Trauma-Focused Cognitive Behavior Therapy

What Is Trauma-Focused Therapy?

As its name implies is a form of cognitive behavioral therapy that addresses the specific emotional and mental health needs of children, adolescents, adult survivors, and families who are struggling to overcome the destructive effects of early trauma. Trauma-focused cognitive behavioral therapy (TF-CBT) is especially sensitive to the unique problems of youth with post-traumatic stress and mood disorders resulting from abuse, violence, or grief. Because the client is usually a child, TF-CBT often brings non-offending parents or other caregivers into treatment and incorporates principles of family therapy.

When It’s Used

Anyone who has experienced a single or repeated experience of sexual, physical, or mental abuse or who has developed post-traumatic symptoms, depression, or anxiety as a result of the loss of a loved one or exposure to violence in the home or community can benefit from TF-CBT. If a child or adolescent also exhibits serious behavioral, substance-abuse, or suicidal-ideation problems, 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. There is little evidence that trauma-focused cognitive behavioral therapy is the best intervention for adult war veterans with complex post-traumatic stress disorder

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. Cognitive behavioral techniques are used to help modify distorted or unhelpful thinking and negative reactions and behaviors. At the same time, a family therapy approach looks at interactions among family members and other family dynamics that are contributing to the problem and aims to teach new parenting, stress-management, and communication skills. 

How It Works

The trauma-focused approach to psychotherapy was first developed in the 1990s by psychiatrist Judith Cohen and psychologists Esther Deblinger and Anthony Mannarino, whose original intent was to better serve children and adolescents who had experienced sexual abuse. TF-CBT has expanded over the years to include services for youths who have experienced any form of severe trauma or abuse.

Early trauma can lead to guilt, anger, feelings of powerlessness, self-abuse, acting out behavior, and mental health issues, such as depression and anxiety. Post-traumatic stress disorder, which affects children and adults, can manifest in a number of ways, such as bothersome recurring thoughts about the traumatic experience, emotional numbness, sleep issues, concentration problems, 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.

What to Look for in a Trauma-Focused Cognitive Behavioral Therapist

Look for a licensed mental health professional with specialized training and experience in cognitive behavioral therapy and family therapy as well as further training and supervised experience in trauma-focused therapy. In addition to these credentials, it is important to find a therapist with whom you and your child feel comfortable working.

Sources

  • U.S. Department of Health and Human Services. Child Welfare Information Gateway. Trauma-focused cognitive behavioral therapy for children affected by sexual abuse or trauma. August 2012.

  • Gillies D, Taylor F, Gray C, O’Brien L, D’Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (review). Evidence-Based Child Health. May 2013;8(3):1004–1116.

  • Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews. 2013;12.

  • Trauma-Focused Cognitive Behavioral Therapy National Therapist Certification Program website