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About TF-CBT

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About TF-CBT

Trauma-Focused Cognitive Behavior Therapy (TF-CBT) is a mental health treatment model designed for children ages 3- 18 who are experiencing difficulties after trauma exposure such as sexual abuse, exposure to violence, or a natural disaster. TF-CBT was developed by Judy Cohen, M.D., Anthony Mannarino, Ph.D. and Esther Deblinger, Ph.D.
TF-CBT is an evidenced-based intervention that is a SAMHSA best practice in the treatment of childhood posttraumatic stress disorder (PTSD). Features of TF-CBT:

  • Treatment is short-term. On average, TF-CBT is completed over 18-24 weekly sessions.
  • TF-CBT is skills–based. Families are taught many skills in sessions, such as relaxation, to reduce trauma-related distress. In order for treatment to be effective, therapists will also ask children and caregivers to practice and use these skills at home and other places where stress may occur.
  • TF-CBT involves the family. Caregivers are actively included in treatment with their child and are key to successful outcomes. Typically, therapists in each TF-CBT session will spend individual time with the child, check in separately with the caregiver, and include combined family time. However, when a child does not have a caregiver who can be involved in treatment, TF-CBT treatment can still be effective in reducing childhood trauma symptoms.
  • Sessions will be structured. TF-CBT therapists will have a planned focus for each session to cover skills and activities known to be important for reducing distress related to trauma.
  • Treatment will be engaging to the family! TF-CBT therapists will strive to be creative and tailor activities to engage children and provide an enjoyable and safe treatment experience.
TF-CBT Therapy FAQ

No. TF-CBT is specifically designed to treat trauma symptoms. What we know is that some children who go through very difficult experiences will not develop trauma symptoms, and would not need TF-CBT. It is recommended that all children who experience trauma participate in an evaluation to determine if trauma symptoms are present in order to plan effective treatment.

Expect therapy to be both hard work and fun. Your therapist will begin by assessing your child for trauma symptoms to determine if TF-CBT is the best treatment. Session time will be structured, although there will always be time for the therapist to check in with you about the past week, he/she will have specific goals and activities to complete with your child (and you) each week. Plan on treatment to last approximately 18-24 weeks. If you are interested in seeking services through The University of Oklahoma Health Sciences Center, please follow this link OUHSC Clinical

Not wanting to talk about difficult or painful memories is very common, and understandable! However, it is often healing to be able to face painful memories and allows a child and family to move forward. In TF-CBT, children gradually progress towards talking about their pasts, while learning important coping skills to manage distress. Children are encouraged to talk about their past only when it can be done in a safe and therapeutic way and the child and family are ready.

Several key elements are required for a therapist to truly learn any new treatment model. The generally accepted trainings requirements for TF-CBT are for a therapist to attend the 2-day in-person “Introduction to Trauma-Focused Cognitive-Behavior Therapy” provided by a Master Trainer and to complete at least one TF-CBT case while under consultation with a Master Trainer. Master trainers in the stte of Oklahoma are Susan Schmidt, Ph.D., Elizabeth Risch, Ph.D., Dolores Subia Bigfoot, Ph.D., and Roy Van Tassell, LPC.

We have developed a interactive map (here) to aid families in locating a TF-CBT provider. And you can always ask!

What if a child is acting out sexually? Is TF-CBT appropriate?

Maybe. It would depend on the child’s level of trauma symptoms. Treatment is also available for children who have sexually acting out beaviors without trauma symptoms. A thorough evaluation of trauma history, symptoms, and sexual behaviors would allow a clinician to determine what treatment will be most appropriate. Please visit the Children with Sexual Behavior Problems website to learn more. 

The resources below are open-access and available for your use.
  1. Working More Effectively with Caregivers
  2. Essentials for Parenting
  3. Waiting Room Check-In
  4. Praise/Connection
    1. Examples of Labeled Praises
    2. Home Activity – Family Fun Activity
    3. Labeled Praise Handout
    4. Time to Talk Cards
  5. Emotion Coping
    1. Child-Caregiver Conjoint Work
    2. Coaching on Coping Skills
    3. Nurturing Children Wheel
    4. Self Care for Parenting
    5. Talking with Foster Children About Trauma
  6. Behavior Plans
    1. Behavior Chart Handout
    2. Behavior Chart
    3. Parent 5-min work chore
    4. Responding to Child Behavior
    5. Parenting In A Challenging World
    6. Raising Well Behaved Kids Factsheet
    7. Rewards and Consequences Menu
    8. Rewards and Consequences Planning
    9. Time-Out Handout
    10. Therapist ABC worksheet
  7. Developmental Education
    1. Lying, Is It Normal? Education for Parents
    2. Supporting Attachment Between Children and Parents
  8. Intellectual and Developmental Disabilities
    1. Understanding Trauma Responses in Children with Intellectual and Developmental Disabilities
    2. Trauma and Children with Intellectual and Developmental Disabilities: Taking Care of Yourself and Your Family
    3. Choosing Trauma-Informed Care for Children with Intellectual and Developmental Disabilities
    4. Children with Intellectual and Developmental Disabilities Can Experience Traumatic Stress
  1. Six Animal Poses
  2. Yoga Cards for Kids
  3. Bubble Breaths
  4. Child Relaxation Script
  5. Hero Rangers Script
  6. Using Feel Better Plan
  7. I Can Relax – PMR Images
  8. Progressive Relaxation Script
  9. Pirate Relaxation Script
  10. Relaxation & Coping Ideas
  11. Mindfulness Flashcards
  12. I Can Relax
  13. Relaxation Log
    1. Simple 3xs-Day
    2. Week with SUDS
  1. Feeling Words and Faces
    1. Young Child 1
    2. Young Child 2
    3. Older Child 1
    1. Older Child 2
    2. Encanto Feelings – English
    3. Encanto Feelings – Spanish
  2. My Feelings About the Trauma
  3. Feelings Questions Activity
  4. Feeling ID – Info for Caregivers
  5. Emotional Regulation – Info for Caregivers
  6. Minnie Mouse Feeling Faces
  7. Name Feelings
  8. Rate Feelings
  9. Feelings ID & Rating
  10. Talking Box Questions
  11. Thought-Feeling Matching
  12. Thoughts That Go with Feelings
  13. Home Activity – Feelings ID & Rating
  14. Let’s Connect Handout – Emotional Coping
  15. Dissociation-Information
  16. Grounding-Worksheet
  17. My Trauma Brain
  18. Active Listening
  19. Active Listening – Spanish
  1. Twenty Ways to Start Trauma Narratives
  2. Analogies to Intro TN
  3. Baseline Narrative Description
  4. Telling My Story Worksheet
  5. TF-CBT Trauma Narrative Disclaimer
  6. The Trauma Narrative
  7. Trauma Narrative Story Development Signs
  8. Blame Pie chart
  9. Socratic Techniques for Changing Unhelpful Thoughts
  10. Socratic Questioning Practice
  11. Socratic Questioning Cheat Sheet
  12. Template for Trauma Impacted Belief Rating
  13. TF-CBT Young Child Storybook
  14. TN Development Worksheets for Youth
  15. TN Development Structure (with timeline)
  16. Trauma Narrative of Child Sexual Abuse
  17. Trauma Narration Info for Caregivers
  1. Conquering the Mountain of Fear
  1. Conjoint Prep. for Caregiver – Writing Your Praise Letter
  1. General Safety Plan
  2. SI Diary Card
  3. Family Violence Information Sheet
  4. My Very Own Safety Plan
  5. Sexual Health & Trauma
  6. Safety Scenarios
  7. Sexual Safety – Teens
  8. Sexual Safety in Sports
  9. Youth Suicide Prevention Toolkit
  10. Passive-Aggressive Examples
  1. Private Part Rules – Preschool
  2. Sexual Behavior Rules – School-age
  3. Recommendations for Supervision and Parenting
  4. Taking Action for Children with Problematic Sexual Behavior
  5. AJ’s Story About Not OK Touches
  6. Sexual Behavior Problems – For Parents
  7. Sexual Development & Behavior – For Parents
  8. Family Safety Plan
  9. How Children Develop Sexually
  10. STOP Steps Handout
  11. STOP Steps Worksheet
  12. Turtle Steps Handout
  13. Turtle Steps Worksheet
  14. Resources for Problematic Sexual Behavior
    1. NCSBY.org
    2. nationalchildrensalliance.org/psb
    3. nearipress.org/webinars
    4. nctsn.org
    5. atsa.org
  1. PPRACTICE Components Goals & Methods
  2. Your Very Own TF-CBT Workbook
  3. Your Very Own TF-CBT Workbook (Fillable)
  4. TF-CBT Grief Workbook (PDF)
  5. TF-CBT Grief Workbook (Word)
  6. Dealing with Trauma- A TF-CBT Workbook for Teens
  7. Dealing with Trauma – A TF-CBT Workbook for Teens (Fillable)
  8. Treatment Planning Form
  9. Active Listening with Teens
  10. Working More Effectively with Caregivers
  11. At-Home Practice – Importance of Homework
  12. Child Traumatic Grief Curriculum Guide
  13. Childhood Traumatic Grief Educational Materials
  14. Take Five – Tips on TF-CBT with Teens
  15. Visual Agenda
  16. ABC Book Insides
  17. Activity Book
  18. Videos for TF-CBT
  19. Books for TF-CBT
  1. Adapting TF-CBT for American Indian and Alaska Native Children
  2. Smartphone Apps for Clinical Use
  3. Art Therapy and TF-CBT
  4. APSAC Task Force on Attachment Therapy
  5. TF-CBT and Ongoing Trauma
  6. Playful TF-CBT
  7. Spirituality and TF-CBT
  8. TF-CBT and Behavior Problems
  9. TF-CBT and Child Experiences
  10. TF-CBT and Complex Trauma
  11. TF-CBT and Co-Occurring Behavior Problems
  12. TF-CBT and Emotion Regulation
  13. TF-CBT and Residential Treatment Settings
  14. TF-CBT and for 3-6 Year Olds
  15. Trauma and Self-Injurious Behaviors
  1. A TF-CBT Workbook for Teens-SPANISH
  2. Your Very Own Grief TF-CBT Workbook – Spanish
  3. What is TF-CBT?
  4. Sexuality Education for Children and Adolescents with Developmental Disabilities
  5. Feelings Faces – Spanish
  6. Positive Parenting Practices
  7. Caregiver Think-Feel-Do
  8. Relaxation Log
  9. Feelings ID Info for Caregivers
  10. Praise Letter
  11. Parenting Essentials
  12. Spanish Language Video Resources