Modalities / Cognitive-Behavioral

TF-CBT

Cohen / Mannarino / Deblinger · 2006
Key text: Treating Trauma and Traumatic Grief (2006)
Cognitive-Behavioral Focus: Skill + Processing Short (12-25) Individual + Parent

Core Mechanism

Gradual exposure through trauma narrative + cognitive processing + parent involvement reduces avoidance and corrects distorted attributions

Ontology

Child trauma creates avoidance, maladaptive cognitions (self-blame), and dysregulated affect maintained by avoidance cycle

Therapeutic Voice

"You did nothing wrong. Let's practice saying that. What does it feel like to hear those words?"

View of the Person

A developing child whose trauma-related cognitions, affect, and behavior respond to structured exposure with parental support


Evidence

NICE: recommended for child PTSD. APA: recommended. SAMHSA: listed

20+ RCTs

Multiple meta-analyses

Very strong evidence. Gold standard for child/adolescent trauma.

PTSD & Acute Trauma
Effect: d = 0.83
~60-70% remission
Mavranezouli et al., 2020 (2020)

Conditions

Epistemology

Empiricist

Blind Spots

Requires parental/caregiver involvement — inaccessible when caregivers are the source of trauma or unavailable

Contraindications

Active psychosis in the child, ongoing abuse in the home without safety planning, caregiver who is the perpetrator and has not engaged in accountability, severe dissociation in the child


Training

TF-CBT Web (free, 10 hrs) + live consultation. For children/adolescents

TF-CBT certification through MUSC

Web: 10 hrs; certification: web + 2-day live + consultation + cases

Free-$2K

Equity & Cultural Adaptations

Cross-cultural adaptationsYouth-adaptedRefugee/displacement populations

Philosophical Roots

Beck (cognitive model); Bandura (social learning); Bowlby (attachment); developmental psychopathology tradition

Related Modalities


Clinical Vignettes

See how TF-CBT formulates these cases:

Test Yourself

PRACTICE acronym?

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Psychoeducation, Relaxation, Affective modulation, Cognitive coping, Trauma narrative, In vivo, Conjoint, Enhancing safety.


Sources