Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a psychosocial treatment model designed to treat posttraumatic stress and related emotional and behavioral problems in children and adolescents ages 3 to18 years. Initially developed to address problems associated with childhood sexual abuse, TF-CBT has been modified and tested with children who have experienced a wide array of traumas, including domestic violence, traumatic loss, war, commercial sexual exploitation, and the often multiple and complex traumas experienced by children who are placed in foster care. TF-CBT is appropriate for use with children exposed to trauma whose parents or caregivers did not participate in the abuse.
The program integrates cognitive, behavioral, interpersonal, and family therapy principles as well as trauma interventions. It is designed to be delivered by trained and certified TF-CBT therapists. The therapy approach is highly collaborative and the therapist works with both the child and the child’s non-offending parents or caregivers to identify and attain common goals. Initially, therapists provide parallel individual sessions with children and their parents or primary caregivers; joint parent–child sessions then become increasingly incorporated over the course of treatment. Each TF-CBT session is aimed at building the therapeutic relationship while also providing education and skills development in a safe environment, in which the child is able to address and process traumatic memories. Joint parent–child sessions are aimed at helping parents and children practice the skills learned during therapy and enabling the children to share their stories of trauma, while also nurturing more effective parent–child communication about the abuse and related issues.
The acronym PRACTICE describes the following components of the model:
P - Psychoeducation and parenting skills
R - Relaxation skills
A - Affective expression and modulation skills
C - Cognitive coping and processing skills
T - Trauma narration and processing
I - In vivo mastery of trauma reminders
C - Conjoint child–parent sessions
E - Enhancing safety and future developmental trajectory
Other components are available for children who develop posttraumatic stress symptoms and maladaptive grief responses, following the death of an important attachment figure. Group and complex trauma applications are also available.
Standard individual or group TF-CBT treatment is typically delivered over 12 to 16 sessions and TF-CBT for complex trauma is typically delivered over 16 to 25 sessions.