Though nonoffending caregivers are strongly encouraged to participate in TF-CBT regardless of the child’s age, primary caregivers are young children’s most influential role models and thus are critical to the TF-CBT process. The repetition of skills is critical for acquisition, particularly with young children. It is recommended that young children be engaged for short bursts of activity (5–15 minutes) of focused skill building or trauma narration with planned positive activities that give children a break while incorporating fun in the therapy exercises. To participate successfully in TF-CBT, young children should be able to provide at least a brief acknowledgement of the trauma(s) to be addressed and demonstrate an ability to share a narrative about a neutral experience with some details.ĭue to their limited attention span, total session time with young children may be 20–30 minutes with the remainder of the session devoted to work with nonoffending caregivers. This may be done by eliciting an account of a positive/neutral recent experience and then eliciting a baseline trauma narrative as described in Deblinger and colleagues ( 2015). In addition to these more general criteria, it is important to assess young children’s verbal capacity and memory of the trauma prior to initiating TF-CBT. Of note, once unsafe behaviours stabilize or substance abuse is treated, TF-CBT may be appropriate. ![]() Exclusionary criteria include active suicidality, dangerous acting out behaviours, very brief placement (although children in foster care, unless in an emergency or other very brief placement, are appropriate), and active substance abuse on the part of the child or caregiver. Single or multiple-incident trauma(s) as well as complex trauma may be addressed using TF-CBT. TF-CBT is appropriate for children ages 3–18 years who have at least some memory of the trauma and their nonoffending caregivers. TF-CBT may be utilized when there is evidence of trauma and a possible link between the trauma and the child’s symptoms. Depending on the complexity of the presenting concerns, treatment is typically completed in 8–20 sessions. Children and caregivers typically move through the components in parallel with caregivers serving as role models and supports for skills being acquired. The components of TF-CBT can be summarized by the acronym PRACTICE: Parenting and psychoeducation, Relaxation, Affect expression and modulation, Cognitive coping, Trauma narration and processing, In vivo mastery, Conjoint sessions, and Enhancing safety and future development. ![]() TF-CBT consists of three phases: stabilization and skill building, trauma narration and processing, and integration and consolidation of lessons learned. TF-CBT engages children and their caregivers in a gradual exposure process that begins at the start of treatment with acknowledgement of the traumas experienced, the learning of skills to cope with trauma reminders and other stressors, and ultimately making meaning of the traumas experienced. The model involves spending session time with children individually, caregivers individually, and with children and caregivers together (conjoint sessions). TF-CBT is a components-based treatment model for children who have experienced trauma and their nonoffending caregivers. ![]() Trauma-focused Cognitive Behavioural Therapy (TF-CBT Cohen, Mannarino, & Deblinger, 2017 Deblinger, Mannarino, Cohen, Runyon, & Heflin, 2015) is an evidence-based treatment for childhood trauma that has been applied to children with diverse trauma experiences across a wide age range.
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