What Is Trauma-Focused Cognitive Behavioral Therapy?

By Michael Puskar

Updated June 03, 2020

Reviewer Aaron Horn

In therapy, cognitive-behavioral therapy, or CBT, is used to treat many different mental health problems and help reverse different bad habits one may have. In this post, we will be looking at a particular type of CBT known as trauma-focused cognitive behavioral therapy, or TF-CBT. What is it? Who can it help? Let's find out.

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What Is CBT?

Before we learn what TF-CBT is, let's first look at CBT. CBT is a form of therapy designed to eliminate bad thoughts and habits and replace them with more productive ones. For example, if you're depressed, you may experience thoughts telling you that you're not good enough and that you deserve everything that's coming to you. CBT would help you throw away those thoughts and replace them with more positive ones. CBT also helps with habits. For example, your procrastinating may be affecting your stress. CBT would help by teaching you how you can procrastinate a lot less.

Because CBT is so versatile, it's one of the most popular forms of therapy available, and it has helped people overcome a variety of mental health concerns. Therefore, if you're interested in this effective means of getting help, you're not alone, and other people have changed their lives by using CBT.

Now that you have a general overview of CBT, let's look at TF-CBT, a more specific type of this treatment method.

What Is TF-CBT?

Trauma-focused cognitive behavioral therapy, as the name implies, helps treat a traumatic experience. It is designed for younger people, children, and teens, as well as their families. The goal is to help them all to get past traumatic experiences.

It is based on evidence, and it's been seen to be quite useful towards someone who is experiencing different or single traumas. Those who can provide TF-CBT can help the younger crowd overcome their trauma before it develops into something much worse.

History Of TF-CBT

TF-CBT was the product of different researchers, including Esther Deblinger, Judith Cohen, and Anthony Mannarino. They wanted to learn more about how traumatized children and teens faced difficulties in their lives. This leads to the development of TF-CBT, and it combined traditional CBT with family therapy, taking a trauma-sensitive approach.

As they researched, they tried five different trials, all controlled, and this helped show the effectiveness that CBT can have. Since then, other researchers have studied TF-CBT as well and have found it to be quite effective for treating the younger crowd.

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How Does TF-CBT Work?

With all that said, how does TF-CBT work? It's, for younger people who are suffering from the psychological effects of trauma. It uses CBT as well as family and humanistic therapies. The treatment is usually less than 16 sessions, and it's seen as quite effective. Approximately four out of five children who go through TF-CBT can improve.

When trauma happens, it can be hard for everyone involved in it to be able to process their feelings about the situation. TF-CBT can help all parties address their thoughts and get past the ones that can lead to PTSD, stress, depression, and other negative emotions. When one experiences trauma, they may mismanage their emotions. TF-CBT aims for people to be able to manage emotions in a much healthier way. To do this, they may go to a safe and familiar environment. This allows the children to express their emotions in a stable comfort zone. Once they're able to do this, CBT and other therapies are given. Those affected can learn that trauma can distort one's perception and that there are healthier ways to cope with it.

TF-CBT is based on skills. In order for it to work, the family and the children need to practice these skills. This may involve assignments at home. In the end, the goal is to allow the family to continue practicing these skills in an environment that is safe and healthy.

Learn More About Trauma-Focused Cognitive Behavioral Therapy Here
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Some lessons TF-CBT can teach are techniques such as relaxation, trauma narrative, psychoeducation, conjoint sessions, future safety skills, and much more. For it to work, there needs to be a significant relationship between all parties involved. Therapy can help all parties strengthen their relationships and learn their coping skills. Parents can help support their child this way, as well. The counselor will give the family the tools needed to help the child be able to deal with their trauma.

What Can TF-CBT Treat?

We mentioned before that TF-CBT can treat trauma, but what kind of trauma is it able to handle specifically? The main goal is to treat post-traumatic stress. When a child is physically, sexually, or mentally abused, they are likely going to have anxiety, depression, and other negative behaviors that are a result of the trauma. A counselor can help them eliminate the negative behaviors and attempt to move on from the trauma.

The age range for people who have TF-CBT ranges from 3 to 18. These children have been abused, and all levels of abuse can benefit from TF-CBT. If someone has had mild trauma, or severe, repeated trauma, they can receive benefits. The parent will also participate unless they were the cause of the trauma. TF-CBT can also help children who are dealing with grief as well as those in foster care or who have been taken away from their parents. All in all, TF-CBT is great for all sorts of trauma.

TF-CBT Counselors

With that said, who exactly are the therapists who give out TF-CBT? These are qualified therapists who need to have child development training and can treat mental health conditions in children. A therapist must be trained if they want to practice in TF-CBT. Extra training is provided for those who wish to be supervised.

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There are certified courses that are designed for TF-CBT. A practitioner needs to have a master's degree if they want to participate in the training course required to get started. It begins with two days of live training, and then follow-up training. This consultation may continue once, twice, or every few months, and once they complete the training, they graduate. A practitioner must also have train on different cases and pass an exam to prove they know TF-CBT.


One may wonder how effective TF-CBT is. It's quite useful, and research has proved that young people who are experiencing the consequences of trauma can respond well. There have been 11 studies on TF-CBT, and they all have shown that it is quite useful for depression, PTSD, anxiety, and other side effects associated with trauma. The more sessions one has, the more effective it is. This is because TF-CBT is designed around the mind of a child or a teenager. They cope with trauma differently, and a counselor needs to get into the head of those who are dealing with the trauma to face it head-on.

With that said, there are some limitations to TF-CBT. It may not be suitable for children who've had conduct or other behavioral problems that occurred before the trauma. This may prevent them from receiving the benefits of TF-CBT, and they may need a different approach to treat their problems.

If a teen is suicidal or is abusing drugs, they may not be able to benefit as well. Or, their symptoms may worsen in the beginning. It can still be quite effective, but the problem comes when a child or teen is in danger. If done at the right pace, TF-CBT can still be useful, but there may need to be another approach beforehand. In this case, Dialectical Behavior Therapy is a suitable solution. If a teen has self-harm issues or problems with running away, there may be benefits, and it can help them stop negative behaviors. As you can tell, TF-CBT is quite beneficial for children and teens who have trauma issues.

How BetterHelp Can Help

It can be difficult for a child to deal with their trauma. Trauma can be a complicated beast to overcome at any age, especially when you're young. It can seem overwhelming, and you may not be able to understand your emotions fully. That's where TF-CBT comes in. It can help to identify any problematic emotions you and your child may have, and then help modify it into something more productive.

A family can work together to solve their problems, and this can help the child learn to cope with the trauma. While it might be very challenging to get over their trauma, therapy can help manage it much better.

Therapy is also suitable for other reasons as well. If the child has a dream or an aspiration, a therapist can work with them to create a goal. A counselor can help them with school, planning for the future, or help with any other problems that they may have. There is no shame in speaking to one if you have a problem. It just proves that you are willing to admit you have a problem, and you want to work on it. Below are some reviews of BetterHelp counselors, from people experiencing similar issues.

Counselor Reviews

"I have had many therapists in the past 10 years, and they have all been helpful, but my experience with Lauren has been transformative. She is bold when necessary and honest, but she always wants to let you make the choices you choose. She always wants you to be healthy first and foremost. She provides goal settings, cognitive behavioral therapy, help with anxiety, and will be honest if more support is needed than just online therapy."

"I enjoyed my session with Traci. She was able to give me a variety of CBT techniques in our very first session. She listened intently to what I had to share, and overall, I felt the session was well-run, and the conversation had a positive effect on my mood."


Traumatic events don't need to control your life and haunt you forever. By finding a therapist who is experienced in using trauma-focused cognitive behavioral therapy, you can learn how to cope and make these negative feelings and sensations less powerful. This will allow you to start living a happier and healthier life that you deserve. Take the first step today.

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