TF-CBT: A Literature Review

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.

As children go through life, they will come upon stressful situations and experiences. Many children will work through the challenges that life brings, build resilience and move forward, however, some children may experience more extreme traumatic events that can result in life difficulties due to serious trauma symptoms that are much harder to manage. Trauma-Focused-Cognitive Behavioral Therapy is an evidence based treatment model designed to help youth who have experienced a significantly traumatic life event. TF-CBT uses skills and strength based therapy to address symptoms of post-traumatic stress disorder (PTSD), depression and anxiety (Cohen et al, 2006). This research is an examination of trauma focused cognitive behavior therapy as a model of practice including the areas of history and development of the model, its relationship with other models of practice, considerations of appropriate populations, methods and components for treatment, effectiveness of the intervention and relevance for social work practice.

Once my client is stabilized from the initial concerns of severe depression and suicide attempts, TF-CBT could be introduced. Trauma-Focused Cognitive Behavioral Therapy for Children Affected by Sexual Abuse or Trauma. (2012) suggests that the following areas be covered psychoeducation and parenting skills, relaxation techniques, affective expressions and regulation, cognitive coping and processing, trauma narrative and processing, in vivo exposure, conjoint parent/child sessions and enhancing personal safety and future

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.

Researchers on Cognitive-behavior Therapy (CBT) report that CBT interventions are the most effective evidence-based treatments to treat depression among Latino youth (Feldman, Trupin, Walker & Hansen). CBT consist of pyscho-education, coping skills, exposure, monitoring of thoughts, moods and activities, illogical thinking, self-regulation and parent education/training when treating children (Carr, 2004). One specific CBT is Trauma-focused which focuses on youth who experience complex trauma. With Trauma-focused Cognitive-behavior Therapy (TF-CBT) therapist gather basic background to make the

CBITS is the most appropriate intervention program due to its focus on symptom reduction, improved functioning, improved grades and attendance, peer and parent support, and increased coping skills. The program reports use with students from 5th grade through 12th grade who have witnessed or experienced traumatic life events such as community and school violence, accidents and injuries, physical abuse and domestic violence, and natural and man-made disasters (CBITS, 2016). As compared to the other programs CBITS appeared to be all encompassing and showed better outcomes at 3-month follow-up. Additionally, CBITS is specifically designed to be administered by mental health clinicians in an actual school setting.

Recognizing a need for mental health professionals efficient in trauma-informed care for these children, Judy Cohen, MD, Ester Deblinger, PhD, and Anthony Manarino, PhD, developed Trauma-Focused Cognitive Behavior Therapy (TF-CBT), to serve as a specialized treatment approach to responding to the needs to these youth. TF-CBT helps children that have experienced traumatic events overcome the symptoms that may be left behind. According to the National Center for Child Traumatic stress, TF-CBT provides education and understanding of common reactions and symptoms that may result from sexual abuse and other forms of trauma. This type

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.

Studies estimate that over one in four children will experience trauma before the age of sixteen, and many of these youth will go on to develop Post-Traumatic Stress Disorder as a result of their trauma (Silverman, Oritz, Viswesvaran, Burns, Kulko, Putnam, & Amaya-Jackson, 2008). Children and adolescents with PTSD can benefit from a mixture of the Cognitive and Behavioral models, presented in the form of Cognitive-Behavioral Therapy (CBT). Specifically, Trauma Focused Cognitive Behavioral Therapy (TF-CBT) is the most effective method to treat PTSD, utilizing techniques from two different perspectives (cognitive and behavioral) that can

The American Counseling Association’s fact sheets provides various symptoms for children and adolescents that are experiencing trauma. According to the American Counseling Association’s Traumatology Interest Network and facilitator, Karin Jordan (2015) children exhibit different trauma related symptoms at different periods in their lives (ACA et al., 2015). While I am providing therapy as a new LCPC, my client may not explicitly say that they have undergone some sort of trauma, but may unknowingly talk about their symptoms. It will then be my responsibility to consult a colleague, or in this case, the ACA to better serve my client’s needs. I will study the specified age group symptoms, while comparing the symptoms of my client and continue with the diagnosis of trauma (ACA et al., 2015).

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a psychotherapeutic approach that involves conjoint therapy sessions of with the child and the parent. This approach is employed among children and/or adolescents that are experiencing emotional and behavioral difficulties that are significant and related to life events that are traumatic (Cohen, Mannarino, & Deblinger, 2012). TF-CBT is a components-based model of treatment that includes intervention that are trauma-sensitive and cognitive behavioral, family and humanistic therapy

TF-CBT is an evidence based practice that has evolved in the past 25 years and has been extensively researched within the treatment of PTSD and trauma effects such as depression, distress, anxiety, and cognitive and behavioral problems. This paper will contain a detailed description of the methodology of TF-CBT and an examination of a few peer reviewed studies, which tests the effectiveness TF-CBT has on children and adolescents who suffer from PTSD, neglect, or other trauma impacts.

This discussion is a review of the Cognitive Behavior Intervention for Trauma in Schools program also known as CBITS. This discussion will include an overview of the program and descriptions of components that are included within the program. The program has been introduced into two other programs that are specifically for children that have experienced trauma and how the program effected children who have been diagnosed with post-traumatic stress disorder. The implementation and effectiveness of this program and its transportability will be discussed. Cost Effectiveness and the quality of care that is received by the clients will also be evaluated. The program will also be reviewed for factors that will influence a provider’s decision to utilize the program and possible institutional obstacles and possible future opportunities will also be discussed.

A series analyses of covariance appears to have indicated that children assigned to TF-CBT, compared to those participants who were assigned to child-centered therapy, demonstrated significantly more improvement with regard to PTSD, depression, behavior problems, shame, guilt, and other abuse-related attributions. (Cohen, Deblinger, Mannarino, & Steer, 2004, p.400). Similarly, parents or guardians who were assigned to TF-CBT showed greater improvement with respect to their own self-reported levels of depression, abuse-specific distress, support of the child, and effective parenting practices allowing them to parent more effectively. (Cohen, Deblinger, Mannarino, & Steer, 2004, p. 401). TF-CBT assists both the primary caregivers along with the child to ensure everyone in the situation who experiences negative symptoms are addressed and helped therapeutically, to create an outcome where children and their families can live successfully together. This can also include communities as whole TF-CBT helps bring empowerment to its participants and allows them to face their issues head on.

TF-CBT is an evidence-based practice that is used for trauma caused by violence, abuse, sexual abuse or other traumatic events. Usually, this evidence-based practice is used for children ages 3-17. The Modular approach to therapy for children (MATCH) is focused on overcoming the current challenges and provide with various treatment to address the current problem (Lucassen et al., 2015). The MATCH is an evidence-based practice that is used for anxiety, trauma and behavior problems with children from ages 6-15 years old. There have been more studies using qualitative research that TF-CBT is effective evidence-based practice and has positive outcomes for clients. TF-CBT is a short-term therapy that will help the client overcome their trauma and have a positive outcome once therapy is over. As for MATCH, there has not been a lot of qualitative research because it is used rarely in other countries. There have been more quantitative research reports that have been conducted based on the client and the statistics. Therefore, based on the research that was conducted with the two evidence-based practice the writer prefer to used TF-CBT because it provides with human behavior and the data that is used is with the current participants that were using TF-CBT and their experience.