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词条 Trauma focused cognitive behavioral therapy
释义

  1. Description

      Major treatment components    Child-specific sessions    Parent-specific sessions    Parent-child conjoint sessions    Group sessions  

  2. Evaluation of effectiveness

  3. Methods of access

      Therapist    Implementation and adaptations  

  4. References

  5. External links

Trauma focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy or counselling that aims at addressing the needs of children and adolescents with post traumatic stress disorder (PTSD) and other difficulties related to traumatic life events.[1] The goal of TF-CBT is to provide psychoeducation to both the child and the non-offending caregivers and help them to identify and cope with emotions, thoughts, and behaviors. Research has shown TF-CBT to be effective in treating childhood PTSD and with children who have experienced traumatic events.[2][3][4]

Description

TF-CBT is a treatment model that incorporates various trauma-sensitive intervention components.[5] It aims at individualizing TF-CBT techniques to children and their circumstances while maintaining therapeutic relationship with both the child and parent.[6] TF-CBT treatment can be used with children and adolescents who have experienced traumatic life events. It is a short-term treatment (typically 12-16 sessions) that combines trauma-sensitive interventions with cognitive behavioral therapy strategies.[7] It can also be used as part of a larger treatment plan for children with other difficulties.[8] TF-CBT includes individual sessions for both the child and the parents, as well as parent-child joint sessions.

Major treatment components

Major components of TF-CBT include psycho-education about childhood trauma and individualizing relaxation skills. The therapeutic elements of TF-CBT are denoted by the “PRACTICE” acronym.[9]

  • Psychoeducation and Parenting skills
  • Relaxation
  • Affective Expression and Regulation
  • Cognitive Coping
  • Trauma Narrative Development and Processing
  • In Vivo Gradual Exposure
  • Conjoint Parent-Child sessions
  • Enhancing Safety and Future Development

Child-specific sessions

During the child therapy sessions, the therapist focuses on relaxation training such as deep breathing and muscle relaxation skills, emotion regulation (identifying feelings), a trauma narrative and processing (discussing the overwhelming events and associated feelings), as well as cognitive coping strategies (identifying and replacing negative thoughts).[10]

Parent-specific sessions

Parents or primary caregivers are considered as the central therapeutic agents for improvement in TF-CBT.[11] During the parent sessions, the therapist discusses the appropriateness of the treatment and safety plans with the parents and encourages positive parenting skills to maximize effective parenting.[12]

Parent-child conjoint sessions

During the conjoint sessions, the therapist shares the trauma narratives and challenges to incorrect/negative thoughts as a means to encourage and facilitate parent-child communication. The therapist would only intervene when inaccurate cognitions were not addressed.[13]

Group sessions

Group TF-CBT is an alternative to individual TF-CBT that reduces individual therapist hours and provides relief after disasters or in areas with limited resources.[14] Similar to individual TF-CBT, group TF-CBT involves both child and caregiver and utilizes the ‘PRACTICE’ elements, typically delivered through 12 structured sessions that target the reduction of distress and feelings of shame.[15]

Evaluation of effectiveness

Randomized clinical trials examining the efficacy of TF-CBT have found it to be an effective treatment plan for a variety of disorders in both children and adolescents.[16][17] TF-CBT has been proven to effectively reduce symptoms of PTSD, depression, anxiety, externalizing behaviors, sexualized behaviors, and feelings of shame in traumatized children.[18] TF-CBT has been shown to improve positive parenting skills and support of the child through the enhancement of parent-child communication.[19] A study examining the combinatorial effect of TF-CBT with sertraline has found that there were only minimal benefits associated with adding sertraline to the treatment, providing evidence for an initial trial of TF-CBT before medication.[20]

Methods of access

Therapist

TF-CBT can be delivered by a variety of mental health professionals ranging from clinical social workers, counselors to psychologists and psychiatrists.[21] Qualified therapists are required to be rostered or nationally certified in TF-CBT. Part of the training for this treatment includes an online TF-CBT certified training course.[22]Additional criteria are required in order for a clinician to be rostered or nationally certified. [23]

Implementation and adaptations

Since its development in the 1980s, TF-CBT has been used by therapists in many countries such as Australia, Cambodia, Canada, China, Denmark, Germany, Japan, the Netherlands, Norway, Pakistan, Sweden, United States, and Zambia.[24] It has also been used with children in the foster care system, with those who have suffered from traumatic life events, including the 9-11 terrorist attacks, and those who experienced Hurricane Katrina.[25] TF-CBT has also been adapted to different cultures, including Latino populations. The treatment manual book has been translated into a variety of languages, such as Dutch, German, Japanese, Korean, and Mandarin.[26]

References

1. ^{{cite book|last=Cohen|first=Judith A.|title=Treating trauma and traumatic grief in children and adolescents|date=2006|publisher=The Guilford Press|location=New York|isbn=978-1593853082|edition=[Online-Ausg.].}}
2. ^{{cite journal|last=Cohen|first=J. A.|author2=Mannarino, A. P. |author3=Perel, J. M. |author4=Staron, V. |title=A pilot randomized controlled trial of combined trauma-focused CBT and sertraline for childhood PTSD symptoms.|journal=Journal of the American Academy of Child & Adolescent Psychiatry|date=2007|volume=46|issue=7|pages=811–819|doi=10.1097/chi.0b013e3180547105 |pmid=17581445}}
3. ^{{cite journal|last=COHEN|first=J. A.|author2=MANNARINO, A. P. |author3=BERLINER, L. |author4= DEBLINGER, E. |title=Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: An Empirical Update|journal=Journal of Interpersonal Violence|date=1 November 2000|volume=15|issue=11|pages=1202–1223|doi=10.1177/088626000015011007}}
4. ^{{cite journal|last=Ford|first=J. D.|author2=Russo, E. |title=Trauma-focused, present-centered, emotional self-regulation approach to integrated treatment for posttraumatic stress and addiction: trauma adaptive recovery group education and therapy (TARGET)|journal=American Journal of Psychotherapy|date=2006|volume=60|issue=4}}
5. ^{{cite journal|last=COHEN|first=JUDITH A.|author2=MANNARINO, ANTHONY P. |author3=KNUDSEN, KRAIG |title=Treating Childhood Traumatic Grief: A Pilot Study|journal=Journal of the American Academy of Child & Adolescent Psychiatry|date=October 2004|volume=43|issue=10|pages=1225–1233|doi=10.1097/01.chi.0000135620.15522.38|pmid=15381889}}
6. ^{{cite journal|last=COHEN|first=JUDITH A.|author2=MANNARINO, ANTHONY P. |author3=STARON, VIRGINIA R. |title=A Pilot Study of Modified Cognitive-Behavioral Therapy for Childhood Traumatic Grief (CBT-CTG)|journal=Journal of the American Academy of Child & Adolescent Psychiatry|date=December 2006|volume=45|issue=12|pages=1465–1473|doi=10.1097/01.chi.0000237705.43260.2c|pmid=17135992}}
7. ^{{cite journal|last=Cohen|first=JA|author2=Mannarino, AP |author3=Iyengar, S |title=Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: a randomized controlled trial.|journal=Archives of Pediatrics & Adolescent Medicine|date=Jan 2011|volume=165|issue=1|pages=16–21|doi=10.1001/archpediatrics.2010.247|pmid=21199975}}
8. ^{{cite journal|last=Cohen|first=JA|author2=Mannarino, AP |author3=Knudsen, K |title=Treating sexually abused children: 1 year follow-up of a randomized controlled trial.|journal=Child Abuse & Neglect|date=Feb 2005|volume=29|issue=2|pages=135–45|pmid=15734179|doi=10.1016/j.chiabu.2004.12.005}}
9. ^{{cite book|last=Cohen|first=Judith A.|title=Treating trauma and traumatic grief in children and adolescents|date=2006|publisher=The Guilford Press|location=New York|isbn=978-1-59385-308-2|edition=[Online-Ausg.].}}
10. ^{{cite web|title=Trauma-Focused CBT Training|url=http://www.thereachinstitute.org/tf-cbt-training-course.html|accessdate=20 April 2014}}
11. ^{{cite journal|last=COHEN|first=J. A.|author2=MANNARINO, A. P. |author3=BERLINER, L. |author4= DEBLINGER, E. |title=Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: An Empirical Update|journal=Journal of Interpersonal Violence|date=1 November 2000|volume=15|issue=11|pages=1202–1223|doi=10.1177/088626000015011007}}
12. ^{{cite journal|last=Cohen|first=Judith A.|author2=Mannarino, Anthony P. |title=Trauma-Focused Cognitive Behavioural Therapy for Children and Parents|journal=Child and Adolescent Mental Health|date=November 2008|volume=13|issue=4|pages=158–162|doi=10.1111/j.1475-3588.2008.00502.x}}
13. ^{{cite book|last=Cohen|first=Judith A.|title=Treating trauma and traumatic grief in children and adolescents|date=2006|publisher=The Guilford Press|location=New York|isbn=978-1593853082|edition=[Online-Ausg.].}}
14. ^{{Cite journal|last=Deblinger|first=Esther|last2=Pollio|first2=Elisabeth|last3=Dorsey|first3=Shannon|date=2015-12-23|title=Applying Trauma-Focused Cognitive–Behavioral Therapy in Group Format|journal=Child Maltreatment|volume=21|issue=1|pages=59–73|doi=10.1177/1077559515620668|pmid=26701151|issn=1077-5595}}
15. ^{{Cite journal|last=Deblinger|first=Esther|last2=Pollio|first2=Elisabeth|last3=Dorsey|first3=Shannon|date=2015-12-23|title=Applying Trauma-Focused Cognitive–Behavioral Therapy in Group Format|journal=Child Maltreatment|volume=21|issue=1|pages=59–73|doi=10.1177/1077559515620668|pmid=26701151|issn=1077-5595}}
16. ^{{cite journal|last=Cohen|first=JA|author2=Deblinger, E |author3=Mannarino, AP |author4= Steer, RA |title=A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=Apr 2004|volume=43|issue=4|pages=393–402|pmid=15187799 |doi=10.1097/00004583-200404000-00005 |pmc=1201422}}
17. ^{{cite journal|last=Cohen|first=JA|author2=Berliner, L |author3=Mannarino, A |title=Trauma focused CBT for children with co-occurring trauma and behavior problems.|journal=Child Abuse & Neglect|date=Apr 2010|volume=34|issue=4|pages=215–24|pmid=20304489|doi=10.1016/j.chiabu.2009.12.003}}
18. ^{{cite journal|last=Seidler|first=GH|author2=Wagner, FE |title=Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study.|journal=Psychological Medicine|date=Nov 2006|volume=36|issue=11|pages=1515–22|pmid=16740177|doi=10.1017/S0033291706007963}}
19. ^{{cite journal|last=Cohen|first=JA|author2=Mannarino, AP |author3=Knudsen, K |title=Treating sexually abused children: 1 year follow-up of a randomized controlled trial.|journal=Child Abuse & Neglect|date=Feb 2005|volume=29|issue=2|pages=135–45|pmid=15734179|doi=10.1016/j.chiabu.2004.12.005}}
20. ^{{cite journal|last=Cohen|first=JA|author2=Mannarino, AP |author3=Perel, JM |author4= Staron, V |title=A pilot randomized controlled trial of combined trauma-focused CBT and sertraline for childhood PTSD symptoms.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=Jul 2007|volume=46|issue=7|pages=811–9|pmid=17581445 |doi=10.1097/chi.0b013e3180547105}}
21. ^{{cite web|title=What is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)?|url=http://academicdepartments.musc.edu/projectbest/tfcbt/tfcbt.htm|accessdate=20 April 2014}}
22. ^{{cite web|title=TF-CBT Web: A web-based learning course for trauma focused cognitive behavioral therapy|url=http://tfcbt.musc.edu/|accessdate=20 April 2014}}
23. ^{{cite web|title=TF-CBT.org Certification Criteria|url=https://tfcbt.org/tf-cbt-certification-criteria/}}
24. ^{{cite web|title=Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)|url=http://www.nrepp.samhsa.gov/viewintervention.aspx?id=135|accessdate=20 April 2014}}
25. ^{{cite journal|last=Dorsey|first=S|title=Trauma-focused CBT for youth in foster care: Preliminary findings from a randomized controlled trial.|journal=In Presented at the San Diego Conference on Child and Family Maltreatment San Diego|date=2012}}
26. ^{{cite web|title=Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)|url=http://promising.futureswithoutviolence.org/?program=trauma-focused-cognitive-behavioral-therapy-tf-cbt|accessdate=20 April 2014}}

External links

  • http://tfcbt.musc.edu/
  • https://www.childwelfare.gov/pubs/trauma/
  • http://clinicaltrials.gov/show/NCT00614068

2 : Cognitive behavioral therapy|Trauma and stressor related disorders
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