Ratings were based on predefined benchmarks that considered the number and quality of the studies. If you’re not sure whether TF-CBT can help a child or teen in your care, it’s best to speak with a medical or mental health professional. Depending on the complexity of the case, treatment with TF-CBT usually involves 8–20 sessions. This article cbt interventions for substance abuse discusses TF-CBT, including who it can help and whether it can help adults. Children living with their parents, in foster care, kinship care, group homes, or residential programs may all be helped by TF-CBT. A significant difference between the two is that, unlike regular CBT, trauma-focused CBT focuses specifically on the impacts of trauma.

Treatment Sessions

• The only exception was one study that included multiple design flaws but that provided new information on treatment of very young children, a population rarely included in this research (35).
• The reviews examined the status of evidence for similar and overlapping bodies of research, including TF-CBT with maltreated children only (20); TF-CBT for traumas that are not related to abuse, maltreatment, or family violence (19); and all cognitive-behaviorally oriented interventions applied to traumatized children (10,12,18,35).
• In a review published in 2008, Silverman and colleagues (12) compared various psychosocial treatments for children exposed to trauma and included seven studies evaluating cognitive-behavioral therapies, including TF-CBT.
• A 2018 review looked at clinical trials to explore the benefit of TB-CBT and two other psychotherapies for treating adults with PTSD.

TF-CBT may still be helpful when treating children who are thus affected, but often the pace or order of interventions must first be modified. Dialectical behavior therapy or another stabilizing therapy approach is often used before TF-CBT is attempted with adolescents who have a history of running away and/or severe self-harm and other parasuicidal behaviors. TF-CBT may still be of benefit and is not necessarily contraindicated in these cases. Childhood traumas such as abuse, domestic violence or neglect can often lead to symptoms of PTSD, depression, and anxiety.

Major treatment phases and components

All of these studies have documented that TF-CBT was superior for improving children’s trauma symptoms and responses. TF-CBT is a structured, short-term treatment model that effectively improves a range of trauma-related outcomes in 8-25 sessions with the child/adolescent and caregiver. Although TF-CBT is highly effective at improving youth posttraumatic stress disorder (PTSD) symptoms and diagnosis, a PTSD diagnosis is not required in order to receive this treatment.

Evaluation of effectiveness

• The non-offending parent or caregiver will typically also participate in the therapy.
• Experienced therapists with knowledge and training in child development, who can assess and treat a wide range of child mental health conditions, are typically the recommended providers of TF-CBT.
• The remaining four studies reviewed by Cary and McMillen focused on interventions for children and adolescents that were similar to TF-CBT (for example, Cognitive Behavioral Intervention for Trauma in Schools) but did not meet the criteria of all five key components for inclusion in our review.

Learning to challenge invasive thoughts of guilt and fear can help a patient to reorganize their thinking in a healthier and happier way. TF-CBT can be delivered by counselors, social workers, psychologists, or psychiatrists. To be considered a TF-CBT therapist, mental health providers have to receive specialized training and supervision and obtain TF-CBT certification. TF-CBT has strong evidence supporting its effectiveness, but it may not be right for everyone.

Three studies found significantly greater symptom reduction for groups receiving TF-CBT than for comparison groups; comparison of TF-CBT with an active treatment group yielded medium effect sizes (25,26), whereas comparison with a wait-list control group yielded large effect sizes (11). Regarding sexual behavior problems, the two studies that included this measure found significant decreases in sexual behavior problems in the TF-CBT group over time (24,33). However, when the TF-CBT group was compared with an active control group, no significant difference between the conditions was found, although a medium effect emerged 12 months after treatment in one study (24). There is no official accreditation for trauma-focused cognitive behavioral therapy, though supplemental trainings and courses exist. It’s most important to look for someone with experience in the practice and someone with whom you feel comfortable discussing personal problems. Cognitive behavioral therapy (CBT) treats several mental health conditions, such as depression and anxiety.

Find a Therapist

In that manual, TF-CBT treatment components were summarized by using the acronym PRACTICE (1), and this summary forms the basis of our definition for TF-CBT as it appears in the research literature. TF-CBT is a viable treatment for reducing trauma-related symptoms among some children who have experienced trauma and their nonoffending caregivers. Based on this evidence, TF-CBT should be available as a covered service in health plans. Ongoing research is needed to further identify best practices for TF-CBT in various settings and with individuals from various racial and ethnic backgrounds and with varied trauma histories, symptoms, and stages of intellectual, social, and emotional development. If a child or adolescent also exhibits serious behavioral, substance abuse, or suicidal ideation, other forms of treatment, such as dialectical behavior therapy, may be more appropriate as an initial intervention and can be followed up with a trauma-sensitive approach. This evidence-based method has been proven effective for treatment after multiple traumas or a single traumatic event, and therapists trained in TF-CBT are frequently able to help children experiencing the emotional effects of trauma address and resolve these effects.

• The short-term intervention was developed to help children and adolescents who have experienced a traumatic event.
• These are psychoeducation; coping strategies, such as relaxation, identification of feelings, and cognitive coping; gradual exposure, for example, through imagining or in-vivo exposure; cognitive processing; and caregiver participation, such as parent training and conjoint sessions.
• This evidence-based method has been proven effective for treatment after multiple traumas or a single traumatic event, and therapists trained in TF-CBT are frequently able to help children experiencing the emotional effects of trauma address and resolve these effects.
• Although exclusion criteria varied across studies, the criteria used indicate that the findings are limited in their ability to be generalized to children with intellectual or developmental disabilities or children and families affected by more serious forms of mental illness.
• The TF-CBT Therapist Certification Program is also designed to assist in responding to the increasing demand for TF-CBT certified therapists across the nation and the world.

Previous research has found that it is more effective than no treatment, supportive therapy, and relaxation techniques. While psychologists initially developed TF-CBT for children, it also benefits adults with post-traumatic stress disorder (PTSD). Based on our experience and similar experiences from others who have developed empirically-supported treatments, we have learned that completing an online web-based course or attending a live training is not adequate for sustained implementation of a treatment approach.

• One of the AHRQ reviews provided a thorough comparative effectiveness study of cognitive-behavioral interventions for children and adolescents that address trauma other than maltreatment or family violence, but it did not cover the specific TF-CBT model defined here (19).
• Overall, the RCTs in our review included strong fidelity procedures coupled with very similar definitions of the service.
• The clinical work and research of Judith Cohen, Anthony Mannarino, and Esther Deblinger led to the development of TF-CBT.
• Regular CBT isn’t only for people who have experienced trauma — it can also address anxiety, mood disorders, eating disorders, schizophrenia, and more.