Trauma-Focused Cognitive Behavioral Therapy with the School-Age Child

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment designed to address the therapeutic needs of children and their caregivers in the aftermath of trauma. The efficacy of this treatment model has been well established in 25 randomized trials, and as a result it has become the standard of care for childhood PTSD and other trauma-related emotional and behavioral difficulties. TF-CBT is a short-term model implemented in a structured manner following the PRACTICE acronym that represents the treatment components including psychoeducation/parenting, relaxation, affect expression/regulation, cognitive coping, trauma narration and processing, in vivo mastery, conjoint sessions, and enhancing safety and future development. An overview of the application of the treatment is provided, highlighting the role of the child, the non-offending caregiver, and the therapist in this intervention. The implementation of the PRACTICE skills with school-age children is highlighted. Parenting guidance to help caregivers optimally support their children’s trauma recovery is also discussed. In addition, strategies for helping caregivers use coping skills to overcome their own trauma-related distress and serve as effective coping role models for their children are offered. Cultural and clinical considerations are discussed and guidance regarding the value and implementation of pre- and posttreatment assessments is offered. Clinical examples, trauma-specific resources, and recommendations for accessing TF-CBT training and consultation are provided.