By Debra Cohen-Melamed, LCSW, Certified TF-CBT Therapist
For many people, the effects of trauma can feel like an invisible weight—one that lingers long after the traumatic experience is over. Whether it’s the result of abuse, loss, violence, or other difficult experiences, trauma can leave emotional wounds that don’t always heal on their own.
If you’ve tried therapy in the past but didn’t see the progress you hoped for, you’re not alone. Trauma can sometimes show up in ways that aren’t immediately obvious—through anxiety, irritability, difficulties at school or work, sleep problems, or even physical symptoms like headaches or stomach aches. For some, traditional therapy approaches might not have felt focused enough on addressing the root cause of these struggles.
But there’s good news: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a specialized, evidence-based treatment designed specifically to help children and teens heal from trauma. However, while TF-CBT was originally developed for younger populations, it has also been shown to be effective for adults who have experienced childhood trauma or other traumatic events.
If you’re feeling hesitant about trying therapy again, or if you’re a parent wondering if this could help your child, let me reassure you: healing is possible. TF-CBT has been rigorously studied and consistently shows positive results across different ages, cultures, and types of trauma.
What is TF-CBT, and How Can it Help?
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a short-term, structured therapy model primarily designed for children and adolescents ages 3–18, but it can also benefit adults processing childhood trauma or ongoing traumatic experiences. Developed by experts Drs. Anthony Mannarino, Judith Cohen, and Esther Deblinger, TF-CBT has been refined through years of research and practice.
At its core, TF-CBT helps people make sense of their traumatic experiences, manage their emotional responses, and build coping strategies that will serve them for life. For children and teens, it also actively involves parents or caregivers, equipping them with tools to support their child’s healing while navigating their own emotional responses.
Some of the challenges TF-CBT addresses include:
- Anxiety and panic
- Depression and feelings of sadness or hopelessness
- Behavioral issues, such as aggression or withdrawal
- Nightmares and sleep problems
- Difficulty trusting others
- Low self-esteem and shame
The goal is not just to “talk about” the trauma but to process it safely in a way that reduces its emotional power and allows clients—regardless of age—to move forward with confidence.
How Does TF-CBT Work?
TF-CBT typically takes place over 12–16 weekly sessions, though this can be extended if the trauma was repeated or ongoing. The therapy includes both individual sessions and, when appropriate, joint sessions with a parent or caregiver. For adults, the process focuses more on individual sessions while still addressing family and relational dynamics when relevant.
The treatment follows the acronym “PRACTICE,” which outlines the key components:
- Psychoeducation: Learning about trauma and how it affects thoughts, emotions, and behavior.
- Parenting Skills: For children and teens, helping caregivers learn positive parenting techniques, stress management, and effective communication.
- Relaxation: Teaching practical tools to calm anxiety, such as deep breathing and muscle relaxation.
- Affective Modulation: Helping clients understand and manage their emotions using self-soothing techniques.
- Cognitive Coping: Identifying and challenging unhelpful thoughts that stem from trauma.
- Trauma Narration: Safely telling the story of the traumatic event to reduce fear, shame, and confusion.
- In Vivo Mastery: Gradually facing fears related to the trauma in a safe, supported way.
- Conjoint Parent-Child Sessions: For children and teens, strengthening trust and communication through shared activities and discussions. For adults, this could involve repairing relationships impacted by trauma.
- Enhancing Safety and Future Development: Building personal safety skills and preparing for future challenges.
Each session builds on the last, creating a safe and supportive space for growth, understanding, and healing.
How is TF-CBT Different from Traditional Therapy?
While traditional therapy approaches like Cognitive Behavioral Therapy (CBT) can be effective for many emotional challenges, TF-CBT is specifically designed to address the unique impacts of trauma.
Key differences include:
- Trauma-Focused Approach: TF-CBT directly addresses the traumatic experience and its lingering emotional and behavioral effects.
- Parental Involvement (for children and teens): Parents or caregivers play an active role in the therapy process, building stronger connections and trust.
- Structured Process: TF-CBT follows a clear, step-by-step model to guide healing.
- Focus on Both Emotional and Behavioral Healing: TF-CBT addresses how trauma affects thoughts, feelings, and actions.
Research consistently shows that TF-CBT helps children, teens, and adults reduce symptoms of trauma, improve emotional regulation, and rebuild a sense of safety and trust.
What Are the Benefits of TF-CBT?
The results of TF-CBT are life-changing for many individuals and families. Benefits often include:
- Reduced symptoms of anxiety, depression, and PTSD
- Improved emotional regulation and behavior
- Increased self-esteem and confidence
- Stronger family relationships and communication (for children and their caregivers)
- Better school or work performance and focus
- Greater ability to handle stress and future challenges
Parents and caregivers also report feeling more confident in supporting their child, managing their own emotional responses, and building healthier family dynamics. Adults who engage in TF-CBT often experience significant relief from long-standing emotional pain and gain tools to create healthier relationships and habits.
Is TF-CBT Right for You or Your Child?
If you or your child have experienced trauma and you’ve been searching for a treatment that feels focused, supportive, and proven to work, TF-CBT could be the answer you’ve been looking for.
Healing is possible, and you don’t have to navigate this journey alone.
When looking for a TF-CBT therapist, it’s important to choose someone who is specifically trained and certified in this approach. You can search for certified therapists at tfcbt.org.
At Cadenza Center, our compassionate, trained TF-CBT therapists are ready to walk alongside you or your family on this healing journey. Together, we’ll create a path forward—one built on trust, resilience, and hope.
Take the first step today. Reach out to us, and let’s begin this journey together.
References:
Cohen, .J A., Mannarino, A. P., & Deblinger, E. (2017). Treating trauma and traumatic grief in children and adolescents (2nd ed.). New York: Guilford
Cohen, .J A,. &Mannarino, A. P. (2015). Trauma-focused cognitive behavioral therapy for traumatized children and families. Child and Adolescent Psychiatric Clinics of North America, 24(3), 557-570. doi: 10.1016/j.chc. 2015.02.005
Cohen, J. A., Berliner, L., & Mannarino, A. (2010). Trauma-focused CBT for children with co-occurring trauma and behavior problems. Child Abuse & Neglect, 34(4), 215–224. https://doi.org/10.1016/j.chiabu.2009.12.003
de Arellano, M. A., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Huang, L., & Delphin-Rittmon, M. E. (2014). Trauma-focused cognitive-behavioral therapy for children and adolescents: assessing the evidence. Psychiatric services (Washington, D.C.), 65(5), 591–602. https://doi.org/10.1176/appi.ps.201300255
Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Heflin, A. H. (2015). Child sexual abuse: A primer for treating children, adolescents, and their nonoffending parents (2nd ed.). New York: Oxford University Press.
