuse or neglect. It is also estimated that 50% of adolescents have experienced or witnessed a traumatic event (De Arellano and Danielson 2008). One particular consequence of extreme abuse and neglect is the development of Posttraumatic Stress Disorder (PTSD). Symptoms of PTSD include persistent and recurrent invasive thoughts focused around the traumatic event, avoidance of symbolic representations related to the traumatic event, increased arousal including difficulties sleeping, irritability, concentration challenges, hypervigilance, increased

“Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic in nature.” (Kassam-Adams, & Winston,2004, p.409). “Trauma Focused Cognitive behavioral therapy (TF-CBT) has been used in the management of PTSD in both children and adolescents for many years.” (Cohen, Mannarino, & Deblinger, (Eds.). (2012, p.3). The premise of this paper is to examine research studies that have already been conducted on trauma focused cognitive behavioral therapy and their outcomes. In order to determine the effectiveness and a safe intervention process for both acute and chronic post- traumatic stress disorder following a wide range of traumatic experiences in children, and adolescents.

There are several treatment options for people who are experiencing traumatic symptoms. One of the most popular therapies being cognitive behavioral therapy, specifically trauma-focused cognitive behavioral therapy. Uniquely, it is crucial that the chosen therapy be successful in treating victims who are female and experienced their trauma at a young age. Furthermore, if the early abuse can be prevented in the first place, it would save many people from experiencing any of the symptoms that may present themselves due to the trauma. In the same fashion, the problem of looking for substances to fix the problem would not be an issue that even needed to be addressed.

Contrary to the research involved in causes, the field of treating Post-Traumatic Stress Disorder has had major advancements. Treatment for PTSD is widely developed and there are several ways in which one can be treated for this mental health condition. Through the Cognitive Behavioral Perspective, the most common form of treatment is Cognitive Behavior Therapy. CBT focuses “on identifying, understanding, and changing thinking and behavior patterns” (Anxitey, 2016). CBT has subdivision as well, which consist of Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EDMR), and Stress Inoculation Training (SIT). In specific, Cognitive Processing Therapy assists people in focusing on the way

According to the research done by Adverse Childhood Experience (ACE), they associated trauma with emotional problems, adult diseases, social problems, health and some disability cases (Classen & Clark, 2017). Traumatized children are often withdrawn and stressed. They are not happy and are not socially active. They prefer to stay alone trying to wonder how they can solve their problems. They wonder whether the way they have to undergo the problems, they undergo unlike some of their friends who lead a normal happy life. They find it hard to accept some of their life situations and wish their lives were same as that of their friends. The trauma amongst children is very common, and they require encouragements so that they can cope with life. Trauma-informed approach tries to impact the following to the affected individuals and