TF-CBT Components: A Case Study

History and Development of the Model TF-CBT was originally developed in 1997 and was eventually published in book form in 2006, by Judith Cohen, Anthony Mannarino, and Esther Deblinger, a team of professionals studying interventions for child sexual abuse survivors. TF-CBT is a merger of earlier trauma-focused approaches that were originally directed toward treatment for child sexual abuse survivors (Cohen et

TF-CBT may address how family rejection, foster care placement, sexual abuse or physical, emotional abuse and/or neglect traumatizes a child. These types of complex trauma, in children, affects them biologically, emotionally, cognitively and it affects their self-perception (Cohen et al., 2012). TF-CBT applies therapy to children in phases which focuses on coping skills, processing trauma and understanding trauma experiences. Therapist integrate and consolidate these phases to create a generalized sense of safety and trust (Cohen et al.,

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.

CBT therapists use the first session or two to complete a problem analysis, perform a detailed assessment and create a case formulation with the client. The therapist seeks to identify: 1) the behaviors, emotions, and thoughts which make the situation a problem, 2) predisposing factors, often going back to childhood and adolescents, 3) precipitants, 4) protective factors, 5) triggers, 6) symptoms, and 7) maintenance cycles (O’Connell, 2012). This starts the session out with a very problem-focused discussion encouraging growth of the problem, with goal setting often not starting until the second

Introduction In the immediate, as well as long-term aftermath of exposure to trauma, children are at risk of developing significant emotional and behavior difficulties (CWIG, 2012). The most damaging types of trauma include early physical and sexual abuse, neglect, emotional/psychological abuse, exposure to domestic violence and other forms of child

History and Background. CBITS 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.,

These 80 patients were broken down into groups of 6-8 clients spread out over 11 groups with two co-therapists, one of each gender all with the same curriculum to minimize any variance. Therapy was conducted in the group setting with patients given homework assignments so they could work on an individual level following each session. Patients who completed the 11 groups were considered at fully completed whereas participants who dropped out before all 11 were complete were listed as drop-outs and the Trauma Recovery Group had a 59% completion rate. The results support the inclusion of group CBT therapy for the management of patients with

The emergence of research dedicated to TF-CBT and its focus removes a significant amount of ambiguity from the prescription of treatment. Due to the overwhelming positive response in research, clinicians now can confidently recommend TF-CBT and prevent further suffering within patients. Also, completing additional research in this area could lead to even more efficient and helpful methods of treatment. For young people who experienced trauma, this interactive treatment method can bring about progressive changes in their behavior and their thoughts, which can help to eradicate PTSD over the course of treatment as well as the time that follows it.

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.

Per the article, evaluation of TF-CBT is supported by several randomized controlled trials and effectiveness studies. The evidence supporting the effectiveness of trauma-focused CBT in children suffering PTSD because of sexual abuse is growing (Kar, 2011). The findings from the review of literature was that Trauma-focused CBT for symptomatic children has been successful within 1–6 months of experiencing sexual abuse. It is also recommended that children have some support going through this process. It has been suggested that, where appropriate, families should be involved in the treatment of PTSD in children and young people (National Institute for Clinical Excellence, 2005). The treatment has portions where family are involved in therapy through psychoeducation and learning coping techniques when the trauma narrative is told and

Intervention St. Paul Children’s Foundation and Counseling primary focuses in on addressing medical, dental, mental health, and social determinants of the low-income children and families in the community. The goal in for the foundations staff, counselor and social work is to identify barriers that are affecting the clients served at the organization form reaching their fullest potential. In the counseling center, the LCSW’s main goal is to support clients in recognizing psychosocial stressors that are impacting their individual and family life. There are many children served in the counseling center who are currently experiencing trauma or have experienced trauma in the past and need help addressing these issues, and receiving tools to help them function better in their daily lives. In the case of Milagros, she came to the counseling center at the request of her mother, Maria, due to issues with parent-child relationship conflict, behavior concerns, and anxiety issues. The therapist and clients worked together on areas that they needed to address in future counseling session and the intervention plan was developed. The LCSW generally utilizes Cognitive Behavioral Therapy (CBT), 1-2-3 Magic, Parent-Child Interaction Therapy (PCIT), and Family Behavior Therapy (FBT) to help clients in therapeutic counseling sessions. In this intervention paper, PCIT is the chosen intervention used in therapy sessions with Milagros and Maria.

The main goal of CBT is to help individuals and families cope with their problems by changing their maladaptive thinking and behavior patterns and improve their moods (Blackburn et al, 1981). Intervention is driven by working hypotheses (formulations) developed jointly by patient, his/her family and therapist from the assessment information. Change is brought about by a variety of possible interventions, including the practice of new behaviors, analysis of faulty thinking patterns, and learning more adaptive and rational self-talk skills. (Hawton, Salkovskis, Kirk, and Clark, 1989).

Evidence Based The CSTC utilizes currents evidence-based theories and practices. These practices include the trauma focused cognitive

Masters level or above therapists would be recruited and trained in TF-CBT and TF-GB-CBT, and then randomly assigned to conduct TAU or TF-GB-CBT. All participants would partake in one 50-minute therapy session every week, for one year, and complete pre-treatment, post-treatment, and six-month follow-up assessments, to assess symptoms of anxiety, depression, PTSD, and interpersonal and behavioral problems. Additionally, all participants would also engage in a pre-treatment and post-treatment structured clinical interview with an independent clinician who was not providing therapy to any of the