Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

For children, adolescents, and teens

Trauma-Focused Cognitive Behavioral Therapy, or TF-CBT for short, has been shown to be effective for children as young as 3 years old, adolescents, and teenagers. In just a few sessions, it can provide some relief for youth with post-traumatic stress and mood disorders resulting from sexual abuse, violence, and other traumatic events.

Overview of Trauma-focused CBT

There are a number of controlled trials and systematic reviews that have shown that TF-CBT and Group Trauma-focused CBT are effective in reducing the symptoms of PTSD, anxiety, and depression.

TF-CBT provides a structure for applying cognitive-behavioral principles to young people who have experienced trauma. In a typical scenario, TF-CBT is delivered in 12–16 sessions.

Key elements of TF-CBT include:

• Psychoeducation (for example, helping the minor and the family/caregivers understand reactions to trauma exposure).
• Coping skills (often including relaxation, feeling identification, and cognitive coping).
• Gradual exposure (reconditioning the response to triggers).
• Cognitive processing (skills to better handle trauma-related thoughts and beliefs).
• Caregiver involvement (this often includes joint sessions with the parent or parent training). 

What issues can trauma-focused CBT treat?

TF-CBT is often used to treat post-traumatic stress disorder (PTSD) and other trauma disorders stemming from:

• Physical abuse.
• Sexual abuse.
• Exposure to violence. 
• Experiencing natural disasters or accidents.

What happens in Trauma-focused CBT?

In TF-CBT, you will build coping tools, be exposed to triggers, learn to respond in more effective ways to triggers, and build cognitive processing skills. An important part of TF-CBT is psychoeducation — to better understand your feelings.

In most cases, some therapy sessions will include family members or caregivers.

What you can hope to gain in Trauma-focused CBT

PTSD can manifest in different ways in different people, and even in the same person at different stages in life. Symptoms can include recurrent negative thoughts about the traumatic experience, difficulty sleeping, feeling numb emotionally, difficulty maintaining focus or concentration, and extreme responses to triggers that activate a memory of the trauma.

TF-CBT has been shown to reduce:

• Hyperarousal.
• Avoidance symptoms.
• Aggressive/disruptive behavior.

What are the upsides and downsides of TF-CBT?

• Often, you can experience tangible results.
• Controlled trials and research studies have shown that TF-CBT is effective.
• You build coping tools and skills that support lifelong healing.

TF-CBT also has limitations. A different behavioral approach may be called for in teens or adolescents who are engaging in alcohol or drug abuse or in children of any age who have suicidal ideation or serious behavioral disturbances. For more information please reach out.

Related information

1. Bryant, R.A. (2019). Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges. World Psychiatry, 18.
2. Dominguez, S., Drummond, P.D., Gouldthorp, B., Janson, D.L., & Lee, C. (2020). A randomized controlled trial examining the impact of individual trauma-focused therapy for individuals receiving group treatment for depression. Psychology and psychotherapy.
3. Fordham, B., Sugavanam, T., Edwards, K., Hemming, K., Howick, J., Copsey, B., Lee, H., Kaidesoja, M., Kirtley, S., Hopewell, S., das Nair, R., Howard, R.J., Stallard, P., Hamer-Hunt, J., Cooper, Z., & Lamb, S.E. (2021). Cognitive-behavioural therapy for a variety of conditions: an overview of systematic reviews and panoramic meta-analysis. Health technology assessment, 25 9, 1-378 .
4. O’Sullivan, C., Bosqui, T.J., & Shannon, C. (2016). Psychological interventions for children and young people affected by armed conflict or political violence: a systematic literature review. Intervention, 14, 142–164.