Trauma-Focused CBT Judy Cohen, M.D. & Tony Mannarino, Ph.D. Allegheny General Hospital Esther Deblinger, Ph.D. New Jersey CARES Institute

Theoretical Underpinnings of TF-CBT A hybrid model incorporating CBT, attachment, family, psychodynamic and empowerment principles Goals: resolve PTSD, depressive, anxiety and other trauma-related symptoms in children and adolescents; optimize adaptive functioning; and enhance safety, family communication and future developmental trajectory

TF-CBT Or Not? Target symptoms: PTSD, depression, anxiety, and behavioral symptoms secondary to trauma. Children presenting with predominance of behavioral problems may benefit more from a different treatment. TF-CBT has been used for all types of traumas TF-CBT has been used for children ages 3-18, with and without parental participation, in schools, group home, foster home and in-home settings but is most commonly provided individually to child and parent in clinical settings.

Evidence That TF-CBT Works Six randomized controlled trials have been conducted for sexually abused/multiply traumatized children comparing TF-CBT to other active treatments In all six studies children receiving TF-CBT experienced significantly greater improvements in a variety of symptoms, both at immediate post-treatment and up to 2 years post-treatment. PTSD symptoms consistently improved significantly more in the TF-CBT groups.

Evidence That TF-CBT Works CATS Project: TF-CBT used following 9-11 terrorist attacks in NYC demonstrated significantly greater improvement in PTSD among children receiving TF-CBT than those receiving usual treatment. Two open studies of TF-CBT for Childhood Traumatic Grief CTG) have offered preliminary support of effectiveness of adding grief-focused module to TF-CBT for children experiencing CTG. Current ongoing randomized trial for children with PTSD secondary to domestic violence.

TF-CBT Components: PRACTICE Psycoeducation Parent Component includes parenting skills Relaxation Affect identification and regulation Cognitive coping Trauma narration and cognitive processing of these experiences In vivo desensitization to trauma reminders Conjoint child-parents sessions Enhancing safety and future development

TF-CBTWeb www.musc.edu/tfcbt TF-CBTWeb is a web-based, distance education training course for learning Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT).

TF-CBTWeb www.musc.edu/tfcbt Web-based learning Learn at your own pace Learn when you want Learn where you want Return anytime 10 hours of CE TF-CBTWeb is offered free of charge.

TF-CBTWeb www.musc.edu/tfcbt Each module has: Concise explanations Video demonstrations Clinical scripts Cultural considerations Clinical Challenges

TF-CBTWeb www.musc.edu/tfcbt TF-CBTWeb is sponsored by: TF-CBTWeb was developed and is maintained through grant No. 1-UD1-SM56070-01 from the Substance Abuse and Mental Health Services Administration.