Introduction

The Basics

What is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)?

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a psychotherapy approach specifically designed to help children, adolescents, and their families recover from the effects of traumatic experiences. It combines cognitive-behavioral techniques with trauma-sensitive interventions and family therapy components to address the complex psychological and emotional impacts of trauma.

Goal

What is the goal of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)?

The primary goals of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) include helping clients:

• Process traumatic memories in a safe environment,
• Reduce trauma-related symptoms (such as PTSD, depression, and anxiety)
• Develop healthy coping skills
• Correct trauma-related cognitive distortions
• Restore normal developmental trajectory.

For families, goals include improving parent-child relationships, enhancing family communication, and building family resilience.

Uses

Who could benefit from Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)?

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is primarily designed for children and adolescents (ages 3–18) who have experienced trauma.

Common symptoms it addresses:

• PTSD symptoms
• Depression
• Anxiety
• Behavioral problems
• Attachment difficulties

Types of trauma treated:

• Physical abuse
• Sexual abuse
• Domestic violence
• Community violence
• Natural disasters
• Accidents
• Other traumatic events

The therapy also benefits caregivers who may be coping with their own trauma-related symptoms or parenting challenges.

Subtypes

Are there any subtypes of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)?

While Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has one core model, it has been adapted for different populations and settings. Adaptations include:

• Culturally responsive versions for specific ethnic and cultural groups
• Adaptations for different age groups (preschool vs. adolescent)
• Modifications for specific trauma types (such as childhood traumatic grief for children who have lost loved ones)

There are also adaptations for group settings, intensive formats, and telehealth delivery.

Effectiveness

Origins

Who developed Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and when?

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) was developed by Judith Cohen, Anthony Mannarino, and Esther Deblinger in the 1990s. These researchers and clinicians created the model based on extensive research into childhood trauma and effective treatment approaches.

The model has been continuously refined and updated based on ongoing research and clinical experience over the past three decades.

Evidence Base

Is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) evidence-based?

Yes, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is considered a gold-standard, evidence-based treatment. It has been extensively researched through numerous randomized controlled trials and has consistently shown effectiveness in treating trauma-related symptoms in children and adolescents.

To date, about 25 randomized controlled trials across the U.S., Europe, and Africa support TF-CBT’s effectiveness. Major guidelines also recommend trauma-focused CBT for children and young people with PTSD.

How It Works

Techniques Used

How does Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) work?

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) uses the “PRACTICE” model, which stands for:

• Psychoeducation and Parenting skills
• Relaxation techniques
• Affective expression and regulation
• Cognitive processing
• Trauma narrative development
• In vivo exposure (when appropriate)
• Conjoint parent-child sessions
• Enhancing future safety and development

The therapy integrates:

• Individual sessions with the child
• Individual sessions with caregivers
• Joint family sessions to address trauma from multiple angles.

Just like untangling a ball of yarn, this process requires patience, the right tools, and a steady hand. But gradually, what once seemed like an impossible knot becomes smooth, manageable threads that you can weave into something beautiful and strong.

What to Expect in a Session

What can I expect from a Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) session?

Early Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) sessions focus on psychoeducation about trauma and its effects, teaching coping skills such as:

• Relaxation techniques
• Emotional regulation strategies

Middle sessions involve creating a trauma narrative where the child processes their traumatic experience through:

• Storytelling
• Art
• Play (depending on their age and preferences)

Throughout treatment, caregivers participate in parallel sessions learning supportive parenting techniques.

Joint sessions help improve family communication and allow the child to share their trauma narrative with their caregiver in a supported environment.

Treatment Length & Structure

How long does Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) take?

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) typically lasts 12–20 sessions, though this can vary based on individual needs and trauma complexity.

The treatment follows a structured, phased approach that moves from:

• Stabilization and skill-building in early sessions
• Trauma processing in middle sessions
• Consolidation and relapse prevention in later sessions

Sessions are usually held weekly and last 45–90 minutes, depending on whether they're individual or family sessions.

Getting Care

Finding a Therapist

How do I find a therapist trained in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)?

Alma’s directory has many therapists who are trained in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), including: