Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a treatment intervention designed to help 3- to 18-year-olds and their parents overcome the negative effects of traumatic life events such as child sexual or physical abuse. TF-CBT was created for young people who have developed significant emotional or behavioral difficulties following exposure to a traumatic event (e.g., loss of a loved one, physical abuse, domestic or community violence, motor vehicle accidents, fires, tornadoes, hurricanes, industrial accidents, terrorist attacks). The program targets boys and girls from all socioeconomic backgrounds, in a variety of settings, and from diverse ethnic groups. It has been adapted for Hispanic/Latino children.
TF-CBT was developed by integrating cognitive and behavioral interventions with traditional child abuse therapies to help children talk directly about their traumatic experiences in a supportive environment. The program operates through the use of a parental treatment component and several child-parent sessions. The parent component teaches parents effective parenting skills to provide optimal support for their children. The parent-child session encourages children to discuss the traumatic events directly with the parent, and both parent and child learn to communicate questions, concerns, and feelings more openly.
In one study, children in the treatment group showed significantly more improvement in their Post-Traumatic Stress Disorder (PTSD) symptoms (reexperiencing, avoidance, and hyper-arousal) than their counterparts in the control group. Their parents also showed greater improvement (than the control parents) in their own self-reported levels of depression, abuse-specific distress, support of the children, and effective parenting practice.
These findings confirm the results of numerous earlier (and smaller) studies, which have repeatedly demonstrated TF-CBT’s efficacy in reducing multiple PTSD symptoms in abused children and their parents. In general, randomized controlled trials have found that, compared with children who received supportive therapy, children who received TF-CBT:
In recent studies, TF-CBT has been evaluated for children experiencing PTSD symptoms related to traumatic grief and terrorism. TF-CBT showed promising effectiveness in reducing PTSD symptoms for these children as well.
Substance Abuse and Mental Health Services Administration, National Registry of Effective Programs and Practices: Model programs
Judith A. Cohen, M.D.
Center for Traumatic Stress in Children and Adolescents
Allegheny General Hospital
4 Allegheny Center, Eighth Floor
Pittsburgh, PA 15212
Phone: (412) 330-4321
Fax: (412) 330-4377
Web site: http://www.pittsburghchildtrauma.com
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———. (1997). “A Treatment Study for Sexually Abused Preschool Children: Outcome During a One-Year Follow-Up.” Journal of the American Academy of Child and Adolescent Psychiatry, 36(9):1228–36.
———. (1998). “Interventions for Sexually Abused Children: Initial Treatment Outcome Findings.” Child Maltreatment, 3(1):17–27.
Cohen, J. A.; Mannarino, A. P.; Berliner, L.; and Deblinger, E. (2000). “Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: An Empirical Update.” Journal of Interpersonal Violence, 15(11):1202–24.
Cohen, J. A.; Deblinger, E.; Mannarino, A. P.; and Steer, R. A. (2004). “A Multisite Randomized Trial for Children With Sexual Abuse-Related PTSD Symptoms.” Journal of the American Academy of Child and Adolescent Psychiatry 43:393–402.
Cohen, J. A.; Mannarino, A. P.; and Deblinger, E. (2006). Treating Trauma and Traumatic Grief in Children and Adolescents. Treatment Manual. New York: Guilford Press.
Cohen, J. A.; Mannarino, A. P.; and Knudsen, K. (2004). “Treating Childhood Traumatic Grief: A Pilot Study.” Journal of the American Academy of Child and Adolescent Psychiatry, 43:1225–33.
Cohen, J. A.; Mannarino, A. P.; and Staron, V. R. (2006). “A Pilot Study of Modified Cognitive Behavioral Therapy for Childhood Traumatic Grief (CBT-CTG).” Journal of the American Academy of Child and Adolescent Psychiatry, 43:1465–73.