Trauma-Focused Cognitive Behavioral Therapy

Trauma-Focused Cognitive Behavioral Therapy, developed by Drs. Judith Cohen, Esther Deblinger, and Anthony Mannarino, is an evidence-based treatment for reducing emotional and behavioral symptoms resulting from trauma exposure. The EPISCenter provides technical assistance for Pennsylvania providers of TF-CBT thanks to support from the Pennsylvania Commission on Crime and Delinquency. Please see the official developers' website, https://tfcbt.org, for official information about TF-CBT and the National TF-CBT Therapist Certification Program®.

Program Type and Risk Level:

  • Intervention program for moderate to high risk children who have experienced trauma and their families

Developed by:

  • Judith Cohen, M.D.; Esther Deblinger, Ph.D.; Anthony P. Mannarino, Ph.D.

Website:

Program Information:

  • TF-CBT consists of weekly therapy sessions to treat children with an identified trauma. Ideally, both the child and a caregiver participate in treatment, which is based on cognitive-behavioral and social learning principles. 

Population:

  • Children, ages 3-18, and their non-offending parents or caregivers.
  • Child exhibits significant emotional or behavioral symptoms as the result of an identified trauma

Return on Investment:

Program Overview:

  • TF-CBT occurs over 8 to 25 sessions, depending on the complexity and severity of the case. Treatment is most commonly delivered as outpatient therapy, but can take place in a variety of settings including schools, clients' homes, and residential facilities.
  • Both child and caregiver participate in TF-CBT. During the first two phases the therapist typically meets separately with the child and the caregiver, covering similar skills and content with each. Conjoint sessions (i.e., parent and child together) are held towards the end of treatment.
  • TF-CBT uses cognitive-behavioral and social learning principles. Exposure and habituation to trauma reminders are critical parts of the model and are integrated throughout treatment. 
  • TF-CBT has eight treatment components, which are organized into three phases: (1) Skill-building and Stabilization, (2) Narrative and Processing, (3) Integration/Consolidation. The components can be remembered using the acronym "PRACTICE":
    • P - Psychoeducation + Parenting Skills
    • R - Relaxation Techniques
    • A - Affective Expression and Regulation
    • C - Cognitive coping
    • T - Trauma Narrative and Processing
    • I - In Vivo Exposure
    • C - Conjoint Parent-Child Sessions
    • E - Enhancing Personal Safety and Future Growth

Proven Research Outcomes:

  • Children receiving TF-CBT show decreases in PTSD symptoms, behavior problems (including sexualized behavior), anxiety, and depression. There is also evidence of improved social adjustment and ability to respond effectively to potentially unsafe situations. 
  • Caregivers show improved parenting skills, increased support to the child, and reduced levels of depression and trauma-related distress.
  • Studies show excellent maintenance of treatment gains up to two years after treatment ends. 

Training:

  • TF-CBT training is available to therapists with graduate degrees in a mental health discipline. Training includes a 10-hour web-based training, two days of live training, and a series of 12 consultation calls with a TF-CBT expert. Outcomes measurement using formal pre- and post-treatment assessment tools is a required part of the training process. 
  • Licensed therapists can become TF-CBT certified by completing the training and passing a knowledge-based test. 
  • Detailed information about training and certification requirements can be found at www.tfcbt.org

Want to learn more about TFCBT?