The model originally was designed to address PTSD symptoms associated with sexual abuse: depressive symptoms, behavior problems (including aggression and inappropriate sexual behaviors), and unhelpful thoughts and feelings regarding the abuse, such as cognitive distortions, guilt, and shame. ![]() TF-CBT provides structure for the use of cognitive-behavioral principles in the context of two paramount developmental considerations: the role of the caregiver and the developing nature of a child’s emotion regulation and coping capabilities. The primary goal of TF-CBT is to reduce PTSD symptoms among children and adolescents. TF-CBT is defined in the 2006 treatment manual Treating Trauma and Traumatic Grief in Children and Adolescents ( 1), although descriptions of the key cognitive-behavioral components developed by Deblinger, Cohen, and Mannarino were described in earlier literature ( 9). The provider, with the patient, has some latitude in selecting which elements of cognitive behavioral therapy are likely to be most effective with any particular individual.Description of Trauma-Focused Cognitive-Behavioral Therapy ![]() Managing stress and planning for potential crises can also be important components of CBT treatment. The goal is to return a sense of control, self-confidence, and predictability to the patient, and reduce escape and avoidance behaviors.Įducation about how trauma can affect the person is quite common as is instruction in various methods to facilitate relaxation. ![]() Note, this exposure is done in a controlled way, and planned collaboratively by the provider and patient so the patient chooses what they do. These are intended to help the person reconceptualize their understanding of traumatic experiences, as well as their understanding of themselves and their ability to cope.Įxposure to the trauma narrative, as well as reminders of the trauma or emotions associated with the trauma, are often used to help the patient reduce avoidance and maladaptive associations with the trauma. Therapists employing CBT may encourage patients to re-evaluate their thinking patterns and assumptions in order to identify unhelpful patterns (often termed “distortions”) in thoughts, such as overgeneralizing bad outcomes, negative thinking that diminishes positive thinking, and always expecting catastrophic outcomes, to more balanced and effective thinking patterns. Therapists use a variety of techniques to aid patients in reducing symptoms and improving functioning. Understanding these theories helps the therapist more effectively use cognitive behavioral treatment strategies. For instance, if someone believes that bad things happen to bad people, being raped confirms that one is bad, not that one was unjustly violated. Social cognitive theory (Benight & Bandura, 2004) suggests that those who try to incorporate the experience of trauma into existing beliefs about oneself, others, and the world often wind up with unhelpful understandings of their experience and perceptions of control of self or the environment (i.e., coping self-efficacy). Changing these associations that lead to unhealthy functioning is the core of emotional processing. Several theories specific to trauma explain how CBT can be helpful in reducing the symptoms of PTSD.įor example, emotional processing theory (Rauch & Foa, 2006) suggests that those who have experienced a traumatic event can develop associations among objectively safe reminders of the event (e.g., news stories, situations, people), meaning (e.g., the world is dangerous) and responses (e.g., fear, numbing of feelings).
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