Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is one of the most commonly utilized interventions for children (Cary & McMillen, 2011). TF-CBT is a highly structured intervention consisting of 90-minute weekly sessions. The clinician works with the client through eight competencies, including psychoeducation, relaxation, affective expression and regulation, cognitive coping, trauma narrative development and processing, gradual exposure, joint parent/child sessions, and enhancing future development (Cary & McMillen, 2011). TF-CBT has an extensive history and many variations. Clinicians utilize a number of other cognitive behavior treatments that have been adapted to meet the needs of traumatized children (Cary, & McMillen, 2012; Smith et al., 2007). While there are a number of cognitive behavior treatments, TF-CBT has received the highest classification rating for supported and effective treatment from many studies (Cary, & McMillen, 2012; Kauffman Best Practices Project, 2004). Studies show that TF-CBT has been effective when working with children and reducing symptoms of post-traumatic stress, depression, and behavior problems following trauma (Cary & McMillen, 2011). Bisson and Andrew (2009) state through systematic review of adults, TF-CBT performed eye-movement desensitization and reprocessing therapy (EMDR) and outperformed other treatments. The Kauffman Best Practices Project (2004) believes that TF-CBT is the “best practice” in the field of child abuse treatment. While many view TF-CBT as the “best practice,” it may not be the best fit for emotional child abuse. In many of the studies completed for TF-CBT, the primary abuse studied is sexual abuse. In TF-CBT studies, they indicate they effectively work with physi... ... middle of paper ... ...nknown. Additionally, some studies use invalid or non-standardized quantitative questionnaires. Despite these limitations, EMDR interventions have significant clinical results. Since EMDR shows significant results when working with cases of adults who suffer trauma and children with self-esteem and behavioral problems, EMDR has the potential to be a beneficial treatment for children who experience emotional child abuse. EMDR is helpful to children because it does not require the child to disclose specific details of the trauma. While the child talks about the trauma broadly, the clinician requests him to make a visual image in his mind. In addition, EMDR does not require homework, specific insight, or intelligence (Luber & Shapiro, 2009). Applying EMDR to emotional child abuse potentially allows children to reach a lasting, stable resolution to the trauma faster.
The first phase is psychoeducation and parenting skills. In the first sessions we discuss the definition and nature of trauma, the effects of trauma on the brain, how it affects cognitions, behaviors, etc. This treatment approach focuses on trauma—it is in the name. It does not necessarily require a formal PTSD diagnosis, but the psychoeducation does focus on the effects of trauma, and the impact of post-traumatic stress. Essentially, it focuses on the label and “mental illness” of PTSD. Reality therapy would shy away from a focus on illness. Reality therapy would encourage the clinician to avoid the labels and focus on the choices behind the condition (pg. 15). Unfortunately, for victims of severe trauma, the neurological impact is very real. Ignoring it will not help the treatment process.
McCoy, M. L., & Keen, S. M., (2009). Child abuse and neglect. New York: Psychology Press.
CBT helps the person learn the symptoms of PTSD and help them understand how it affects the person’s life (Hawk, 2012). A person’s emotions, thinking and actions are not separated, they overlap with each other. This approach is used to change the client’s way of thinking and behaving into a more positive and healthier way of thinking and behaving (Corey, 2013).
Trauma Focused Cognitive Behavioral Therapy (TFCBT) is a form of CBT, which focuses on processing the trauma the patient has experienced. Drs. Judith Cohen, Esther Deblinger, and Anthony Mannarino developed TFCBT in the late 1980’s (Trauma-Focused Cognitive Behavioral Therapy for Children and Adults, 2014). TFCBT uses principles adapted from cognitive behavioral therapy and exposure techniques in order to address symptoms related to trauma as well as symptoms of depression, behavior problems, and difficulties with caregivers. Behavior modeling and body safety skills training may also be integrated into TFCBT (Ramirez de Arellano et al., 2014).
According to Sharf, (2008) the eye movement desensitization and reprocessing (EMDR) was designed to treat posttraumatic stress disorder. EMDR requires that the clients visualize an upsetting memory and accompanying physical sensations. The clients repeat negative self-statements that they associate with the scene. The procedure is repeated again and again until the client’s anxiety is reduced. EMDR focuses on desensitizing strong emotional reasons in clients and help them to reframe their belief systems to accommodate new emotional states (Sharf, 2008).
With an average of more than three million instances of child abuse reported annually in the United States, social workers face an overwhelming client list of children and adults who are or have been victims of cruelty and negligence. Left untreated, the chances that these individuals may lead lives fraught with future psychological conditions are increased exponentially. Since many children and some adults are incapable of verbalizing disturbing experiences, a treatment called Eye Movement Desensitization and Reprocessing (EMDR) can often provide the resolution that more traditional therapies can’t. Overall EMDR therapy is important because it helps to process distressing memories, reducing their lingering effects which allow patients to develop more adaptive coping mechanisms and lead normal lives.
Based on Rachael’s symptoms one type of treatment she should engage herself in is Trauma Focused Cognitive Behavioral Therapy (TFCBT). TFCBT focuses on reducing symptoms of children who have significant emotional. (Dahl, 2015). This type of treatment would be helpful for Rachael because she can learn cognitive coping skills to deal with her traumatic past, such as she can also have someone to express her feelings to because holding them is not good for her.
Grasso, D. J., Joselow, B., Marquez, Y., & Webb, C. (2011). Trauma-focused cognitive behavioral therapy of a child with posttraumatic stress disorder. Psychotherapy, 48(2), 188-197. doi:10.1037/a0023133
TBRI utilizes a variety of principles to address the different needs of these children: “connecting principles” for attachment needs, “empowering principles” to address physical needs, and “correcting principles” to defuse behaviors based on fear. The core of TBRI is connection, although the intervention is based on years of sensory processing, attachment, and neuroscience research (Purvis et al., 2013). Children who have endured circumstances such as neglect, abuse, and/or trauma are the ones that will benefit most from TBRI’s design. A goal of TBRI is for parents, teachers, caregivers, or anyone who works with children to apply the practical tools it offers so that they can see the “whole child.” In doing so, they can help
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a short-term treatment for youth ages 4-18 that have significant behavioral or emotional problems due to traumatic life experiences. TF-CBT uses weekly, clinic-based, individual treatment to assist youth in addressing their traumatic memories while helping them developing skills to manage their painful emotions, thought and behaviors ().
The cognitive processes that serve as the focus of treatment in CBT include perceptions, self-statements, attributions, expectations, beliefs, and images (Kazdin, 1994). Most cognitive-behavioral based techniques are applied in the context of psychotherapy sessions in which the clients are seen individually, or in a group, by professional therapists. Intervention programs are designed to help clients become aware of their maladaptive cognitive processes and teach them how to notice, catch, monitor, and interrupt the cognitive-affective-behavioral chains to produce more adaptive coping responses (Mah...
As we enter the field of Marriage and Family Counseling we need to determine what modality would best serve our clients. Of course, depending upon the concerns the family enter counseling for will help determine the modality applied when working with your client. Deblinger (2006) reports, TF-CBT can be an effective modality when working with families when there has been past traumatic experiences. One of the components when using TF-CBT is making clients aware of their cognitive triangle, which teaches them how to recognizing triggers in their thoughts, feelings, and behaviors and teaching them skills recognize and manage them. This is done by the means of teaching the family new effective tool such as relaxation skills, psychoeducation
There are several domains that must be considered when treating a survivor of child abuse: the need for safety and trust, sense of belonging, protection from perceived or actual threats, facing the defendant in court, prevention of revictimization, and empowerment (Sawyer & Judd, 2012). Davis, 2005, states that “children terrorized through sexual abuse, neglect, physical abuse, or wartime atrocities may suffer from lasting wounds, nightmares, depression, and troubled adolescence involving substance abuse, binge eating, or aggression.” Victims of child abuse need to regain their sense of control over their lives. Experiencing healthy relationships, being nurtured by adults and helping them to learn resilience are all interventions that have been well-documented (Sawyer & Judd, 2...
Childhood Trauma is defined as “The experience of an event by a child that is emotionally painful or distressful, which often results in lasting mental and physical effects.” (The National Institute of Mental Health). Childhood trauma is an epidemic that seems to be running its way throughout the world. Childhood trauma is a worldwide problem that can affect anyone and everyone. People tend to just try and help the problems that occur due to the childhood trauma, but not the problem itself. Many of these issues will also follow the child into their adult years and will cause negative effects. This paper will discuss the negative outcomes for a child who suffers from childhood trauma, and the negative outcomes that can follow them into adulthood.
Trauma relates to a type of damage to the mind that comes from a severely distressing event. A traumatic event relates to an experience or repeating events that overwhelmingly precipitated in weeks, months, or decades as one tries to cope with the current situations that can cause negative consequences. People’s general reaction to these events includes intense fear, helplessness or horror. When children experience trauma, they show disorganized or agitative behavior. In addition, the trigger of traumas includes some of the following, harassment, embarrassment, abandonment, abusive relationships, rejection, co-dependence, and many others. Long-term exposure to these events, homelessness, and mild abuse general psychological