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Trauma-focused cognitive behavioral therapy is a form of cognitive-behavioral therapy (CBT) designed to assist in the treatment of families, children, and teens who have survived a traumatic event. 

Therapists trained in trauma-focused cognitive behavioral therapy have had greater success in treating children and teens with trauma-related mental health issues, from induced anxiety and clinical depression to post-traumatic stress disorder. 

Explaining Trauma-Focused Cognitive Behavioral Therapy

Trauma-focused cognitive behavioral therapy is a short-term treatment option that usually lasts about 16 sessions or less. Over 80 percent of teens treated via trauma-focused CBT see notable improvements in symptoms within this period. 

This form of therapy is also used to help families navigate post-traumatic stress and the symptoms that follow, particularly by arming them with the necessary tools to manage stress, anxiety, and depressive symptoms better through healthier coping mechanisms, thought experiments, and self-reflective methods. 

Individuals treated through trauma-focused cognitive therapy learn to identify and differentiate errant and intrusive thoughts, disarm them more effectively, and develop the tools to improve their perspective. Some of the most crucial elements explored through trauma-focused cognitive behavioral therapy through its program include: 

  • A safe and stable treatment environment – outpatient or residential treatment establishes an environment that assures the patient that they are safe and taken care of. 
  • Affect regulation – taking charge of your own emotional state.
  • Cognitive trauma processing and trauma narrative – working through the events of what happened, while providing therapeutic exposure to traumatic memories, and recontextualizing them into tools to overcome trauma
  • Child-parent sessions – helping parents better understand what their child is going through while demonstrating how trauma-focused therapy works and helping them arm themselves with the tools to help support their loved one in the long term after therapy. 
  • Focusing on future development – because this therapy is often short-term, a large focus is placed on the effectiveness of future treatment options, and the transition towards long-term treatment via an established support system continued therapeutic support and other mental health resources. 

A Short History of Trauma-Focused Cognitive Behavioral Therapy

Trauma-focused cognitive behavioral therapy was developed through the clinical work of Anthony Mannarino, Judith Cohen, Esther Deblinger, and other researchers. They worked together to establish a form of cognitive-behavioral therapy that centered on the treatment of traumatized children and adolescents, by incorporating family therapy and centering on specific core elements of cognitive-behavioral therapy that were most effective for children and teens. 

Once the basic framework for trauma-focused cognitive behavioral therapy was established, it was followed by five different randomized controlled trials, the golden standard of scientific testing. The result was an explicitly proven efficacy for children and teens with traumatic experiences, proven again multiple times by other researchers. 

How Does TF-CBT Differentiate Itself from CBT?

The main differences in trauma-focused cognitive behavioral therapy versus traditional cognitive behavioral therapy include: 

  • A focus on establishing a safe day-to-day environment for the treated child or teen. 
  • Revisiting their trauma in treatment. 
  • Incorporating family therapy to ensure their continued safe development. 
  • Centering on treatment elements that resonated best with children and teens. 

What Does TF-CBT Treat?

Trauma-focused cognitive behavioral therapy is most often used for the treatment of post-traumatic stress disorder in children and teens. Children and teens experience and display signs of PTSD differently from adults. Children re-experience trauma more often through play, while teens are far more likely to struggle with irritability and outbursts of rage following a traumatic experience. 

TF-CBT helps them avoid destructive behaviors, identify, and push back against intrusive thoughts, and overcome trauma. TF-CBT is specifically used to treat individuals between ages 3-18, for both single traumatic events and recurring trauma. TF-CBT has also been used in the treatment of teens with complicated grief, as well as stress-induced anxiety and depression. 

Should I Speak to My Therapist About TF-CBT?

It’s never a bad thing to express an interest in a certain treatment method or modality. If you are interested in exploring the applications of trauma-focused cognitive behavioral therapy in your own treatment, it isn’t a bad idea to talk about it with your therapist. 

Ultimately, your mental healthcare provider is the best person to advise you on any treatment you should or shouldn’t try, as well as where or when to try them. Treating individual cases of a mental health issue is vastly different from reading about them, or providing textbook examples of illnesses and treatments. 

Case-by-case details greatly affect how efficacious any given treatment might be, and you should always defer to a professional who has spent time working with you and your issues and knows best how you process certain activities and modalities. 

It also helps to understand that there are distinct limitations in both the application and usefulness of trauma-focused cognitive behavioral therapy. For example, this form of therapy may not be suitable for children or teens who have had severe conduct or behavioral problems before their trauma. Their therapist might instead focus on helping them overcome these conduct issues before addressing their trauma.

Both substance use and suicidal ideation might be contraindicative of trauma-focused therapy as well. The keyword here, however, it might. Because such a core tenet to trauma-focused cognitive behavioral therapy is gradual and frequent exposure, both suicidal ideation and drug addiction can be amplified by this type of treatment. 

But by modifying exposure frequency and taking a dialectical approach to address factors such as suicidal ideation and self-harm, trauma-focused cognitive behavioral therapy can still be a useful modality in cases with these issues. Otherwise, teens with these issues may be better served with a different treatment approach that tackles both their addiction or severe depression and trauma appropriately, and effectively. 

If you have questions about the treatment options offered to you by your therapist or mental health professional, be sure to ask as many of them as possible. It’s important to be on the same page with your treatment provider and to understand how and why certain treatment modalities might work better for you than others. 

Patients are encouraged to be involved with their treatment, always – and to have a better understanding of both how their condition is affecting them, and how their treatment is helping them overcome that.