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Trauma Focused Cognitive Behavioral Therapy

Rujuta Borkar Mar 2, 2020
Cognitive behavioral therapy is used as one of the most recognized forms of treatment for patients who suffer from trauma, either sexual or otherwise. In this following story, we will focus on what and how this therapy is brought into practice.
Think back to a time in your childhood when you felt really, really scared. When you felt alone and lonely and insecure. Maybe you lost your way in the market and had to roam the crowded lanes before you met your mom or dad.
Or maybe when you were a little older and you were coming back late taking a lonely street, a drunkard approached you and you managed to escape with your heart pounding hard. These are simple incidents, so to say. There are others which are more brutal and have a deep psychological impact on any person, especially a child or an adolescent.
Incidents like being catcalled on a street, being touched inappropriately in a public transport, the tuition class teacher or a distant uncle trying to hug you too hard or touch you inappropriately - In all these incidents, there is the stink of molestation involved. Think of how insecure, helpless and lost you felt then.
While sexual trauma has some of the most deep rooted effects on a child - domestic violence, witnessing war and terrorism, death of a parent and other such incidents are factors that lead to severe trauma as well.

Introducing CBT Techniques

Facing any form of trauma at any age, is difficult. When it comes to childhood trauma, it becomes even more difficult. It has a deep-rooted effect on the way in which a child thinks and behaves and can form the basis of developing social and behavioral anxieties in them (For example - Post Traumatic Stress Disorder {PTSD}).
A child who is going through post traumatic stress and tension will find it difficult to adjust in society and lead a normal life.
Do these children go through life feeling lost and alone and are rendered incapable of living a normal life? If this issue is not addressed in the right manner and the underlying feelings are not dealt with well enough, then it could very well lead to a crippling effect.
But there are several cognitive behavioral therapy techniques that have been developed which aim at addressing this issue and focus on negating the effects that trauma can have on a person's life.
In this direction, trauma focused cognitive behavioral therapy (TF-CBT) is an especially formulated treatment method that chooses to address the core factors that lead to the stress and trauma. In the following sections, we will try and understand what this treatment model is all about and how it helps a person deal with stress and trauma.

What is Trauma Focused Cognitive Behavioral Therapy?

Maybe you've experienced this for yourself - Every time I'm stressed and I talk to one of my friends, I find that the solutions for the problems I face make themselves come through. I feel lighter and better and the degree of the tension and stress reduces.This behavioral therapy works on the same lines.
It focuses on targeting the post traumatic stress and tension that a child faces. It goes to the root of the problem and helps a child face the trauma and find solutions for the same. Not only does it focus on the child involved, but also the parents who might be suffering on account of the child.
They are provided with certain means and methods by which they can help the child deal with the problem at hand. It is a program that focuses on providing a safe and secure environment for the parents and the child, in which the core problems can be targeted and the solutions for the same, found.
These programs are especially tailored and formulated to target the needs of each individual case. A unique program is thus brought into practice for every child.
Several modes and mediums are used by way of this program, which focus on counseling, mental exercises and factors like cognitive behavioral modification (changing ones negative thoughts in order to change negative behavior). Together, all these methods and means work to form a program that helps a child deal with the stress and trauma.
The success of TF-CBT has been apparent in the way in which it helps to deal with varied emotions like depression, traumatic nightmares and memories of the trauma, so also the triggers that evoke the feelings of trauma and varied other physical symptoms of trauma that are brought into the picture.
It has also been seen to work over a wide range of ethnic groups and socio-cultural backgrounds with some of the highest success rates.

The Varied Means and Methods Involved

No psychological problem, or a problem that deals with the human mind, psyche and behavior can be as simple as 1+1=2. There are no simple and guaranteed solutions because the way in which we think and thereby behave is guided by several factors. That's why, there are several means and methods that address the issue on varied levels to find a solution. Let us peruse through these methods in brief.


The case is thoroughly assessed to understand the degree of the damage done. This involves talking to the child and the parents in order to get a clear understanding of the case. This step is necessary to formulate the action plan that will follow.

Play Therapy Interventions

Play interventions are methods by which the traumatic experience is related to the child using instruments like puppets, books and activity books. The incident is related to the child and the parents and the child will try to find solutions through means of painting and role play.


The role of the parents in helping the child overcome the trauma cannot be negated. The parents are provided with special counseling techniques by which they can help the child deal with the trauma. They are trained to encourage the child to talk and share and are trained to praise and encourage the child whenever there is progress made.

Relaxation Techniques

The child is taught several breathing techniques which focus on strengthening not only the inhalation and exhalation techniques, but also the relaxation of muscles. This area of the TF-CBT technique is known to reduce the stress that comes with the trauma.

Affective Modulation

In this technique, the child is taught a wide range of emotions and feelings and how to express them by using modes of puzzles, dolls with changeable expressions, colors that depict different moods and emotions, games like charades and the like. These techniques are brought into play depending on the age of the child and his/her exposure to the world.

Cognitive Processing

In this technique, the child is taught to connect his feelings, thoughts and behavior and understand how each of these affects the other. This technique is known to help especially those cases which deal with trauma related to death.

Trauma Narrative

In this therapy session, the child is asked to act out the trauma with the help of props like dolls and blocks. This is shown to help because many times, certain factors that were not revealed during the verbal narrative might make way in the practical way and help in formulating a more effective solution of the same.

In Vivo Exposure

The child is taught to identify the triggers that lead to the feelings of stress and trauma in him. Based on his traumatic experience, the parents and the counseling heads will make a list of the triggers and help the child identify them.
This concept can also be introduced with the help of several children movies and plays. After they've been taught how to identify the triggers, the children are also taught how to cope with them.

Enhancing Future Safety

This is the most important part of the therapy and focuses on providing a plan by which the child will be taught how to recognize and avoid future incidents of trauma (mostly in the case of sexual abuse).
These involve saying 'No' and setting boundaries, as well as formulating a security team like the parents, social workers or counselors who will help the child. This us what will help the child finally deal with the traumatic experience.
Trauma focused cognitive behavioral therapy is a highly developed and specialized program that is formulated to deal with the negative effects that trauma of any form can have on a child or an adolescent. A reading through this piece will have given you a fair idea of the 'what' and 'how' of cognitive behavioral therapy, what it involves and why it is known to be successful.
The burden of trauma is not something that is easy to carry through for anyone, especially a child. In such a case, if there are techniques which are known to help a person deal with the same and lead a normal life thereafter, why would one not want to take them up?