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Trauma-focused cognitive behavioral therapy TC-CBT

Updated: Mar 9

What is TC-CBT and how is it applied in therapy?

Trauma-focused cognitive behavioral therapy TC-CBT

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment model designed to aid children, adolescents, and their families in overcoming the negative effects of a traumatic experience.

This evidence-based method has been proven effective for treatment after multiple traumas or a single traumatic event, and therapists trained in TF-CBT are frequently able to help children experiencing the emotional effects of trauma address and resolve these effects. 


The clinical work and research of Judith Cohen, Anthony Mannarino, and Esther Deblinger led to the development of TF-CBT. Out of a desire to better understand the difficulties faced by traumatized children and adolescents, they expanded traditional cognitive behavioral methods, extending their reach by incorporating family therapy and using a trauma-sensitive approach in the therapy’s application to children and youth. 

Preliminary research on this treatment model was followed by five randomized controlled trials, which demonstrated the effectiveness of the TF-CBT model on the target population. Many other researchers have gone on to replicate these results, proving the efficacy of this model in treating children and adolescents who have experienced traumatic stress. 


In TF-CBT, interventions specifically tailored to meet the needs of children and adolescents experiencing emotional and psychological difficulties as a result of a trauma are integrated with humanistic, cognitive behavioral, and familial strategies. This treatment is short-term and generally lasts no more than 16 sessions, as more than 80% of traumatized children see improvement in this time.

Both parents and children may become able to better process emotions and thoughts relating to a traumatic experience through TF-CBT, which can provide those in therapy with the necessary tools to alleviate the overwhelming thoughts causing stress, anxiety, and depression. TF-CBT can help people who have experienced trauma learn how to manage difficult emotions in a healthier way.  A secure and stable environment is provided in order to enable children to disclose details of trauma. It is at this time the cognitive and learning theories of treatment are applied. Children are shown how perceptions may be distorted and are given the tools to redesign those perceptions.

TF-CBT is a skills-based model, and it requires the child and parent to practice its components in order to be optimally effective. Parents and children are commonly asked to practice skills at home. The goal of TF-CBT is to allow both child and parent to continue to develop their skills and communication techniques in a healthy manner. 

Core components of TF-CBT include:

Psycho-education and parenting skills/ Relaxation/ Affective regulation/ Cognitive processing of the trauma/ Trauma narrative/ In vivo mastery of trauma reminders/ Conjoint child-parent sessions/ Enhancing future safety and development.

Practitioners of TF-CBT strive to give parents the resources and skills necessary to help their children cope with the psychological ramifications of the abuse or other trauma. 

The success of TF-CBT relies heavily on a trusting, genuine therapeutic relationship between therapist, child, and parent. The therapist incorporates individual child and parent sessions as well as joint sessions using family therapy principles. Including the non-offending parent in therapy can help the parent cope, and this also allows the parent to support the child in this treatment framework. Practitioners of TF-CBT strive to give parents the resources and skills necessary to help their children cope with the psychological ramifications of the abuse or other trauma. 


TF-CBT’s main application is the treatment of post-traumatic stress. The goal of this therapy is to help survivors of trauma, whether the trauma was a single occurrence or multiple events, address and resolve the distress resulting from these events and ultimately decrease the negative behavior patterns and emotional responses often developing as a result of sexual abuse, physical abuse, or other trauma. Children and adolescents who have experienced these traumas may find TF-CBT an effective method in the process of returning to a healthy state of functioning. 

Childhood traumas such as abuse, domestic violence or neglect can often lead to symptoms of PTSD, depression, and anxiety. Children or young people between the ages of 3 and 18 who have been sexually or physically abused or exposed to domestic violence may obtain benefit from TF-CBT, whether they have experienced repeated episodes of trauma or a single occurrence of trauma. The non-offending parent or caregiver will typically also participate in the therapy. Children who are learning to cope with the death of a loved one have also been shown to obtain great benefit from TF-CBT.

Children living with their parents, in foster care, kinship care, group homes, or residential programs may all be helped by TF-CBT. Good Therapy (2018)

For more such guidance, you can book counseling sessions online, at Lighthouse Mental Health Counseling. It extends a lifeline to those facing anxiety, depression, trauma, and other mental health challenges. With the help of Counseling and therapy, individuals learn to differentiate their own needs and desires by strengthening their sense of self-worth.

How TF-CBT sessions progress

Sessions are structured by the therapist to introduce interventions that are relevant to the particular stage of treatment. For example, during the Stabilization Phase of therapy, a child session may begin with a review of coping skills that the child was encouraged to practice between sessions; continue with a new skill component; then provide role play and practice of that skill; ending with a discussion with child and parent about what the child is encouraged to practice during the coming week. This is a planned progression towards the next stage of therapy.


Since TF-CBT is a skills and strengths-based model, its components typically need to be practiced by the child and parent in order to be effective. We use the acronym PRACTICE to remind the child and family of the core TF-CBT components and the value of practicing them for the duration of treatment and beyond. A good deal of the therapy work associated with TF-CBT will occur between sessions, when parents and children are asked to practice certain skills at home. In the following list, the components of PRACTICE are arranged in relation to the phase of treatment.


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