Trauma Cognitive Behavior Therapy

Trauma Focused Cognitive Behavior Therapy

Trauma Focused Cognitive Behavior Therapy, as the name implies is a form of cognitive behavioral therapy that addresses the specific emotional and mental health needs of children, adolescents, adult survivors, and families who are struggling to overcome the destructive effects of early trauma.

Trauma-focused cognitive behavioral therapy (TF-CBT) is especially sensitive to the unique problems of youth with post-traumatic stress and mood disorders resulting from abuse, violence, or grief. Because the client is usually a child, TF-CBT often brings non-offending parents or other caregivers into treatment and incorporates principles of family therapy.

When It’s Used

Anyone who has experienced a single or repeated experience of sexual, physical, or mental abuse or who has developed post-traumatic symptoms, depression, or anxiety as a result of the loss of a loved one or exposure to violence in the home or community can benefit from TF-CBT.

If a child or adolescent also exhibits serious behavioral, substance-abuse, or suicidal-ideation problems, other forms of treatment, such as dialectical behavior therapy, may be more appropriate as an initial intervention and can be followed up with a trauma-sensitive approach.

There is little evidence that trauma-focused cognitive behavioral therapy is the best intervention for adult war veterans with complex post-traumatic stress disorder.

What to Expect

TF-CBT is a short-term intervention that generally lasts anywhere from eight to 25 sessions and can take place in an outpatient mental health clinic, group home, community center, hospital, school, or in-home setting. Cognitive behavioral techniques are used to help modify distorted or unhelpful thinking and negative reactions and behaviors.

At the same time, a family therapy approach looks at interactions among family members and other family dynamics that are contributing to the problem and aims to teach new parenting, stress-management, and communication skills.

How It Works

The trauma-focused approach to psychotherapy was first developed in the 1990s by psychiatrist Judith Cohen and psychologists Esther Deblinger and Anthony Mannarino, whose original intent was to better serve children and adolescents who had experienced sexual abuse. TF-CBT has expanded over the years to include services for youths who have experienced any form of severe trauma or abuse.

Early trauma can lead to guilt, anger, feelings of powerlessness, self-abuse, acting out behavior, and mental health issues, such as depression and anxiety. Post-traumatic stress disorder, which affects children and adults, can manifest in a number of ways.

Most likely as bothersome recurring thoughts about the traumatic experience, emotional numbness, sleep issues, concentration problems, and extreme physical and emotional responses to anything that triggers a memory of the trauma.

By integrating the theories and techniques of several therapeutic interventions, TF-CBT can address and improve the symptoms of post-traumatic stress in youth.

What to Look for in a Trauma-Focused Cognitive Behavioral Therapist

Look for a licensed mental health professional with specialized training and experience in cognitive behavioral therapy and family therapy as well as further training and supervised experience in trauma-focused therapy. In addition to these credentials, it is important to find a therapist with whom you and your child feel comfortable working.


  • U.S. Department of Health and Human Services. Child Welfare Information Gateway. Trauma-focused cognitive behavioral therapy for children affected by sexual abuse or trauma. August 2012.
  • Gillies D, Taylor F, Gray C, O’Brien L, D’Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (review). Evidence-Based Child Health. May 2013;8(3):1004–1116.
  • Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews. 2013;12.
  • Trauma-Focused Cognitive Behavioral Therapy National Therapist Certification Program website.


Cognitive behavioral therapy 

What is Cognitive Behavioral Therapy (CBT) and how does it work?

Cognitive behavioral therapy (CBT) is a form of talking therapy which can be used to treat people with a wide range of mental health problems.

Tips to Change Your Mood

Tips to Change Your Mood Right Now

Change, as you know, can take time. It takes practice to un-learn things, to relearn things, to work at finding the path and staying on it until the changes come. The journey can be a long one.

Sometimes, though, you just want to feel a little something RIGHT NOW. Long term sustainable change is awesome, but every once in a while there’s nothing wrong with making a little mid-course correction that you can feel right away. Here are three things you can do that will help right now.


Give a call.

Everyone, I mean everyone, has a call they can make to someone who could use it. A friend, a parent, a coworker – someone could really use a call from you that simply says, “I was thinking about you. How are you doing?” The trick here is to not expect anything in return. Call with the simple goal of listening, and caring. Truly listen. Truly care. The rest will follow.


Lend a hand.

Unexpected help lifts the mood on both sides of the equation. Carry a grocery bag. Open a door. Take a minute to find a volunteer effort that could use your help. Write a check to a charity and mail it. Donate online to a friend’s fundraising walk. It should be pretty easy to find an opportunity.


Drop some praise.

“Your yard looks amazing.” “I love that coat.” “Your smile always brightens my day.” Just say something positive to someone. If you’re the shy type, push yourself a little. Or, leave a note for the restaurant manager to talk about great service someone gave.

Write a letter to someone you admire. The way you do it doesn’t matter. The fact that you give appreciate and praise without any expectation of return is what counts.

All of these decidedly little things can do decidedly big things for your mood, but here’s the big secret: they can also be completely lame. The key is in your approach. If you’re just making another obligatory phone call, that’s lame. That won’t do a thing for you. If, on the other hand, you decided to completely engage in that moment, if you can find yourself completely in love with that little piece of the path, if you can give all the love you have within yourself through the act of making that phone call, then you’re onto something.

It’s like everything else – nothing has to be boring, or worthless, or stupid, if we choose to engage in it to the peak of our abilities.

Flow is flow, whether you’re doing brain surgery or cutting up a piece of celery. Find yourself there, give of yourself, and watch your mood change for the better ! 👍


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HELP! I Just Discovered My Therapist is Just a Human Being!!! Should a Therapist be an Authority Figure or A Human Being? As a therapist I sometimes encounter patients who come to me seeking an authority figure.

Now don’t misunderstand…I have worked for several decades as a therapist, hypnotherapist and life coach, helping adults and children face difficult behaviors, thoughts and uncomfortable emotions.

As a human being however, I too have thoughts, feelings, fears vulnerabilities, sensitivities and demands. So how am I different from my clients)?

via HELP! My Therapist is Just a Human Being!!! — Best Friend Life

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I have been approached by many people, saying that therapy is not working for them and they don’t know what else to do. They have also tried combining therapy with medicines and still see no change.

Mental illness is still considered a first world problem by many out there. It takes time for someone to finally agree to see a therapy and when it does not yield results; it can break you.

I am here to tell you that therapy might not work the same for everyone. But this does not mean that you cannot be helped.

We will first tackle the question – Why?

Why is it that therapy might not work for everyone? There are a couple of reasons: 


  • Your therapist might not be taking the right therapeutic approach for you

    Different people respond to different types of therapy and the same approach might not work the same over a spectrum. It could be that your particular therapist lacks the training required to tackle your issue and is not able to adjust their approach based on the individual’s problem. This is okay. You can always bring this to their notice and ask for next steps.


  • The client only wants to rant

    Lot of people think of therapy as a place to go and vent out one’s problems. While discussing one’s problem is a huge part of therapy, therapy is also about the client working on those problems and making progress. It’s about change! This could be with the help of exercises, homework, lifestyle changes or simply listening to what your therapist has to say with an open mind.


  • Therapist and client don’t share a good rapport

    Therapists are always asked to practice empathy and have a positive transference towards their clients. There have been instances where the therapist and client are simply not a good fit for each other. The therapist may realize that he/she is not able to help this person progress any further and will then refer them to someone who can be a better interpersonal fit.


  • The client doesn’t open up

    Therapy is considered as a last resort by many because of the stigma. Sometimes, people are forced to go for therapy and don’t actually want to be there. They don’t cooperate with the therapist and are not completely honest.
    People also experience shame or anxiety when discussing their problematic behaviour and only tell part of the story. This prevents proper diagnosis. People need to understand that this is a safe space, it is a place where you don’t have to pretend. You can be vulnerable without being ashamed.


  • Clients drop out of treatment

    There could be a number of reasons for a client to drop out of treatment. It could be because they don’t have the money to afford therapy, believe that therapy is not helping or it is hard work. They might also stop taking medication and this may lead to a relapse which can indeed be very dangerous.


  • Negative associations with therapyPeople who have never been to therapy might have a negative preconceived notion about it. This can sabotage therapeutic success. For e.g., if the client thinks that it is the therapist’s job to “fix” him or “cure” him within a few weeks, this will affect their perception of therapy and lead to failure.


What do we do if we feel that therapy is not working for us?


  • Talk to your therapist

    It is very important to be honest with your therapist about your progress. If you feel that the current approach has left you stagnant, tell your therapist about it. Do not rant about it to your friends and family members, they wouldn’t know what to do. The best person to give you directions would be your therapist. He/she may change their treatment approach or refer you to someone else.


  • Do your homework

    Therapy is not magic. It requires diligence and hard work from both ends. If the client doesn’t want to get better, he will never try and this would be a wastage of time for everyone involved. You will never learn Math or English and get better at it if you don’t do your homework. Similarly, you will not see results if you don’t do your therapy homework. Complete all assignments and exercises given to you by your therapist. If they are not giving you homework, ask for it!


  • Have patience

    Therapists can’t remove all the problems from your life. This is not how therapy works. It doesn’t make your problems disappear, rather it equips you to go out there and solve those problems for yourself. It takes time and effort.
    The results also differ from person to person. You need to work on yourself and your emotions, you need to be ready to open up about your actions and problematic behaviours. You need to be patient with yourself and the process. You need to trust.


  • Pursue lifestyle changes

    This has helped me a lot, personally. My therapist is a brilliant lady, she told me that I will never get better if I don’t make some major lifestyle changes. I used to sleep around 3 AM and would wake up at noon. This had been going on for a while and it took a major toll on my body and mind. I started suffering from insomnia which in turn led to me having anxiety attacks almost every night. Medication works as a short-term fix. So, eventually I had to make some tough lifestyle changes in order to get better.

This included:


  • Sleeping and waking up on time.
  • Getting a good night’s sleep (7 – 8 hours)
  • Eating better
  • Taking some time out to develop a proper schedule and planning my day.
  • Exercise!
  • No screens before bed (keeping the phone away 1 hour prior to bedtime)
  • Meditation or yoga! or just taking out 5 mins to slow down and focus on my breathing.


  • Try a new therapist

    I understand that it is difficult to change your therapist, start from scratch and talk about your issues all over again with someone new. But mental illness is just like any other health condition. If you have a heart disease and a particular treatment doesn’t work for you, do you throw a fit and give up? No, you try another treatment because you WANT to get better. It should be the same with therapy. Why would you want to compromise with your mind? If one type of therapy fails, there are plenty of other options.

Change your therapist if the following has not been established:

  • Realistic goals and milestones haven’t been set in order to measure progress.
  • They have not talked to you about the treatment and what is in store for you.
  • They haven’t had a conversation with you about medication or if it’s needed.


  • Talk to your doctor about medication

    If therapy alone is not working for you, you might need to start taking medicines too. If you are already on medication and it’s not getting better, you may have to increase the dosage or switch medicines completely. Talk to your doctor about these next steps, do not stop taking medicines or increase the dosage without consulting your doctor.



  • If one treatment doesn’t work, don’t give up!
  • Don’t resist the idea of taking medication and be responsible with it.
  • Never stop medication on your own, always consult your doctor.
  • Work closely with your doctor to find the correct treatment for you.
  • Be honest with your doctor!


If you are planning to go for therapy or are looking to change your approach, remember!

  • Therapy is not going to show instant results, you will have to work.
  • Therapy is NOT an easy fix. If you have taken the decision to go for therapy, I applaud you. You have finally decided to confront your issues instead of taking the easy road.
  • Therapy is not going to change your personality but it will optimize you. It will help you introspect and better understand your inner self.
  • Therapy can’t change other people in your life but it will change how you respond to them and external situations.
  • Success and failure are subjective. I don’t think therapy ever fails. You learn something new from every person you meet, every therapist you see and every time you fail.

It is a long process but with the right kind of help, you will get through it.

Hope this was helpful. How has therapy helped you? Do let us know in the comment section!

Who am I

Who Am I?

Who am I? Who am I now? I’m Between “ Who I Was ” And “Who I Want To Be”.

I’ve been talking recently with a client who I’ll call Robert. A bright guy who’s moved way up in the high tech industry.

But he’s not a happy camper. For a few years now, he’s been thinking of getting out, shifting to his first love: he wants to see if he can make a career out of being a crossword puzzle writer. He’s written puzzles, had some success getting them published. But could he make a go of it, full time? Would it really satisfy him?

It’s quite a change. He knows he’s not there yet, not ready to make the break from the “golden handcuffs” of his current work. At the same time, he knows he’s headed in that direction. And he knows that it takes time. And effort. Effort to stay with living in the unknown. Contemplating change. (For more on the process of change, I highly recommend an oldie but goodie, Changing for Good by Prochaska, Norcross, and DiClemente.


So who is he? Who is he now?

He’s between “ Who He Was ” and “Who He Wants To Be” , more correct between selves.

Here are some other examples. As with Robert, details have been changed to protect their privacy:

  • There’s Florence ( as I’ll call her ), who wonders if her most recent ACL injury will jeopardize her skiing career;
  • Or Stephane, a business executive who couldn’t pass up a lucrative buyout. She’s now trying to figure out what’s next;
  • Or Andrei, who—yet again—lost an audition he was sure he’d nailed.

        Each of these people—well, all of us at one point or another or another, whether it’s related to work or health or activities or relationships—is dealing with being “between selves.”

Imagine two large hills, one on each side of a river. On one side is your old self, who you were BEFORE. On the other hill is your new self, who you are going to become, AFTER. At various times in our lives, we are neither the old, known, familiar self nor yet the new, untried, person who we’re going to become.

Instead, we are swimming in the river. We may be splashing, floundering, or swimming strongly as we move from one side to the other. We are between selves.

The concept of being between selves isn’t new. Sociologist Robert Weiss used this phrase while researching the experience of adult couples who had recently separated. (His book, Marital Separation, another oldie but goodie, offers vignettes of the stresses, challenges, and exhilarations at the end of these relationships.)

Expanding the concept to different times of change in our lives can be helpful. Just being able to label this experience and this process—“I am between selves”—offers comfort and is therapeutic in and of itself. It recognizes process and change. It allows for self-forgiveness for at least some of the uncertainty involved in change. It gives temporary identity to the person whose identity is so very disrupted.

As people walk—or run or are shoved—down the metaphoric hill of their old self, there comes a point where it actually feels impossible to climb back up. Who I am now no longer can be who I was. And yet….who will I become? What parts of who I was will come with me on this journey? Which parts do I want? What do I wish to discard? What have I learned about me?

While swimming in the river, can I find an occasional rock on which to rest, to pause, to assess how far I’ve come? Do I get tangled up in odd (old) tree branches or stub my toes on lurking sharp-edged stones? Does a white water eddy swirl me in the wrong direction? Do I need to float on my back for a while or just find some temporary water wings? How do these experiences inform my progress?

That other hill, the new me, may seem far away. Beginning to climb its banks may seem extraordinarily challenging. Meanwhile, it’s vital to let myself swim between selves, reflecting, anticipating, being in the murk. Who I will become—at least for now—will emerge.

And so, back to Robert and his challenge. We’ve been using the swimming metaphor for a while now. Here’s what he says:

            “I’m trying to be here for real. I’m trying not to say ‘yes’ to opportunities that I could agree to when I sense that they wouldn’t move me forward toward who I want to become.

         “The swimming part knows: Don’t take it! Don’t be a buyer right now. It feels weird. I don’t feel settled. I need—for now—to not feel settled.”

Robert has been writing in a journal; he’s been talking with me. His partner knows he’s working on this process. Mostly, he lets himself stand still, ask the questions, see what answers develop. It’s the hardest work that he’s done. He’s scared, but also excited and committed to this process.