Summary: <p>Trauma Focused CBT<br> Part 2<br> Treating Trauma and Traumatic Grief in Children & Adolescents<br> Objectives<br> ~ Continue learning about TF-CBT<br> ~ Explore<br> ~ Cognitive Triangle<br> ~ Creating the Trauma Narrative<br> ~ Cognitive Processing<br> ~ Behavior Management<br> ~ Parent-Child Sessions<br> ~ Explore ways to use TF-CBT with adult clients<br> Cognitive Coping<br> ~ Recognize and understand the difference between<br> ~ accurate and inaccurate cognitions<br> ~ helpful and unhelpful cognitions<br> ~ Recognize the distinction and relation among feelings, thoughts, and behavior<br> ~ Generate alternative thoughts that are more accurate or more helpful<br> ~ Attempt to change their feelings and behavior by thinking differently<br> Cognitive Triangle<br> Cognitive Triangle<br> ~ Application<br> ~ Differentiate between thoughts, feelings and behaviors<br> ~ Generate scenarios to illustrate how thoughts impact feelings and behaviors<br> ~ Explore how changing a thought impacts the feelings and behaviors<br> ~ Apply the skill to real life<br> ~ Not everyone will be able to differentiate between thoughts and feelings<br> ~ Children under 8 will likely struggle identifying their personal thoughts. Ask what someone else might think</p> <p>Parent Sessions During Cognitive Triangle<br> Common Thoughts<br> ~ I can only be happy if my child is happy.<br> ~ I can't trust anyone anymore.<br> ~ Being strong for my child means I should never feel upset.<br> ~ Good parents always know the right thing to say to their children<br> Alternate Thoughts<br> ~ I can find things to be happy about, to show my child that happiness is possible<br> ~ Most people are good at heart and many are trustworthy.<br> ~ Being strong means doing what you have to do, and I am doing that.<br> ~ Although we try our best, even the best parents sometimes don’t know the best thing to say.</p> <p>Creating the Trauma Narrative<br> ~ Purpose<br> ~ Helping to control intrusive and upsetting trauma-related imagery<br> ~ Helping to reduce avoidance of cues, situations, and feelings associated with trauma exposure<br> ~ Identifying unhelpful cognitions about traumatic events<br> ~ Helping the child recognize, anticipate, and prepare for reminders of the trauma.<br> ~ Break apart thoughts, reminders, or discussions of the trauma from overwhelming negative emotions</p> <p>Creating the Trauma Narrative<br> ~ Legal issues<br> ~ Encouraging discussion of the trauma may be perceived as “coaching,” “implanting memories,” or “tampering with testimony”<br> ~ In TF-CBT, the therapist does not lead children by suggesting details or asking leading questions<br> Creating the Trauma Narrative<br> ~ Decide on the best format (poem, book, pictures)<br> ~ Start with a general introduction of the child/person<br> ~ Next (3 Approaches)<br> ~ start with what happened before the day of the trauma and work forward<br> ~ start with the day of the trauma<br> ~ start from the present and work backwards.<br> ~ Encourage sharing of thoughts and feelings during the event<br> ~ If feelings are overwhelming, start with thoughts and add emotions later<br> ~ Present/read the narrative<br> ~ Add the worst part of the traumatic event<br> Creating the Trauma Narrative<br> ~ Reading through the trauma narrative several times<br> ~ Identifying thoughts and feelings<br> ~ Correcting cognitive distortions and errors<br> ~ After several “exposures” the child will typically experience progressively less extreme emotional reactions and physiological reactivity.<br> ~ It is important to help the child<br> ~ Create a positive and optimistic ending to the narrative<br> ~ Realize th</p>
