What Is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)?
TF-CBT is a special type of talking therapy for people who have experienced trauma, and who are su ering from post-traumatic stress disorder (PTSD).
What is trauma?
Many of us will experience trauma at some point in our lives: an experience which is threatening, scary, overwhelming, or out of our control. Common traumas include: accidents, being a victim of physical or sexual violence, or being in a life-threatening situation such as a war or natural disaster. Survivors of trauma might feel shocked, scared, guilty, ashamed, angry, or vulnerable. With time most people get over their experiences without needing professional help. However in a significant proportion of people the effects of trauma can last for much longer. Trauma tends to be harder to recover from if it is repeated, or if it happens in childhood.
What is post-traumatic stress disorder (PTSD)?
PTSD can develop after trauma and has four main groups of symptoms:
- re-experiencing memories or feelings from the trauma
- a heightended sense of threat and vigilance
- avoidance of reminders
- changes in your beliefs about yourself, the world, other people, or your future
What will TF-CBT sessions look like?
Cognitive behavioral therapy (CBT) is a collaborative form of therapy: you and your therapist will need to form a trusting working relationship. Components of therapy might include some or all of the following:
Grounding and stabilization
Practising techniques to manage the overwhelming feelings PTSD brings. These might include relaxation exercises, or other techniques to help you stay grounded in the here-and-now.
Work with memories
You will need to approach your memories of the trauma in order to process them properly. This might involve talking through what happened, deliberately imagining the events, or writing or drawing about it. This is called memory processing and is done very carefully and deliberately in TF-CBT.
Work with beliefs
People always try to make sense of what happens to them. Sometimes events happen that are so catastrophic that we come to see ourselves and the world in a very negative way. Belief work in TF-CBT is about making sense of what you thought at the time of the trauma, and deciding what is a fair way to think about yourself and your situation now.
Reclaiming your life
PTSD often has the effect of stealing people’s lives: it is very common after trauma to start avoiding things which make you uncomfortable, but this can have the effect of shrinking your world. Effective therapy is about taking back the things that you used to enjoy, or building a new life that you can value.
What is the evidence for TF-CBT?
There is very good evidence that TF-CBT is an effective treatment for PTSD. Research trials have shown that it is superior to therapies which do not involve talking about the trauma, and it is as effective as other evidencebased therapies for PTSD such as eye movement desensitization and reprocessing (EMDR).