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AF-CBT: Alternatives for Families: 
A Cognitive Behavioral Therapy
 

By Jack Komer, 12/2021.

What is AF-CBT?                                                                                     

AF-CBT is a trauma-informed, evidence-based treatment (EBT) designed to improve the relationship between children and caregivers in families involved in arguments, frequent conflict, physical force/discipline, child physical abuse, or child behavior problems.

Components of AF-CBT (NCTSN, 2012)

Child-Directed Components of AF-CBT:

  • Engagement and goal-setting

  • Psychoeducation about force/abuse

  • Disclosure of incidents involving hostility and physical force/abuse (causes, 
    characteristics and consequences) to help child understand the context in which 
    they occurred

  • Cognitive processing of automatic thoughts that could maintain aggressive 
    behavior or family conflict

  • Training in affect identification, expression, and management skills (e.g., 
    relaxation training, anger control)

  •  Social/interpersonal skills training to enhance social competence and 
    development of social support plans

  • Imaginal exposure and making meaning from the disclosure of traumatic events 
    related to physical abuse/discipline, as needed

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Evidence of AF-CBT Effectiveness (NCTSN, 2012)

Pilot of Intervention: 

  • Kolko, D. J., Iselin, A. M., Gully, K. (2011). Evaluation of the Sustainability and Clinical Outcome of 
      Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a Child Protection Center. Child            Abuse & Neglect, 35, 105-116.

Randomized Controlled Trials:

  • Kolko, D.J. (1996). Clinical monitoring of treatment course in child physical abuse: Psychometric 
      characteristics and treatment comparisons. Child Abuse & Neglect, 20, 23-43.

  • Kolko, D. J. (1996). Individual cognitive-behavioral treatment and family therapy for physically abused 
      children and their offending parents: A comparison of clinical outcomes. Child Maltreatment, 1, 322-342.

Effectiveness Trial:

  • Kolko DJ, Baumann BL, Herschell, AD, Hart, JA, Holden, EA, Wisniewski, SR. (2012). Implementation of 
      AF-CBT by community practitioners serving child welfare and mental health: A randomized trial. Child 
    Maltreatment, 17    , 32-46.

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AF-CBT
Program Site
 

National Child Traumatic Stress Network Fact Sheet on 
AF-CBT
 

References

Kolko, D.J. (1996). Clinical monitoring of treatment course in child physical abuse: Psychometric characteristics   and treatment comparisons. Child Abuse & Neglect, 20, 23-43.

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Kolko, D. J., Iselin, A. M., Gully, K. (2011). Evaluation of the Sustainability and Clinical Outcome of Alternatives     for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a Child Protection Center. Child Abuse &                       Neglect, 35, 105-116.

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 Kolko DJ, Baumann BL, Herschell, AD, Hart, JA, Holden, EA, Wisniewski, SR. (2012). Implementation of AF-       CBT by community practitioners serving child welfare and mental health: A randomized trial.    Child Maltreatment, 17, 32-46.

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Kolko, D. J. (1996). Individual cognitive-behavioral treatment and family therapy for physically abused children     and their offending parents: A comparison of clinical outcomes. Child Maltreatment, 1, 322-342

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NCSTN. (2012). AF-CBT: Alternatives for Families: A Cognitive Behavioral Therapy [Fact sheet]. https://www.nctsn.org/sites/default/files/interventions/afcbt_fact_sheet.pdf

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