Evidence Based Intervention: Trauma-Focused Cognitive Behavioral Therapy for Children and Families
This chapter describes an evidence-based intervention for child maltreatment and other traumas, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
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Introduction A great deal of progress has been made in developing effective interventions for children who experience child abuse and other traumas. The most extensively evaluated child trauma treatment model is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Initially developed for and tested with children or adolescents who experienced sexual abuse and their non-offending parents or primary caregivers (hereafter referred to as “children” and “parents”, respectively), TF-CBT has now been tested in 20 randomized controlled trials for diverse trauma types, developmental levels, settings and cultures. Three core TF-CBT Principles are (1) proper duration and proportionality of the three TF-CBT treatment phases; (2) sequencing of the TF-CBT components, summarized by the acronym “PRACTICE”; (3) the use of gradual exposure throughout treatment; and (4) including parents or caregivers in treatment whenever possible. This chapter briefly describes the TF-CBT treatment model, reviews the current state of TF-CBT research, and provides information about TF-CBT therapist certification.
J.A. Cohen, M.D. (*) • A.P. Mannarino, Ph.D. Department of Psychiatry, Allegheny Health Network, Drexel University College of Medicine, Pittsburgh, PA, USA e-mail: [email protected]; [email protected] © Springer International Publishing Switzerland 2017 D.M. Teti (ed.), Parenting and Family Processes in Child Maltreatment and Intervention, Child Maltreatment Solutions Network, DOI 10.1007/978-3-319-40920-7_6
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The Trauma-Focused Cognitive Behavioral Therapy Model General Description of TF-CBT TF-CBT is a child and family-focused trauma treatment model that addresses problems associated with significantly traumatic events that children experience or witness. These traumas may include but are not limited to experiences such as sexual, physical and/or emotional abuse or neglect, domestic or community violence, bullying, serious accidents, natural or other disasters, fires, traumatic deaths, war, terrorism, medical traumas, or multiple or complex traumas. Complex trauma is not officially included in DSM-5 but as proposed in ICD-11, it includes the following features : (1) early repeated interpersonal trauma typically perpetrated by a caregiver (2)significant PTSD symptoms; and (3) significant dysregulation in multiple functional domains such as affect, negative self-perception, and interpersonal relationships. TF-CBT does not treat traumatic experiences themselves, but children’s trauma-related mental health problems. These may include PTSD symptoms (e.g., intrusion, avoidance, maladaptive cognitions or mood changes; or arousal) but children do not need to have a specified level of PTSD symptoms in order to receive TF-CBT. Due to traumatic avoidance, children may initially report relatively few of these symptoms, and if reassessed after a few treatment sessions, children may report substantially more. Other children may have difficulties in other areas and have relatively few PTSD symptoms. TF
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