Trauma-Focused Cognitive Behavioral Therapy (TF–CBT)

Program Goals

Trauma-Focused Cognitive Behavioral Therapy (TF–CBT) is designed to help 3- to 18-year-olds and their parents overcome the negative effects of traumatic life events such as child sexual or physical abuse. TF–CBT aims to treat serious emotional problems such as posttraumatic stress, fear, anxiety, and depression by teaching children and parents new skills to process thoughts and feelings resulting from traumatic events.


 

Target Population

TF–CBT was created for young people who have developed significant emotional or behavioral difficulties following exposure to a traumatic event (e.g., loss of a loved one, physical abuse, sexual abuse, domestic or community violence, motor vehicle accidents, fires, tornadoes, hurricanes, industrial accidents, terrorist attacks). The program targets boys and girls from different socioeconomic backgrounds, from diverse ethnic groups, and in a variety of settings.



Program Components

TF–CBT is a treatment intervention that integrates cognitive and behavioral interventions with traditional child-abuse therapies. Its focus is to help children talk directly about their traumatic experiences in a supportive environment. The program operates through the use of a parental treatment component and several child–parent sessions. The parent component teaches parents parenting skills to provide optimal support for their children. The parent–child session encourages the child to discuss the traumatic events directly with the parent and both the parent and child to communicate questions, concerns, and feelings more openly. Typically, TF–CBT is implemented as a relatively brief intervention, usually lasting from 12 to 18 weekly sessions. These aim to provide the parents and children with the skills to better manage and resolve distressing thoughts, emotions, and reactions related to traumatic life events; improve the safety, comfort, trust, and growth in the child; and develop parenting skills and family communication.


 

Program Theory

TF–CBT combines cognitive behavior and family theory and adapts them to the treatment of traumatic events. It is based on the theory that children (and others) have difficulty processing the complex and strong emotions and feelings that result from exposure to single or multiple traumatic events. By providing the child and the care-giving parents with the support, skills, and techniques to process traumatic events and their psychological consequences, TF–CBT aims to minimize the resulting emotional disorders.

Intervention ID
195
Ages

3 to 14

Rating
Effective
Outcomes

Study 1

Child’s Posttraumatic Stress Disorder Symptoms (PTSD)

Deblinger, Lippman, and Steer (1996) found that children assigned to the child-only and parentchild conditions exhibited significantly fewer PTSD symptoms than children assigned to the parent-only and community conditions.


 

Parenting Skills of Mothers

Mothers of children assigned to the child-only and parentchild conditions reported significantly greater use of effective parenting skills than mothers of children assigned to the parent-only and community conditions.


 

Other Child Psychiatric Symptoms

Mothers of children assigned to the child-only and parentchild conditions reported significantly fewer externalizing behaviors and less depression among their children than mothers of children assigned to the parent-only and community conditions. Results of the follow-up evaluations indicated that improvements in externalizing behavior, depression, and PTSD were maintained over the 2-year follow-up period.


 

Study 2

General Behavior

Cohen and Mannarino (1996) found that children in the treatment condition scored significantly lower than children in the control condition on the Internalizing Behavior and Total Behavior Profile.


 

Sexualized Behavior

Children in the treatment condition scored significantly lower than children in the control condition on sexualized behaviors.


 

Problematic Behavior

Children in the treatment condition scored significantly lower than children in the control condition on problematic behaviors.


 

Study 3

Child’s PTSD

Cohen and colleagues (2004) found that children in the treatment condition scored significantly lower than control group children on the three PTSD subscales of the Schedule for Affective Disorders and Schizophrenia for School-Aged Children: re-experience, hyperarousal, and avoidance.


 

Other Child Symptoms

Children in the treatment condition scored significantly lower than control group children on the Child Behavior Checklist total scale, the Child Depression Inventory, and the Shame Questionnaire.


 

Parents’ Symptoms

Parents in the treatment condition scored significantly lower than control group parents on the Beck Depression Inventory, lower on the Parent Emotional Response Questionnaire, and significantly higher on both the Parenting Practices Questionnaire and the Parent Support Questionnaire.


 

Child’s Diagnosis of Posttraumatic Stress Disorder Symptoms

Twenty-one percent of treatment children were diagnosed with PTSD at posttest, compared with 42 percent of control group children. This difference was statistically significant.

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