Trauma Focused CBT: Cognitive Behavioral Therapy for Trauma Recovery
Cognitive-behavioral therapy (CBT) is a well-known therapy technique often used to treat mental health disorders, including depression and anxiety. But less well-known may be a variant of CBT called trauma focused cognitive behavioral therapy, or trauma focused CBT. Trauma focused CBT is a specific type of experience-based CBT that generally focuses on helping children and adolescents move past traumatic experiences.
What is cognitive behavioral therapy?
Before we can understand what trauma-focused cbt is, we may benefit from first understanding CBT. Cbt is one of many types of psychological therapies that has a cognitive base (meaning it is designed around thinking and thought processes) and is generally designed to help individuals reduce unhelpful thoughts and habits and replace them with more productive ones. For example, depression may bombard you with thoughts that you deserve what comes to you. A course of CBT may help you recognize these negative thought patterns and replace them with more positive ones, such as believing that you deserve to live a happy and fulfilled life.
CBT’s efficacy and versatility have made it one of the most popular forms of therapy today, and CBT techniques have helped many people overcome a variety of mental health concerns.
Trauma-focused cbt is a specific form of CBT that can help individuals heal from traumatic experiences. Adults can utilize trauma-focused CBT, but it may be more effective for children or adolescents impacted by trauma. The goal of TF-CBT is usually to help individuals move past traumatic experiences.
Is TF-CBT similar to cognitive processing therapy (CPT)?
They have many same concepts, but trauma-focused cbt was distinctively developed for teens and children. It can be especially useful in the treatment of post-traumatic stress disorder (PTSD) in adolescents and children, though it has uses for may different post-traumatic disorders and reactions to past experiences.
Just like cognitive processing therapy for ptsd, TF-CBT may help young people manage their past trauma before it develops into a mental health disorder. Systemic reviews of CBT therapy show that it may be more effective than other forms of therapy for young people impacted by trauma. TF-CBT may help with sleep problems, trauma due to physical abuse, changing emotional responses to stimuli, reducing emotional distress, PTSD, and more.
How does trauma focused CBT work?
TF-CBT typically combines CBT techniques with family and humanistic therapy approaches. TF-CBT treatment is usually less than 16 sessions, and it can be highly effective at helping young people heal from stress.
Creating a narrative through trauma focused CBT
The trauma-focused CBT approach may include systematic reviews of past experiences to help individuals address and move past thoughts that can lead to PTSD, stress, depression, and other forms of traumatic stress disorder and mental health conditions. In doing so, TF-CBT can help individuals with stress disorders manage their emotions in a healthy way. One way in which this may be accomplished is by receiving treatment in a safe, familiar environment. This may allow the impacted individual to stay present with recovery, express their emotions more comfortably, and tell their own trauma narrative. Once individuals are comfortable telling their story to their therapist, they will normally work together to discover how their past has distorted their perception of reality and how to cope with it in a healthy manner.
Managing effects from physical or sexual abuse, PTSD, and grief with cognitive behavioral therapy
TF-CBT can teach individuals new skills, so for it to be maximally effective, families and children may need to practice these skills. In some cases, therapists may assign homework to encourage opportunities to practice new skills and reach therapy goals.
Therapists may meet with families or children affected by trauma in joint family therapy sessions as well as individually to help relatives develop skills together. For TF-CBT to work, a significant relationship between all parties involved may be beneficial. Therapy may help all parties strengthen their relationships and improve their coping skills.
What can TF cognitive behavioral therapy treat?
TF-CBT is generally a trauma-based therapy, but you may be wondering what specific types of trauma TF-CBT works best for. The primary use of TF-CBT is usually to treat individuals living with PTSD. Physical, mental, or sexual abuse* may leave a child with anxiety, depression, or other unhealthy behaviors. A counselor can help these adolescents impacted by trauma to eliminate negative behaviors and move on.
Trauma-focused cbt (TF-CBT) is generally designed for individuals between ages three and 18 who have had a traumatic experience, anything from mild to severe, repeated trauma. Individuals undergoing TF-CBT will often learn techniques such as the gradual exposure treatment model, cognitive processing, deep breathing exercises, and validation techniques. While the treatment length depends on the individual, the Child Welfare Information Gateway estimates that TF-CBT treatment typically lasts between 4 and 6 months.
Therapists
A TF-CBT therapist may have specialized training in child development and the mental health of children and adolescents impacted by trauma. To provide TF-CBT, therapists may obtain their master’s degree before taking certified courses designed for TF-CBT. A typical course may require two days of live training followed by additional virtual training, which occurs once, twice, or every few months. Before providing services, a mental health provider usually must also pass an examination.
Effectiveness of trauma focused cognitive behavioral therapy
A comprehensive literature review of the research on TF-CBT confirms its efficacy for treating depression, PTSD, anxiety, and other side effects associated with trauma. The more TF-CBT sessions one has, the more effective the treatment could be.
Not every individual who has experienced trauma will be a good candidate for TF-CBT. For instance, children exhibiting behavioral problems prior to trauma may not benefit from TF-CBT. A licensed mental health provider can work with you to determine a different treatment approach for these individuals.
Youth experiencing suicidal ideation* or addiction may not be good candidates for TF-CBT because the treatment may cause their symptoms to temporarily worsen. Above all else, mental health providers generally want to defend individuals from harm, so to avoid putting individuals in a dangerous position, another therapy, such as dialectical behavior therapy, may be more appropriate.
The benefits of online therapy
Online therapy can be a convenient and effective way for adults to obtain CBT for trauma or to get a wide variety of support for various other mental health challenges. Parents with children who may benefit from TF-CBT may also discuss treatment options for their children with an online therapist. Online therapy may be more suitable for many people because sessions can be held virtually from the comfort of your home.
Takeaway
Trauma-focused cognitive-behavioral therapy is a specific type of therapy that can help young people and adults move past traumatic life events, including abuse, loss, and displacement. Therapists experienced in TF-CBT often help individuals learn to cope with the negative impacts of trauma before they develop into mental health conditions. Online cbt can be a convenient option for those who wish to try this type of therapy.
What are the key elements of trauma focused cognitive behavioral therapy?
Trauma-focused CBT is a child-centered therapy for children and adolescents ages 3 to 18 with post-traumatic stress disorder or other trauma-related conditions. It is an evidence based treatment, and randomized controlled trials have proven its efficacy with PTSD and affective disorders among sexually abused children compared to control groups. Anyone who has survived a traumatic event can pursue TF-CBT, though it was designed to treat children.
The acronym PRACTICE is often used to describe the key elements of trauma-focused CBT:
Psychoeducation: Children learn that many people experience traumatic events and that their associated feelings and reactions are normal.
Relaxation techniques: The therapist teaches the child relaxation techniques to use in various environments including guided imagery, progressive muscle relaxation, and breathing techniques, for example.
Affect expression: Children are encouraged to talk about their feelings when faced with trauma reminders, which is thought to reduce externalizing behaviors.
Cognitive coping: The therapist helps children identify negative and unhelpful thoughts they may have related to the trauma, such as self-blame.
Trauma narrative: The child talks about the trauma as well as any feelings that surface.
In vivo exposure: The child learns how to deal with fear and anxiety by facing reminders of the trauma.
Conjoint sessions: The therapist holds parent sessions during which the child is encouraged to share their trauma narrative. In cases of child abuse or intimate partner violence, the sessions are held with the non-offending parent or other caregiver.
Enhancing safety: The therapist helps the child develop strategies for enhancing a sense of safety in the future, including what to do if they feel unsafe. This can help in reducing symptoms of fear and anxiety.
What interventions are typically used in trauma- focused cognitive behavioral therapy?
Trauma-focused CBT can be used to treat trauma as a result of various situations including child abuse, child maltreatment, traumatic grief, natural disasters, PTSD symptoms, and children exposed to substance abuse, interpersonal violence or community violence, for instance. Treating children in these highly emotional situations requires a trauma-sensitive approach. Therapeutic interventions associated with the TF-CBT treatment model may include:
Journaling
Cognitive restructuring
Mindfulness practice
Behavioral activation
Exposure therapy
Relaxation techniques
For an adolescent, medicine may be prescribed as a supportive therapy for posttraumatic stress symptoms as they undergo TF-CBT.
What are the pros and cons of TF cognitive behavioral therapy?
This particular form of trauma therapy may have advantages and disadvantages. For example, while the TF-CBT model is evidence-based and can be highly effective, it requires an extensive time commitment and may make symptoms worse initially.
Can this type of therapy be beneficial for adults as well?
Yes. Trauma-focused CBT was designed to treat traumatized children, but it can be adapted to treat adults as well. This form of therapy can have similar effects on adults who have experienced trauma such as the reduction of post-traumatic stress symptoms. It may also be appropriate for other types of mental illness and conditions such as depression, anxiety, and bipolar disorder.
What age range has CBT been proven to be most effective?
In children, CBT appears to be most effective for ages 7 and older.
What is the length of treatment for managing children with trauma?
According to the American Psychological Association, a course of trauma-focused CBT can last between 12 and 18 sessions. For children with complex trauma, up to 25 sessions may be recommended.
How are cognitive behavioral therapy sessions typically done?
Treating trauma with CBT usually includes various phases of treatment, including psychoeducation, relaxation skills, and trauma narration and processing.
What are the most commonly used TF techniques?
Some of the most commonly used techniques and mental health services in TF-CBT treatment include:
Assessment and engagement
Psychoeducation
Affective modulation
Cognitive coping
Trauma narrative
In vivo exposure
Enhancing safety
Parenting skills
What are the major goals of cognitive therapy?
Major goals of trauma-focused CBT include reducing trauma-related symptoms (including PTSD symptoms), teaching coping skills for psychological difficulties, improving emotional regulation, and enhancing overall wellbeing.
Does cognitive therapy base its treatment on past experiences?
Typically, CBT focuses more on the present than the past. In the case of trauma-focused CBT, however, there is a necessary emphasis on the traumatic experience that occurred in the past to provide context for treatment and to help children process the trauma. You can learn more about this type of therapy by visiting the Child Welfare Information Gateway online. You can also find TF-CBT licensed therapists at TFCBT.org.
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