By Jack Komer, 12/2021.
What is TF-CBT?
Trauma-focused cognitive behavioral therapy is a therapeutic intervention utilized with children and adolescents that have experienced trauma. This intervention can be provided to children 3-18 by trained professionals. The parents are also included in the treatment and participate in individual sessions with the practitioner and conjoint sessions with the child or adolescent and practitioner. TF-CBT works to assist in developing coping strategies for traumatic stress reactions and reduce symptoms of depression, anxiety, or externalizing behaviors in children and adolescents exposed to trauma. This intervention is intended for children and adolescents whose primary presenting problems are related to their traumatic life experiences (e.g., PTSD, depression, anxiety, or behavioral problems that clearly emerged following the traumatic event(s) the child or adolescent experienced (Therapist Certification Program, 2019).
Components of TF-CBT
TF-CBT consists of 8-25 sessions, including individual sessions for the child or adolescent, individual sessions for the parent(s), and conjoint sessions between the parent(s) and the child/adolescent (Therapist Certification Program, 2019).
This intervention is intended to be short-term and structured.
Each component of TF-CBT is provided to the child/adolescent and parent(s) in parallel sessions, with the exception being parenting skills being additionally provided to the parent(s).
Two of the creators of TF-CBT, Drs. Judith Cohen and Anthony Mannarino, summarize the components of TF-CBT with PRACTICE. PRACTICE stands for Psychoeducation and Parenting skills; Relaxation skills, Affective regulation skills; Cognitive coping skills; Trauma narrative and cognitive processing of the traumatic event(s); In vivo mastery of trauma reminders; Conjoint child-parent sessions; and Enhancing safety and future development trajectory (2008).
The components of TF-CBT aim to provide information on trauma and child outcomes, build a toolkit of skills to assist with parenting trauma related behaviors, relaxation, emotional regulation, cognitive restructuring, processing and mastering the trauma experience(s) and reminders, and developing plans to ensure children remain safe in the future and developing appropriately (Cohen & Mannarino, 2008).
Evidence of TF-CBT Effectiveness
A meta-analysis of 21 randomized controlled studies found that TF-CBT was exceptionally superior to no-treatment or waitlist comparisons and moderately superior to alternative treatments in decreasing symptoms of PTSD in children and adolescents (Lenz & Hollenbaugh, 2015). It was also found to be notably more effective than no-treatment/waitlist conditions and had a modest effect size when compared to alternative treatments in reducing depressive symptoms in children and adolescents (Lenz & Hollenbaugh, 2015).
Cohen, J. A., & Mannarino, A. P. (2008). Trauma-focused cognitive behavioural therapy for children and parents. Child and Adolescent Mental Health, 13(4), 158-162. doi:10.1111/j.1475-3588.2008.00502.x
Lenz, A. S., & Hollenbaugh, K. M. (2015). Meta-analysis of trauma-focused cognitive behavioral therapy for treating PTSD and co-occurring depression among children and adolescents. Counseling Outcome Research and Evaluation, 6(1), 18-32. doi:10.1177/2150137815573790
Therapist Certification Program. (2019, December 06). About trauma-focused cognitive behavior therapy (TF-CBT). Retrieved from https://www.tfcbt.org/about-tfcbt/