Summary: <p>Trauma Focused CBT Part 1 Treating Trauma and Traumatic Grief in Children & Adolescents<br> Objectives<br> ~ Define Trauma Focused CBT<br> ~ Explore the components of Trauma Focused CBT and their intended functions<br> ~ Explore ways to use TF-CBT with adult clients<br> Facts about TF-CBT<br> ~ Works for children who have experienced any trauma, including multiple traumas.<br> ~ Is effective with children from diverse backgrounds.<br> ~ Works in as few as 12 treatment sessions.<br> ~ Has been used successfully in clinics, schools, homes, foster care, residential treatment facilities, and inpatient settings.<br> ~ Works even if there is no parent or caregiver to participate in treatment.<br> Facts About Trauma<br> ~ TF-CBT is intended for children with a trauma history whose primary symptoms or behavioral reactions are related to the trauma.<br> ~ Traumatic stress reactions can be more than simply symptoms of PTSD and often present as difficulties with<br> ~ Affect regulation<br> ~ Relationships<br> ~ Attention and consciousness<br> ~ Somatization<br> ~ Self-perception<br> ~ Systems of meaning.<br> ~ These effects can also interfere with adaptive functioning<br> Components of TF-CBT<br> ~ Psychoeducation<br> ~ Parenting skills<br> ~ Relaxation and stress management skills<br> ~ Affect expression and modulation<br> ~ Cognitive coping and processing are enhanced by illustrating the relationships among thoughts, feelings and behaviors.<br> ~ Trauma narration<br> ~ In-vivo mastery of trauma reminders<br> ~ Conjoint parent-child sessions<br> Effects of TF-CBT<br> ~ Reduction in:<br> ~ Intrusive and upsetting memories<br> ~ Avoidance<br> ~ Emotional numbing<br> ~ Hyperarousal<br> ~ Depression<br> ~ Anxiety<br> ~ Behavior problems<br> ~ Sexualized behaviors<br> ~ Trauma-related shame<br> ~ Interpersonal distrust<br> ~ Social skills deficits<br> Inappropriate Populations<br> ~ Primary issue is defiant or conduct disordered<br> ~ Child is suicidal or homicidal<br> ~ Child is severely depressed<br> ~ Child is actively abusing substances</p> <p>~ When children remain in high-risk situations with a continuing possibility of harm, such as many cases of physical abuse or exposure to domestic violence, some aspects of TF-CBT may not be appropriate. For example, attempting to desensitize children to trauma memories is contraindicated when real danger is present.</p> <p>Challenges<br> ~ Potential barriers and obstacles may include the following: The parent caregiver…<br> ~ Does not agree that the trauma occurred<br> ~ Agrees that the trauma occurred but believes that it has not affected the child significantly or that addressing it directly will make matters worse.<br> ~ Is overwhelmed or highly distressed by his or her own emotional reactions and is not available or able to attend to the child’s experience.<br> ~ Is suspicious, distrustful, or does not believe in the value of therapy.<br> ~ Is facing many concrete problems such as housing, that consume a great deal of energy.<br> ~ Is not willing or prepared to change parenting practices even though this may be important for treatment to succeed.<br> Interventions to Strengthen Parental Alliance<br> ~ Specific strategies that can be undertaken include:<br> ~ Perseverance in establishing a therapeutic alliance<br> ~ Exploring past negative interactions with social service agencies or therapy<br> ~ Exploring the parent/caretaker’s potential concerns that may make them feel as if they are not being understood, accepted, believed, listened to, or respected<br> ~ Exploring/helping to overcome barriers to participating in treatment<br> ~ Emphasizing the centrality of the caregiver’s role in the child’s recovery</p>
