If you’re trying to help a child who’s experienced trauma, it can be hard to know what to do. They may suffer from post-traumatic stress symptoms like nightmares, anxiety, or behavioral issues. It can feel like neither of you has control over their trauma responses. And that can put more stress on your child and your family.
Thankfully, trauma-focused cognitive behavioral therapy, a family-focused type of talk therapy, can help your child heal from their trauma. They get to relearn that the world is a safe place full of trustworthy people—namely you.
TF-CBT may be offered as part of family therapy at rehab. This therapy, along with others, can give you tools, space, and support to work through your child’s healing journey.
What Is Trauma-Focused Cognitive Behavioral Therapy?
Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment for families looking to heal a child’s past trauma.1 It’s a form of CBT designed specifically for children and adolescents, and focuses heavily on caregiver involvement. Treatment takes place over the course of 8-25 sessions, which both you and your child attend.
During individual sessions, your child will work on dealing with negative thoughts, feelings, and behaviors resulting from trauma with healthy coping skills. They’ll also be able to process their trauma in a safe, supportive environment.
Caregivers’ individual sessions are designed to teach positive parenting strategies. You’ll learn how to best support your child when they feel the need to talk.
During joint sessions with your therapist, you’ll work on practicing those skills to strengthen your relationship and encourage more open communication. There is a lot of flexibility in how quickly you move through TF-CBT, so you can work at your pace.
Who Can TF-CBT Help?
Treatment professionals use TF-CBT to help children aged 3-18 overcome trauma symptoms and learn healthy coping strategies. It can also address depression or behavioral issues stemming from childhood trauma. Children don’t need a post-traumatic stress disorder (PTSD) diagnosis to benefit from TF-CBT.
Both the caregiver(s) and child take part in therapy sessions. Abusive or otherwise traumatic caregivers are excluded from participating.2
Is it Effective?
TF-CBT is shown to be effective in improving PTSD symptoms. Components of TF-CBT can also effectively reduce the frequency and intensity of nightmares3 among children who have suffered trauma.
It can also lessen the symptoms of other mental and behavioral issues in children with trauma. In TF-CBT, children gain important emotional regulation strategies.4
Studies also show that TF-CBT can increase caregivers’ ability to parent positively and lessen their emotional distress.1
How Can You Access TF-CBT?
Treatment is done via weekly sessions with a therapist.
Some rehabs cater specifically to young people. If you’re interested in TF-CBT and other trauma-specific therapies, ask potential treatment centers about their clinical staff qualifications and how they involve family in your child’s treatment process.
What to Expect: TF-CBT in 3 Phases
TF-CBT takes place in 3 stages1 to gradually increase exposure to trauma reminders. This way, your child isn’t confronted with their trauma without skills necessary to safely address it.
1. Stabilization:
This phase helps children and caregivers understand trauma in general.
Your therapists will explain to your child what trauma is and how it can show up in their lives after it’s over.
Meanwhile, you’ll learn important safety information. For example, if your child has been sexually assaulted, you’ll learn to communicate with them about appropriate vs. inappropriate touches. Your therapist will also teach you to identify cues that might trigger your child.
Trauma Narration and Processing
In this phase, therapists work with your child to describe their trauma in detail.
Because TF-CBT builds up your child’s resilience in the previous stage, they’ll be better prepared to handle their trauma using healthy coping strategies. This stage helps them reclaim their own experience.
During the session, you’ll hear your child’s trauma narrative read by your therapist. While this can be extremely difficult, your therapist will be there to support you and help you move through feelings that arise.
Integration and Consolidation
During this phase, you’ll begin joint sessions. Your child will share their trauma narrative with you face-to-face. Then, you can ask questions and share feelings. This phase improves the connection and understanding between you and your child.
The Goals of This Therapy
TF-CBT works on 8 key components5 to improve the lives of children and their caregivers:
- education about trauma and positive parenting skills
- techniques for relaxation
- emotional regulation skills
- understanding of the connection between thoughts, feelings, and behaviors
- mastery over past trauma through recounting exercises
- gradual exposure to reminders of trauma
- improved communication and connection between caregivers and child
- personal health and safety skills
Limitations of TF-CBT
TF-CBT has not been studied for effectiveness for children who have intellectual disabilities. Not only are these children more at risk for exposure to trauma,6 they’re also at a higher risk of developing PTSD. It’s an area that needs more research.
If you are the caregiver to a neurodivergent child, read more about how to find neurodiversity-affirming treatment.
Rehab Can Help You Reconnect With Your Child After Trauma
As a caregiver, you want to protect your child from anything bad that could ever happen to them. That’s why it’s so hard to handle when something does.
Trauma-specialized rehabs use treatments like trauma-focused cognitive behavioral therapy to allow both you and your child to make peace with the past and move forward.
Visit our searchable directory of treatment centers offering family therapy to learn more about their programs, facilities, pricing, insurance, and more.
Reviewed by Rajnandini Rathod
- Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused cognitive behavioral therapy for traumatized children and families. Child and Adolescent Psychiatric Clinics of North America, 24(3), 557–570. https://doi.org/10.1016/j.chc.2015.02.005 [↩] [↩] [↩]
- Ramirez de Arellano, M. A., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Huang, L., & Delphin-Rittmon, M. E. (2014). Trauma-focused cognitive behavioral therapy: Assessing the evidence. Psychiatric Services (Washington, D.C.), 65(5), 591–602. https://doi.org/10.1176/appi.ps.201300255 [↩]
- Levrier, K., Marchand, A., Belleville, G., Dominic, B.-P., & Guay, S. (2016). Nightmare frequency, nightmare distress and the efficiency of trauma-focused cognitive behavioral therapy for post-traumatic stress disorder. Archives of Trauma Research, 5(3), e33051. https://doi.org/10.5812/atr.33051 [↩]
- Farnia, V., Naami, A., Zargar, Y., Davoodi, I., Salemi, S., Tatari, F., Kazemi, A., Basanj, B., Jouybari, T. A., & Alikhani, M. (2018). Comparison of trauma-focused cognitive behavioral therapy and theory of mind: Improvement of posttraumatic growth and emotion regulation strategies. Journal of Education and Health Promotion, 7, 58. https://doi.org/10.4103/jehp.jehp_140_17 [↩]
- Trauma-Focused Cognitive Behavioral Therapy: A Primer for Child Welfare Professionals. (n.d.). US Department of Health and Human Services Administration for Children and Families Children’s Bureau. https://www.childwelfare.gov/pubPDFs/trauma.pdf [↩]
- Mevissen, L., Didden, R., Korzilius, H., & de Jongh, A. (2016). Assessing posttraumatic stress disorder in children with mild to borderline intellectual disabilities. European Journal of Psychotraumatology, 7, 10.3402/ejpt.v7.29786.
https://doi.org/10.3402/ejpt.v7.29786 [↩]
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