Trauma Focused Cognitive Behavioral Interventions: Trauma Informed Care

Learn how to use CBT to enhance resilience and safety when addressing trauma.
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Cultural Considerations
~ Meet the child and family where they are by presenting information in a way in which they can relate it to their own belief system.
~ Assess general beliefs about the trauma
~ Focus on the events THEY perceive as traumatic
~ Tailor the psychoeducational information so the family can be more receptive to it.
~ General views of mental health and mental health treatment should be assessed and addressed.
~ Demystify
~ Destigmatize/normalize

Parent Sessions
~ Provide a rationale and overview of the treatment model.
~ Educate parents about the trauma.
~ Talk about:
~ The child's trauma-related symptoms
~ How early treatment helps prevent long-term problems
~ The importance of talking directly about the trauma to help children cope with their experiences.
~ Reassure parents that children will first be taught skills to help them cope with their discomfort and that talking about the trauma will be done slowly, with a great deal of support and discussion.
~ Help the caregiver understand their role in the child's treatment, since this treatment model emphasizes working together as a team.
~ Parent input, questions, and suggestions are welcome
Stress Management Techniques
~ Controlled Breathing
~ Helps slow heart rate
~ Triggers “rest and digest”
~ Thought Stopping

Stress Management Techniques
~ Relaxation Training
~ Persons of Asian and Hispanic origin tend express stress responses in more somatic (i.e., physical) terms
~ When deciding how to present relaxation techniques, be creative.
~ Have the child help you to integrate elements into the technique to make it more relevant to them.
~ Have the child identify methods that he/she uses to relax (drawing, listening to music, walking…)
~ Be sensitive to children’s wishes if they do not wish to close their eyes or lie down
~ Parents can often also benefit from relaxation training
Feelings Identification
~ Helps therapist judge child’s ability to identify and articulate feelings
~ Teaches the child how to rate the intensity of the emotion
~ Teaches how to express feelings appropriately in different situations
~ Some children may have difficulty initially identifying and/or discussing their own feelings.
~ Try discussing the feelings of other children or characters from books or stories
~ Help children identify how they experiences emotions if they seem detached from the experience.
~ Introduce the difference between thoughts and feelings.
~ Many children describe thoughts when asked to identify feelings
~ How would you feel? I would want to run away.

Summary
~ TF-CBT can be an effective intervention for children or adolescents whose primary presenting issue is trauma-related emotional or behavioral dysregulation
~ TF-CBT is not appropriate for clients who are actively suicidal, severely depressed or currently abusing substances.
~ TF-CBT starts with psychoeducation, then teaches stress management and coping skills to aid in the management of distressing feelings.
~ Psychoeducation helps to clarify inappropriate information children may have
~ Feelings identification helps participants start effectively labeling and communicating their feelings

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