Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

fter trauma, a child is desperate to feel secure. Naturally, it is difficult to talk about the painful event. As a parent, it can feel overwhelming to know what to do or say to help your child cope. At Restore Therapy, our team of clinicians center upon this therapy because of it’s beautiful ability to elicit difficult content in a gradual and secure way. With the help of one of our therapists, your child will be able to process their memories while feeling in-control of their mind and body.

Trauma can be like a deep wound. It’s natural to want to ignore it and put a band-aid on it to stop the temporary bleeding. Over time however, the wound can become infected if not properly cleaned. Addressing the wound can be painful, but if you gradually wash it out and apply treatment, the sting lessons and healing can begin.

TF-CBT was what my child needed to move on, confidently. As a parent, I did not have the strength or the tools to help my child because I was greatly affected too by the trauma. With therapy, my child and I quickly learned how to grow resilient together and we are much stronger because of it. Thinking about the trauma doesn’t bother us as much—Father of 12 year-old

Trauma- Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based therapy for children ages 3-17 who are experiencing symptoms related to trauma and traumatic grief. Therapy sessions focus on understanding and managing distress while emphasizing education, parent support, skill-building, resiliency and confidence.

TF-CBT is on average 15 sessions. Therapy is flexible and takes the child and parent through a series of components starting with stress management skills, cognitive skills and gradually moving into discussing the child's traumatic memories through the development of a trauma narrative.

TF-CBT components are summarized by the acronym PRACTICE:

Psychoeducation, Parenting skills
Relaxation skills
Affective modulation skills
Cognitive coping skills
Trauma narrative and cognitive processing of the traumatic event(s)
In vivo mastery of trauma reminders
Conjoint child-parent sessions
Enhancing safety and future developmental trajectory.

Trauma is a difficult event in one’s life that causes stress. Some examples include:

  • Community violence
  • Complex Trauma
  • Domestic Violence
  • Early Childhood Trauma
  • Medical Trauma
  • Natural Disasters
  • Neglect
  • Physical Abuse
  • School Violence (Bullying)
  • Sexual Abuse
  • Terrorism
  • Traumatic Grief

Signs can include:

  • Acting out behavior
  • Avoidance of talking about the traumatic event
  • Change in sleep and/or appetite
  • Clinginess to parent
  • Decreased socialization
  • Developmental regression
  • Excessive worry
  • Fear of specific places
  • Feelings of shame and guilt
  • Flashbacks
  • Inability to focus
  • Intrusive thoughts
  • Isolation
  • Night terrors
  • Re-experiencing the traumatic event

Once safety is achieved, it is important to consider therapy. It’s normal to want to avoid talking about trauma or carry on and be tough, however, it’s best to start therapy right after the trauma so that coping skills can be learned quickly.

Children are incredibly resilient and have the ability to work through difficult life events. The trauma will always be a part of their story, but kids who are successful in treatment are able to recall the event in a way that is not too emotionally charged for them to handle in the present moment. Children learn that they have overcome something difficult and are now stronger and more confident because of it.

Several clinical studies confirm that TF-CBT is the most effective treatment for children who are struggling with traumatic stress. It has been regarded by top institutions as best practice and a model program widely used across the country and internationally. (1)

TF-CBT is proven to be effective in reducing symptoms of Post-Traumatic Stress Disorder, depression, anxiety, sexualized behaviors, and feelings of shame and guilt. (2)

It has also been shown that TF-CBT improved parent’s levels of depression, abuse specific distress, support of the child and effective parenting practices. (3)

(1) National Center for Mental Health Promotion and Youth Violence Prevention, "Childhood Trauma and Its Effect on Healthy Development," July 2012

(2) Bell, C.C. & Jenkins E.J. (1993). "Community Violence and Children on Chicago's Southside." Psychiatry, 56 (1): 46-54.

(3) Cohen, J & Mannarino, A (2008). Trauma- Focused Cognitive Behavioral Therapy for Children and Parents. Child and Adolescent Mental Health, 13, 4, 158-162