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Trauma Focused Cognitive Behavioral Therapy & Kids (#NCAPM)

This is the third installment of a six-week National Child Abuse Prevention Month (#NCAPM) blog series about child abuse and how we are working to prevent it. MaryBeth is a Trauma Focused Cognitive Behavioral Therapy trained therapist at Children’s Center. 

Guest post by: MaryBeth Hernandez LCSW, Children’s Center Therapist and Family Support Specialist 

Helping kids and teens navigate difficult emotions and changes in behavior after experiencing a trauma can be a daunting task for parents and caregivers, especially when they are struggling with their own thoughts and feelings about what has occurred. They sensibly seek help but are often confused and overwhelmed with finding the best path toward healing. All the different methods of treatment options can seem like alphabet soup; EMDR, CBT, DBT, PCIT, the list goes on.

I began my journey as a therapist in 1995 and over the years have learned and practiced many different methods of trauma informed therapeutic services. It has only been in recent years that research studies have been conducted to identify which methods are most effective in helping traumatized kids get better preventing long-term negative effects. Trauma Focused Cognitive Behavioral Therapy, or TF-CBT, is a method that I not only enjoy providing and have witnessed success with, but it is also one that the evidence supports as highly effective.

How does it work?

TF-CBT can help kids and families learn how to manage difficult emotions in a healthier way. Children often have less awareness of emotions and less vocabulary to express those emotions than adults. Children may also have more difficulty understanding their symptoms or why they are experiencing them.  TF-CBT helps children and teens become better able to process emotions and thoughts relating to traumatic experiences and to identify and modify inaccurate beliefs that lead to unhealthy behaviors, such as beliefs that they are to blame for abuse they have endured.TF-CBT also identifies unhealthy patterns of behaviors (for example, acting out or isolating) or fear responses, and attempts to modify these by identifying healthier ways of responding.Children gain the necessary tools to alleviate the overwhelming thoughts causing stressanxiety, and depression.

Unique to TF-CBT, and in my experience, what makes it incredibly impactful, is that it incorporates an intervention for parents or caregivers who were not involved in the abuse. This helps families to heal together and build stronger and healthier relationships that will carry on well beyond the bounds of the therapy sessions. It is very important to me that children walk away from this process with a high level of trust and feeling of support from their caregivers, and caregivers feel capable of providing that support on an ongoing basis. Studies have shown that caregivers who have participated in TF-CBT with a child report lower levels of depression, distress about the abuse, and symptoms of PTSD. It has also been found that TF-CBT increases parents’ ability to support their child.​2   This increased communication between parent and child, combined with learning and enhancing safety skills can also serve as a protective factor in helping to prevent future abuse.

Trauma Focused – Cognitive Behavioral Therapy includes:

  • Education about trauma and common reactions;
  • Help with parenting and behavior difficulties;
  • Relaxation/Stress Management training;
  • Learning about feelings and ways to express them;
  • Learning about thoughts, feelings, and actions;
  • Developing creative ways for kids to tell their stories about what happened in a gradual and supportive manner;
  • Changing any unhelpful thoughts about the trauma;
  • Helping caregivers learn skills in providing empathy and support to the child;
  • Family sessions to help the family talk together about the trauma and its impact;
  • Learning and practicing safety skills.

I feel passionate that every child and family that experiences trauma should have access to evidence-based methods of therapy in a timely manner to promote healing. Many mental health providers lack the expertise needed to provide effective treatment for trauma symptoms. I am currently one of only 23 therapists in Oregon to be nationally certified in TF-CBT. It is my hope that more and more therapists can gain access to this training and be able to provide this evidenced-based method of helping children heal.

More information: https://www.nctsn.org/sites/default/files/interventions/tfcbt_fact_sheet.pdf

Find a nationally certified TF-CBT provider in your area: https://tfcbt.org/members/


1. Mavranezouli I, Megnin-viggars O, Daly C, et al. Research Review: Psychological and psychosocial treatments for children and young people with post-traumatic stress disorder: a network meta-analysisJ Child Psychol Psychiatry. 2020;61(1):18-29. doi:10.1111/jcpp.13094


2. Tutus D, Keller F, Sachser C, Pfeiffer E, Goldbeck L. Change in Parental Depressive Symptoms in Trauma-Focused Cognitive-Behavioral Therapy: Results from a Randomized Controlled TrialJ Child Adolesc Psychopharmacol.2017;27(2):200-205. doi:10.1089/cap.2016.0136


– MaryBeth 


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