What is trauma focused cognitive behavioral therapy (TF-CBT)?
Generally, TF-CBT is completed in 12-18 weeks as it is very structured. The clinician works with the child directly, as well as conducts parent sessions to review the information processed with the child with the parent so that the parent can help the child practice the coping skills between sessions and develop a common language for them to speak about the trauma. After the child and parent receive psychoeducation regarding the trauma itself, the child is taught relaxation skills to utilize when managing the strong reactions they may have to trauma triggers or for general anxiety. Once the stress coping mechanisms are in place, the trauma specialist will work with the child on affect regulation: understanding and managing emotions. The relaxation skills and affect regulation skills tend to help bring some relief from the day to day symptoms of trauma, however more work is needed. The clinician then moves into what is called "cognitive coping," essentially helping rewrite negative and maladaptive thoughts related to the trauma. A large portion of the treatment is utilized to help the child work on their "trauma narrative," telling and retelling their story. In the process, the clinician helps the child utilize some aspects of relaxation, affect regulation, and cognitive coping to work through the stress that arises when the child recounts the trauma. Once the narrative is ready, the child shares the trauma narrative with a caregiver or supportive person, most typically a parent or guardian. The clinician has prepared the parent/guardian/support person before sharing the narrative so that all that person should do is listen and provide support to the child without adverse reactions or arguing about the details. The final steps of TF-CBT are in-vivo exposure (whenever possible), helping the child make sense of the trauma, and working to ensure future safety.
