What is the recommended caseload for a Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) clinician?

Therapist caseload will vary, depending upon the needs of the agency and community. It is important that programs find a balance regarding the number of therapists trained and actual demand for services.

Therapists only need to complete three cases for initial certification, but due to client attrition they will likely need several cases in order to meet this benchmark. In addition, having a larger number of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) cases provides greater opportunity for experience delivering the model. We encourage organizations to aim for at least 10 TF-CBT cases per year for each therapist.

It is also imperative to keep in mind that working with traumatized children and families can be emotionally taxing for therapists. Studies show that the risk of secondary traumatic stress (STS), which can compromise client care, “is higher for professionals who carry a heavy caseload of traumatized children; are socially or organizationally isolated; or feel professionally compromised due to inadequate training.” (NCTSN) For this reason, many therapists benefit from having a varied caseload, rather than treating only trauma clients. More information about minimizing STS, burnout, and compassion fatigue, as well as an Organizational Readiness Guide, can be found on the websites of the National Children’s Traumatic Stress Network and the federal Office for Victims of Crime.