Benefits of TF-CBT

Does TF-CBT work?

  • Trauma-Focused Cognitive-Behavioral therapy is the most well-supported and effective treatment for children who have been abused and traumatized. Multiple clinical research studies consistently have found it to help children with PTSD and other trauma-related problems, and it has been rated a Model Program and Best Practice for use with abused and traumatized children. TF-CBT currently is being used successfully in community service agencies across the country.
  • TF-CBT has proven to be effective in addressing posttraumatic stress disorder, depression, anxiety, externalizing behaviors, sexualized behaviors, feelings of shame, and mistrust.  The parental component increases the positive effects for children by reducing parents’ own levels of depression and emotional distress about their children’s abuse and improving parenting practices and support of their child.
  • TF-CBT was rated a “1-Well-supported, efficacious treatment”, the highest level of empirical support in the U.S. Department of Justice sponsored report Child Physical and Sexual Abuse: Guidelines for Treatment.  Similarly,
  • The California Evidence-Based Clearinghouse for Child Welfare rated TF-CBT a “1-Well-supported, effective practice” its highest score for Scientific Rating and its highest score for Relevance to Child Welfare Rating.
  • TF-CBT was selected as a “Best Practice” for cases of child abuse in the Kaufman Best Practices Task Force Final Report sponsored by the National Child Traumatic Stress Network.


Essential Components

Gradual exposure is included in all components to help children gain mastery in how to use skills when trauma reminders or cues occur. The components are:

  • P – Psycho-education and parenting skills
  • R – Relaxation techniques: Focused breathing, progressive muscle relaxation, and teaching the child to control their thoughts (thought stopping).
  • A – Affective expression and regulation: To help the child and parent learn to control their emotional reaction to reminders by expanding their emotional vocabulary, enhancing their skills in identification and expression of emotions, and encouraging self-soothing activities
  • C – Cognitive coping: Through this component, the child learns to understand the relationships between thoughts, feelings and behaviors and think in new and healthier ways.
  • T – Trauma narrative and processing: Gradual exposure exercises including verbal, written and/or symbolic recounting (i.e., utilizing dolls, art, puppets, etc.) of traumatic event(s) so the child learns to be able to discuss the events when they choose in ways that do not produce overwhelming emotions. Following the completion of the narrative, clients are supported in identifying, challenging and correcting cognitive distortions and dysfunctional beliefs.
  • I – In vivo exposure: Encourage the gradual exposure to innocuous (harmless) trauma reminders in child’s environment (e.g., basement, darkness, school, etc.) so the child learns they can control their emotional reactions to things that remind them of the trauma, starting with non-threatening examples of reminders.
  • C – Conjoint parent/child sessions: Held typically toward the end of the treatment, but maybe initiated earlier when children have significant behavior problems so parents can be coached in the use of behavior management skills. Sessions generally deal with psycho-education, sharing the trauma narrative, anxiety management, and correction of cognitive distortions. The family works to enhance communication and create opportunities for therapeutic discussion regarding the trauma.
  • E – Enhancing personal safety and future growth: Provide training and education with respect to personal safety skills and healthy sexuality/ interpersonal relationships; encourage the utilization of skills learned in managing future stressors and/or trauma reminders.