Trauma-Focused CBT: Techniques & Interventions

Instructor: Gaines Arnold

Gaines has a Master of Science in Education with a focus in counseling.

How can a parent or caregiver support a child who has experienced a trauma? This lesson discusses how trauma in children and teens can be effectively dealt with using the technique of trauma-focused cognitive behavioral therapy.

The Victim/Patient

Danny was a well-adjusted, bright child of seven when he was confronted with an event that changed his young life. A neighbor, who was trusted to watch him for a couple of hours after school, used that opportunity to molest Danny over a period of six months. Danny's parents began to notice something was wrong when he began to throw tantrums at bath time and refused to let his parents stay in the room with him while he bathed. Danny's mother got home from work early one day and found the neighbor and Danny in his bedroom. She quickly called the police.

Unfortunately, when a trauma such as the one Danny experienced happens it is only the beginning. Danny began to experience night terrors, waking up screaming in the middle of the night. He was uncharacteristically quiet and he had no interest in playing video games with his dad (something that used to be one of his favorite activities). He now spends more time in his room alone and he appears terrified when his parents have to leave him even for a little while with a relative.

He is experiencing symptoms of post-traumatic stress disorder (PTSD), extreme anxiety which develops after a traumatic event, and his parents are unsure how they can help him. A friend mentions that maybe therapy would help him. Danny's parents take him to a children's therapist who specializes in trauma-focused cognitive behavioral therapy or TF-CBT.

What is TF-CBT?

Before the development of TF-CBT in the United States in 1997, therapists often advised parents to make sure that their child remained in a safe and comfortable environment. This meant that the parent or caregiver tried to remove any evidence of the trauma and respond with loving attention any time symptoms occurred. The problem with this approach is that it does not teach the child to cope with the trauma that he or she has faced.

Of course, Danny, and every child, should be in a safe and loving environment, but they also need to learn to cope with the events of the trauma. Cognitive behavioral therapy is a type of talk therapy that helps the victim of trauma to work through the events experienced. The cognitive aspect comes in the form of being able to identify negative thoughts (Danny may think that his environment is unsafe or that his parents may abandon him again) and reframing them into positive messages (I am safe; the bad person is in jail; my parents love me and they are just going to work). Besides working with the child, the therapist also works with the parents or caregiver to teach them how to cope with their child's new reality.

What Happens in Therapy?

During a session with Danny (this therapy is for those who have experienced trauma and are between three and 18 years of age), the therapist will use different techniques to reduce the negative symptoms associated with the molestation. After the trauma, it was difficult for Danny to relax so the therapist will teach him relaxation techniques. The counselor also discusses what happened during the trauma and how Danny feels about the event. Emotions are identified and compared to the reality of the emotions experienced without the trauma present. Danny is then taught coping mechanisms and how to reframe the negative thoughts that occur when he thinks about what happened.

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