Trauma-Focused Cognitive Behavior Therapy (TF-CBT)

TF-CBT is a treatment model that integrates trauma interventions, cognitive-behavioral principles, attachment theory, developmental neurobiology, family therapy, and humanistic therapy. The model is appropriate for children and adolescents who have experienced at least one traumatic incident and exhibit symptoms consistent with post traumatic stress disorder, depression, anxiety, or oppositional defiant disorder. A full diagnosis of post-traumatic stress disorder is not required. The model is responsive to the different developmental needs of younger children and adolescents.

The model is focused on addressing the multiple domains in which trauma causes significant problems: thinking, relationships, mood, family relations, behavioral self-control, and physical pain and dysfunction.

The developers of TF-CBT state that its core values include:

• Respect for cultural values.
• Adaptability and flexibility.
• Focusing on the family.
• Recognizing the therapeutic relationship as central.
• Emphasizing the child's own ability to solve problems (self-efficacy).
• Using multiple components that can be flexibly employed to the needs of the child and situation.

The components included in TF-CBT are:

• Psycho-education (teaching about trauma and its effects) and parenting skills.
• Relaxation skills – to produce a feeling of safety, and to enhance the child's ability to use the other therapeutic components.
• Affective modulation (learning to identify and manage one's own feelings).
• Cognitive processing (learning to think more clearly and accurately about the traumatic events and their implications).
• Developing a trauma narrative, or a story of the trauma that makes sense and leads the child to new solutions.
• "In vivo desensitization" (gradually practicing your skills in situations that actually make you scared).
• Conjoint parent-child sessions.
• Enhancing safety and social skills (to help the child avoid being hurt in the future).

A number of randomized controlled research studies have been completed on TF-CBT indicating that TF-CBT provides better outcomes for the target population than no treatment, or treatment as usual. Outcome studies indicate that the model is successful for diverse ethnic and racial population.