10.3: Key Components of TF-CBT
- Page ID
- 215515
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)Key Components of TF-CBT
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a structured, short-term treatment usually consisting of 12 to 16 weekly sessions, although this can extend to 25 sessions for youth with complex trauma. Each session typically lasts about 60 minutes, divided equally between the child and the parent, with some joint sessions later in the therapy. TF-CBT is generally completed within 4 to 6 months, though additional services may be necessary after addressing the trauma-specific impacts.
During each session, the therapist focuses on building a therapeutic relationship while providing education, skills, and a secure environment to process traumatic memories. Parents and children work together with the therapist to set and achieve common goals. Joint sessions help parents and children practice the skills learned, facilitate the sharing of trauma narratives, and improve parent-child communication about the trauma.
The components of the TF-CBT protocol can be summarized with the acronym "PRACTICE":
- P - Psychoeducation and Parenting Skills: Educating about child abuse and typical emotional and behavioral reactions, along with training parents in positive parenting, behavior management, and effective communication.
- R - Relaxation Techniques: Teaching methods such as focused breathing, progressive muscle relaxation, and visual imagery to help manage stress for both the child and parent.
- A - Affective Expression and Regulation: Assisting the child and parent in managing emotional reactions to trauma reminders, improving emotional expression, and engaging in self-soothing activities.
- C - Cognitive Coping and Processing: Helping the child and parent understand the link between thoughts, feelings, and behaviors, and correcting inaccurate or unhelpful beliefs related to everyday events.
- T - Trauma Narration and Processing: Facilitating gradual exposure exercises, including verbal, written, or creative recounting of traumatic events, and addressing unhelpful thoughts about the abuse.
- I - In Vivo Exposure: Gradual exposure to trauma reminders in the child’s environment (e.g., darkness, places where the trauma occurred) to help the child control emotional reactions.
- C - Conjoint Parent/Child Sessions: Family sessions to enhance communication and provide opportunities for therapeutic discussion about the abuse and sharing of the child’s trauma narration.
- E - Enhancing Personal Safety and Future Growth: Educating and training on personal safety, interpersonal relationships, and healthy sexuality, and encouraging the use of new skills to manage future stressors and trauma reminders.
In cases where children live in dangerous or high-risk environments (e.g., domestic violence, neighborhood violence), safety planning may be prioritized at the beginning of the treatment and revisited throughout therapy.